Female Orgasmic Disorder

• Female orgasmic disorder, sometimes called inhibited female orgasm or anorgasmia, is defined as the recurrent or
persistent inhibition of female orgasm, as manifested by the recurrent delay in, or absence of orgasm after a normal
sexual excitement phase that a clinician judges to be adequate in focus, intensity, and duration—in short, a woman’s
inability to achieve orgasm by masturbation or coitus.
• Research on the physiology of the female sexual response has shown that orgasms caused by clitoral stimulation and
those caused by vaginal stimulation are physiologically identical. Many women achieve orgasm during coitus by a
combination of manual clitoral stimulation and penile vaginal stimulation.
• A woman with lifelong female orgasmic disorder has never experienced orgasm by any kind of stimulation.
• A woman with acquired orgasmic disorder has previously experienced at least one orgasm, regardless of the
circumstances or means of stimulation, whether by masturbation or while dreaming during sleep.
• The incidence of never having experienced orgasm is reported as 10 percent among all women. The incidence of
orgasm increases with age. According to Kinsey, the first orgasm occurs during adolescence in about 50 percent of
women as a result of masturbation or genital caressing with a partner; the rest usually experience orgasm as they get
older.
 Specifiers
• Lifelong: Disturbance has been present since the individual became sexually active.
Acquired: Disturbance began after a period of relatively normal sexual function.

• Generalised: not limited to certain types of stimulation, situations, or partners.

Situational: Only occurs with certain types of stimulation, situation, or partners.

• Never experienced an orgasm under any situation.

• Mild: Evidence of mild distress over the symptoms like difficulty in experiencing orgasm and/or markedly reduced
intensity of orgasmic sensations (criterion A).
Moderate: Evidence of moderate distress over the symptoms in criterion A.
Severe: Evidence of severe or extreme distress over the symptoms in criterion A.
 Diagnostic Features
• Female orgasmic disorder is characterized by difficulty experiencing orgasm and/or markedly reduced intensity
(Criterion A).
• For diagnosis of FOD, symptoms must be experienced on almost all (approx. 75-100%) or all occasions of sexual
activity (identified in situational context or, if generalized, in all contexts). Have a minimum duration of of
approximately 6 months (Criterion B).
• In many cases, the causes are multifactorial or cannot be determined. For women to have a diagnosis of FOD,
clinically significant distress must accompany the symptoms (Criterion C).
• If the disorder is deemed to be better explained by another mental disorder, the effects of a substance/medication or
a medical condition, then a diagnosis would not be made.
• Finally, if interpersonal or significant contextual factors, such as severe relationship distress, intimate partner
violence, or other significant stressors, are present, then a diagnosis of FOD would not be made.
• Women’s experiencing orgasm through clitoral stimulation but not during the actual intercourse does not meet the
criteria for a clinical diagnosis of FOD.
• It must also be considered if there is inadequate sexual stimulation; in this case, the diagnosis of female orgasmic
disorder would not be made.
Etiology
• Numerous psychological factors are associated with female orgasmic disorder:
1. Fear of impregnation
2. Rejection by a sexual partner
3. Damage to the vagina
4. Hostility toward men
5. Poor body image
6. Feelings of guilt about sexual impulses.
• Cultural expectations and social restrictions on women are also relevant. Many women have grown up to
believe that sexual pleasure is not a natural entitlement for so called decent women.
• Nonorgasmic women may be otherwise symptom free or may experience frustration in a variety of ways;
they may have such pelvic complaints as lower abdominal pain, itching, and vaginal discharge, as well as
increased tension, irritability, and fatigue.
 Development and course
• Lifelong female orgasmic disorder indicates that the orgasmic difficulties have always been present, whereas the
acquired subtype would be assigned if it developed after a period of normal orgasmic functioning.
• First orgasm in woman’s life can occur any time from the prepubertal period to well into the adulthood. Women’s reports
of having experienced orgasm increase with age.
• Many women experience orgasm as they experience a wide variety of stimulation and acquire more knowledge about
their bodies.
• Women’s rate of orgasm consistency are higher during masturbation than during sexual activity with a partner.