Female orgasmic disorder (FOD)

Female orgasmic disorder (FOD) is a disorder characterized by a female having difficulty reaching orgasm. For women with female orgasmic disorder, it may take a very long time to orgasm or orgasm may be unreachable. Female orgasmic disorder can occur even when a woman feels sexually excited. The cause of female orgasmic disorder is different for each woman, and it is usually a combination of physical and psychological factors. Medical conditions, medications, depression, anxiety, sexual abuse, and sexual inexperience have all been cited as possible causes for female orgasmic disorder. Treatment for female orgasmic disorder depends on each specific case and often relies on identifying the cause of the disorder and plotting treatment around the specific cause. Counseling and sexual therapy are often suggested for women experiencing female orgasmic disorder as a result of psychological problems. Treatments may also address physical causes in cases where disease or pharmacological side effects are at play.

Background

Female orgasmic disorder is a type of orgasmic dysfunction, which is a condition in which a person has difficulty reaching orgasm even when sexually aroused and with adequate sexual stimulation. An orgasm occurs at the climax of sexual excitement and is reached through stimulation of the genital area. In women, the clitoris is stimulated to bring about orgasm. When orgasm is reached, it releases an intense wave of pleasurable tingling sensations throughout parts of the body. This feeling varies in intensity as well as duration. Some women can orgasm sequentially, while others cannot achieve climax as frequently. The amount of stimulation needed for orgasm varies by person. Some need very little stimulation, while others require a great deal of time and effort. Studies have shown that many women experience issues orgasming with a sexual partner even after continued sexual stimulation. Studies suggest that anywhere between 11 and 41 percent of women may experience orgasmic dysfunction.

It can be challenging to establish the underlying cause of female orgasmic disorder. The condition can be the result of physical, psychological, or emotional factors. A number of medical conditions can affect a woman’s ability to orgasm. Some conditions that can cause female orgasmic disorder include diabetes, multiple sclerosis, vascular disease, spinal cord injuries, pelvic conditions, arthritis, asthma, and thyroid problems. Women who have had a hysterectomy may have trouble achieving orgasm. Age can also be a factor in a woman’s ability to orgasm.

Certain medications can interfere with a woman’s capacity for orgasm. Antidepressants such as serotonin reuptake inhibitors (SSRIs), antipsychotics, chemotherapy drugs, and blood pressure and heart disease medications can affect a woman’s ability to orgasm. Women experiencing depression and anxiety may also experience female orgasmic disorder as a result of these mental health conditions. Other psychological factors that may affect a woman’s ability to orgasm include stress, shyness, guilt, and low self-esteem. A woman’s level of sexual experience may also play a part in her developing female orgasmic disorder. A woman may not be educated about what types of stimulation bring about orgasm. This can make it difficult for some women to communicate what gives them pleasure to their sexual partners. Some women may feel guilty about feeling pleasure during sex because of cultural or religious beliefs, which can also impact their ability to achieve orgasm. Psychological problems stemming from past sexual abuse or relationship issues may also impede a woman’s orgasmic potential.

Overview

When diagnosing a patient with female orgasmic disorder, clinicians must ensure certain criteria are met. The diagnosis of female orgasmic disorder requires that the patient does not have another disorder that would explain the orgasmic dysfunction better than female orgasmic disorder does. The patient’s dysfunction must also not be the direct effect of a substance, such as a medication or drug abuse, or a general medical condition. Physicians can order blood panels to check the chemistry and hormone levels to rule out certain factors. Once a diagnosis is achieved, a treatment plan may be coordinated around a patient’s specific issues.

Successful treatment of female orgasmic disorder is highly dependent on identifying the underlying cause of the disorder. For patients experiencing female orgasmic disorder due to psychological factors, psychotherapeutic interventions such as cognitive behavioral therapy, sensate focus therapy, couples or family therapy, or sexual therapy may be helpful. Sexual education training and communication practice may also help a patient move toward achieving orgasm. Sex therapy can involve sexual education training to help a patient learn new ways to masturbate so that she may explore what types of stimulation bring her the most pleasure. Sex therapy can take a couples counseling approach to help couples who are struggling to communicate their needs to each other. Sex therapists may suggest ways in which a couple can expand their sexual horizons by trying new activities in the bedroom. Sex therapy can sometimes incorporate sensate focus therapy, which is a technique that begins with nonsexual touching and gradually escalates to sexual touching. This technique is often used on individuals and couples experiencing trust issues.

For patients whose disorder is caused by chemical imbalances due to medication, drug abuse, or hormone levels, treatment should be focused on mediating these substances. Examples would be adjusting depression and anxiety medications or beginning hormone therapy. Patients who are prescribed SSRIs often have orgasm issues because of the medication’s effect on libido, or sex drive. SSRIs can reduce women’s libido, which can lead to sexual dysfunction. Several studies have shown certain antidepressants have less of an effect on libido than others do. Bupropion, for example, has been shown to cause less sexual dysfunction than other SSRIs.

Bibliography

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“What Is Female Orgasmic Disorder (FOD)?” International Society for Sexual Medicine, www.issm.info/sexual-health-qa/what-is-female-orgasmic-disorder-fod/. Accessed 5 Mar. 2019.