Orgasmic disorder (Anorgasmia) is said to prevail when a woman either can’t reach orgasm, or has difficulty reaching orgasm when she is sexually excited. This could be primary or secondary depending on the past occurrence or experience. The condition is called primary orgasmic dysfunction when a woman has never had an orgasm. This is the case in 10 – 15% of women. It is called secondary orgasmic dysfunction when a woman has had at least one orgasm in the past, but is currently unable to have one.
Factors Responsible for Orgasmic Disorder
- A background of sexual abuse or rape
- Boredom and monotony in sexual activity
- Certain prescription drugs, including fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
- Hormonal disorders, hormonal changes due to menopause, and chronic illnesses that affect general health and sexual interest
- Women who abuse alcohol, crack, cocaine, or other illicit drugs are at increased risk of orgasmic dysfunction; estimates of orgasmic dysfunction range from 15% to 60%, depending on the frequency and chronicity of abuse.
- Medical conditions that affect the nerve supply to the pelvis (such as multiple sclerosis, diabetic neuropathy, and spinal cord injury)
- Fatigue and stress
- Negative attitudes toward sex (usually learned in childhood or adolescence)
- Shyness or embarrassment about asking for whatever type of stimulation works best
- Strife or lack of emotional closeness within the relationship
Systems theory suggests that all sexual problems are best seen as a matter of discordance between partners, not as one partner wanting too much or giving too little
It is important to track down the factor(s) responsible in order to find solution. For example, if a woman is having problems reaching orgasm because of illness or medication, targeting those factors can certainly help.
- Encouraging the couple to become participants in the act rather than critics of their sexual lives.
- Opting for Psychodynamic sex therapy focusing on the interpersonal relations of the couple. This is accomplished by helping each partner distinguish between the relationship he or she imagines and the realities (and possibilities) of the relationship as it exists.
- Another area of focus should be Cognitive treatment that aims to increase positive sexual experiences and to change the dysfunctional beliefs that underlie treatment failures.
- Directed masturbation (DM), a treatment of choice. The directed masturbation procedure consisted of a gradual series of assignments that were to be practiced by the patient. The test of the effectiveness of directed masturbation was conducted with three couples who had not benefited from a sexual treatment program modeled after that of Masters and Johnson. The results indicated that directed masturbation holds promise as an effective adjunct to sexual counseling.
- The use of a vibrator, dilators and moisturizers is suggested.
- In case of further guidance, a follow-up appointment should be scheduled within 2 to 3 months to determine progress and to keep the avenues of physician – patient communication open.
- Practice Sensate focus exercises, designed to help couples increase their comfort with physical intimacy and familiarize themselves with each other’s (and their own) body.
- Medical problems, new medications, or untreated depression may need evaluation and treatment in order for orgasmic dysfunction to improve. The role of hormone supplementation in treating orgasmic dysfunction is controversial and the long-term risks remain unclear.
- If other sexual dysfunctions (such as lack of interest and pain duringintercourse) are happening at the same time, these need to be addressed as part of the treatment plan.
- Sometimes improving orgasm can be as easy as changing your sexual position. Switching a woman from the missionary position to being on top can help give her increased clitoral stimulation as well as control of the depth of penetration and rate of thrusting.
How Sensate Focus Works
- The key component to the Sensate Focus technique is opened lines of communication.
- Each exercise activity, usually involves a recommended forty minutes of participation. It is a touching and speaking exercise, which has been designed to break the mold, and help the injured party express to their mate, what does or does not give them intense pleasures. The paired partnership will then take turns touching each other in very specific ways.
- During the initial stages of the Sensate Focus technique, a couple should select who is to go first beforehand. It was discovered that more often than not, the injured party chooses to go last. This is perfectly normal and allows the injured party to rebuild their foundations of trust, in which was stolen from them during the moments of the traumatized event. However, couples who have lost their sense for communicating between each other, are advised to draw straws. Sometimes just picking who will be first, can be a traumatic experience but just realize, it does not have to be.
- Once a couple has decided on who should go first that person should lay down on a bed, or someplace that is not intimidating to them. Some people prefer to sit on a couch or in a reclining chair. It does not really matter where the exercise takes place, as long as it is a comfortable and private spot.
- Depending on how severe or traumatic the situation was for the individual, evaluate the situation between yourselves, and for the first exercise at least, remain partially or totally clothed. There is nothing written in stone here people. Nowhere does it state, that the Sensate Focus has to be done with all persons naked, the first time they try it! Remember, time is on your side. Even though you maybe really frustrated inside with how your private relationship has been going, remember time is on your side. Before you even try to go on to the next step, make sure all parties involved are absolutely comfortable with how it is going so far. Once a comfort level has been established, the one chosen to go first, is the one who begins touching their mate.
- NO touching of the personal and private areas are allowed, during the first few initial exercises. It defeats the whole purpose of this exercise. Abstain from bedroom intimacy activity. This does not include kissing, holding hands or hugging. What is the point in having, yet another bad intimate experience. All closely-intimate activities need to be curtailed, until the course is completed. Having intimate relations now, before someone is (truly) ready, only defeats any long terms goals that you or your mate have set.
- Continue to touch your partner’s hands, face, neck, legs, arms, back, hair, etc…, for the full twenty minutes. Set a timer.
- When that 20 minutes is over, change roles… Continue on with exercise until both of you are comfortable. A full two weeks of intimate touching in the buff is suggested, before true intimate contact is made between you two.
- Then relax, talk about what was points were erotic and how the experience made you feel.
Once a comfortable level has been established and touching is no longer an issue, try different positions. Try laying together in the spooning position first. Apply the same basic principles that were established with the touching exercise, only this time it is full body contact
When orgasmic dysfunction continues to happen, sexual desire usually declines, and eventually sex occurs less often. This can create resentment and conflict in the relationship.
Take it seriously.