The American Psychological Association (2013) defines Female Orgasmic Disorder as “delayed, infrequent or absent ability to experience orgasm or markedly reduced intensity of orgasmic sensations.” It is an extremely common sexual dysfunction. Below are 10 important facts about FOD:
- Situational orgasm difficulties: Most women cannot orgasm with penetration alone, usually due to not receiving enough clitoral stimulation during penetrative sex. Some women with FOD can orgasm during solo sexual activity but struggle with orgasming with a partner. Other women are unsure entirely if they have ever had an orgasm alone or with a partner.
- Prevalence: One study found 45% of women reported difficulty in reaching orgasm half of the time with 25% stating they are unable to achieve orgasm 75% of the time, and 30% stating they cannot reach orgasm all of the time (Rowland & Kolba, 2016).
- Cultural issues contribute to orgasm difficulties for women: Lack of sexual education, lack of sexual experiences, cultural beliefs that women should not have pleasure with sex or that sex is only for reproduction can contribute to orgasm difficulties for women. The myth of “vaginal orgasm” or the belief that women should orgasm through penetrative sex contributes to the orgasm gap between men and women.
- Distracting thoughts interfere with orgasm: Leading up to orgasm, parts of the brain associated with conscious thought turn off, resulting in brain waves that resemble a meditative-like state (Prause et al., 2017). Therefore, if your mind is elsewhere (for instance thinking about all of the additional tasks you still have to get done for the day, thinking that sex is dirty or bad, or simply feeling annoyed at your partner) you are likely not going to be able to orgasm.
- Variable orgasms for women: Most women need clitoral stimulation to achieve orgasm. However, some women are able to orgasm through non-genital stimulation (like breast stimulation) or fantasy alone.
- Common factors that contribute to orgasm in women: Generally women who experience orgasm are engaging in sexual positions that stimulate the clitoris, have high sexual self-esteem, effective sexual communication, report positive qualities of their partner & their relationship, have learned about what they find pleasurable via masturbation and often use of vibrators & other sex toys.
- Certain physical health issues can cause or contribute to orgasm difficulties: Health issues that can make orgasm difficult for women include chronic pain, MS, arthritis, fibromyalgia, thyroid problems, spinal cord injuries, kidney disease, vulvar diseases, pelvic floor conditions, and anything disrupting blood flow (smoking, diabetes, obesity, peripheral vascular diseases).
- Medications can cause or contribute to orgasm difficulties in women: Medications that negatively impact the ability to orgasm include oral hormonal birth control, SSRIs, mood stabilizers, cardiovascular medications, chemo-therapeutic agents and certain blood pressure drugs.
- Mental health matters: Of women with FOD, 50% of women met criteria for depression, and 27% had anxiety. Emotional intelligence is associated higher orgasm frequency, and introversion, emotional instability, and not being open to new experiences are associated with less frequent orgasm.
- There is no magic pill: To date there are no FDA approved medications to help women with orgasm difficulties. However, many behavioral techniques have shown to be effective including psychoeducation about female sexual response and pleasure, reframing distorted beliefs about sex and sexuality, reducing performance anxiety, improving sexual communication with partner, guided masturbation to uncover sexual pleasure, cultivating sexual fantasy & learning mindfulness skills to use during sexual experiences. Sex therapy can help you learn these behavioral techniques and improve your sexual self-esteem.
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