181 Female Orgasmic Disorder (302.73)

DSM-IV-TR criteria

• Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of Female Orgasmic Disorder should be based on the clinician’s judgment that the woman’s orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives.
• The disturbance causes marked distress or interpersonal difficulty.
• The orgasmic dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition.
• Specify type:
  • Lifelong Type
  • Acquired Type
• Specify type:
  • Generalized Type
  • Situational Type
• Specify:
  • Due to Psychological Factors
  • Due to Combined Factors

Associated Features

The disorder may affect body image, self-esteem, or her relationship satisfaction. Chronic general medical conditions such as diabetes or pelvic cancer have a more likely reason to impair the arousal phase of the sexual response.

Child vs Adult Presentation

There is little information on how this affects children since children are typically not sexually active or mature. It mostly begins in early adulthood. Younger women seem to have this disorder because the ability increases with age.

Gender and Cultural Differences in Presentation

This certain disorder only affects females, although there is a Male Orgasmic Disorder as well. Cultural presentation will be the same as western cultures.

Epidemiology

The epidemiology of Female Orgasmic Disorder varies extensively. Some examples are 10-15% of women had never had an orgasm, 10-15% hardly ever had experienced an orgasm, 50% of women had experienced an orgasm during intercourse, and 10-15% had experienced orgasm difficulty.

Etiology

There is evidence that a traumatic experience likely leads to this disorder. It can also be related to problems in a relationship. Another cause is a pelvic floor prolapse. This is the loosening of the muscles that support the organs. It can be caused by surgery or childbirth.

Empirically Supported Treatments

• Some treatments for Female Orgasmic Disorder are as follows: Developing proper communication skills, sexual aides, behavioral and cognitive therapy, directed masturbation training, and body awareness. These can be developed through sex counseling and therapy.
• There are substance-induced (drug related) sexual dysfunctions for which inhibited orgasm can be the result.

Prognosis

Many women with FOD can be helped to achieve orgasm through a combination of psychotherapy and guided sexual exercises. However, this does not mean that they will be able to achieve an orgasm all of the time or in every situation, or that they will always be satisfied with the strength or quality of the climax. Couples often need to work through relationship issues that have either caused or resulted from FOD before they can see improvement. Working through the problems take time, and commitment from both parties.