What is Female Orgasmic Disorder?
Female orgasmic disorder (FOD) is defined as a medical condition in which there is a continuous delay or absence of orgasm, even when intercourse is enjoyable, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition [DSM-4]. However, it should be noted that FOD should not be confused with anorgasmia, another sexual dysfunction. Anorgasmia specifically refers to the inability to achieve orgasm, while female orgasmic dysfunction encompasses a range of orgasmic problems.
How Common is FOD?
The National Library of Medicine [NIH] reports that nearly 11% to 41% of women have never experienced orgasm, and many are displeased with how they reach orgasm. Achieving climax is a complex interplay of the mind and body, and the etiology or causes of female orgasmic dysfunction cannot be definitively determined. Oftentimes, orgasmic disorder is a result of several life stressors, medical conditions, or medications.
Causes of FOD
The causes of female orgasmic disorder can be multifactorial. Some common causes include:
Psychological Causes:
- Sexual trauma
- Problems with a partner
- Problems in the relationship
- Worry or anxiety about one’s sexual performance
- Fatigue, stress, or depression
- Negative assumptions about sex (often developed during childhood)
- Lack of knowledge about intercourse
Physical Causes:
- Insufficient stimulation
- Hormonal changes like menopause
- Taking certain medications like antidepressants
- History of gynecological surgery
- Having medical conditions like heart disease or multiple sclerosis
- Chronic pelvic pain
- Vaginal dryness
- Vaginismus
- Vulval dystrophy
The term ‘orgasm gap’ was coined by Laurie Mintz, an author, professional sex therapist, and psychologist, in her book “Becoming Cliterate: Why Orgasm Equality Matters – And How to Get It.” The orgasm gap refers to the disparity in orgasms between couples. Several studies throughout the years have shown that heterosexual women are the demographic that experiences the least orgasms during intercourse.
Similarly, studies also found that 39% of women achieve orgasm when they are alone, compared to 6% of women who reach climax during intercourse. Although researchers attribute the orgasm gap to many factors, the primary factor remains a lack of understanding of the female anatomy in both men and women. In fact, a study showed that 59% of men and 45% of women could not correctly label the vagina.
Since women experience significantly fewer orgasms than other demographics, they have slowly begun to believe they will achieve few or no orgasms at all. A 2022 study revealed that such beliefs had led women not to prioritize orgasms, which makes their sex lives even less satisfying.
Types of FOD
Female orgasmic dysfunction can be classified into two categories:
- Primary: Women who have never experienced orgasm.
- Secondary: Women who have experienced orgasm but are unable to now.
Symptoms of FOD
Symptoms of orgasmic disorder include difficulty or inability to reach orgasm, decreased intensity of orgasm, and delayed orgasm. Additionally, women with the disorder may also experience depression, anxiety, distress, and frustration.
Diagnosis of FOD
Doctors diagnose the disorder through in-depth interviews with both partners, individually and together. Usually, a woman is diagnosed when she has experienced the following symptoms for more than six months:
- Delayed, infrequent, or absent orgasm
- Reduced intensity of orgasm
- Emotional distress due to orgasmic disorder
- Absence of any other disorder or substance causing the orgasmic disorder
The diagnosis of a woman’s response to orgasmic stimulation requires doctors to use their clinical judgment, considering factors such as age, sexual experience, and the stimulation received.
Treatment of FOD
Treatment for female orgasmic disorder involves two approaches: self-stimulation and psychological therapies. Countless studies have shown favorable results with self-stimulation, which includes recommended exercises involving a vibrator.
Moreover, psychological therapies help women understand and address concerns about sexual performance, utilizing cognitive-behavioral therapy and psychotherapy to manage the fear of vulnerability and trust with a partner. Mindfulness is also recommended to prioritize sexual sensation without judgment.
Further treatment includes:
- PRP (Platelet-Rich Plasma) Injections
PRP injections are utilized to improve blood flow and nerve function around the genital area (clitoris, G-spot, or others) in individuals with orgasmic disorder. Sensitivity is enhanced, and the sexual response is improved through the promotion of tissue regeneration and the growth of new blood vessels. This treatment, which is minimally invasive and necessitates minimal rest, has shown favorable results in studies, despite being relatively new for the treatment of orgasmic disorder. - ESWT [Extracorporeal Shock Wave Therapy]
Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive treatment that employs low-intensity shock waves to stimulate the healing of damaged tissues. While it is commonly used to treat musculoskeletal injuries, it has recently been recognized as a successful treatment for orgasmic disorders. By utilizing shock waves, ESWT enhances blood flow around the clitoral region, thereby improving sensitivity and arousal. Furthermore, ESWT has the potential to promote nerve regeneration and repair in the pelvic area, leading to an overall improvement in sexual function.
Related Q&A
Q1. Can FOD be prevented?
There is no guaranteed prevention method. However, maintaining a healthy lifestyle, openly communicating, and managing stress can help.
Q2. Can menopause cause FOD?
Yes. During menopause, there is a drop in estrogen levels which can change the vaginal tissues and decrease the blood flow to the genitals, thus leading to female orgasmic disorder.
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Q3. Can medication help with FOD?
Yes, certain medications can help with FOD. Please talk to your doctor to understand which medications work best for you.
Q4. Can FOD signify a more serious health concern?
In some cases, FOD may be a symptom of an underlying health condition like diabetes or multiple sclerosis.
Q5. Can FOD affect the overall quality of a woman’s life?
Yes, FOD can cause significant emotional distress in women, thus reducing their overall quality of life. It can also impact their relationship and intimacy with their partners.
Q6. Can FOD be cured?
Yes, through proper treatment and support, FOD can be cured. However, in extreme cases, it may take longer.
Orgasmic dysfunction can be frustrating; however, it is absolutely nothing to be ashamed about. When living with sexual dysfunction, it is imperative to establish open communication with your partner and doctor to help navigate it better.
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