Treatment of female orgasmic disorder
- Andrea Bradford, PhD
Andrea Bradford, PhD
- Baylor College of Medicine
- Department of Medicine - Section of Gastroenterology
Female orgasmic disorder is characterized by a persistent or recurrent delay in or absence of orgasm following sexual arousal and adequate sexual stimulation. To diagnose female orgasmic disorder, the symptoms must cause marked distress or interpersonal difficulty .
Treatment for female orgasmic disorder consists principally of education and psychosocial interventions; clinical trials of their efficacy are limited.
This topic discusses the treatment of female orgasmic disorder. The epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of female orgasmic disorder are discussed separately. The assessment of patients with sexual dysfunction is also discussed separately. The epidemiology, risk factors, evaluation, and an overview of treatment of women with sexual dysfunction are also discussed separately. The prevalence and management of sexual dysfunction due to serotonergic antidepressants is also discussed separately. (See "Female orgasmic disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Sexual dysfunction in women: Epidemiology, risk factors, and evaluation" and "Sexual dysfunction in women: Management" and "Sexual dysfunction caused by selective serotonin reuptake inhibitors (SSRIs): Management", section on 'Assessment'.)
Female orgasmic disorder may be lifelong or acquired, generalized (occurring in all situations) or situational (occurring in select situations). An example of the situational type of the disorder is a woman who has orgasms through masturbation but not during partnered sexual activity
Primary female orgasmic disorder — Women with primary female orgasmic disorder have not previously experienced orgasm in any situation. Other terms used synonymously include:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013.
- Sarwer DB, Durlak JA. A field trial of the effectiveness of behavioral treatment for sexual dysfunctions. J Sex Marital Ther 1997; 23:87.
- Hawton K, Catalan J. Prognostic factors in sex therapy. Behav Res Ther 1986; 24:377.
- McMullen S, Rosen RC. Self-administered masturbation training in the treatment of primary orgasmic dysfunction. J Consult Clin Psychol 1979; 47:912.
- Heiman JR, LoPiccolo J. Becoming Orgasmic: A sexual and personal growth program for women, revised and expanded edition, Simon & Schuster, New York 1988.
- Pierce AP. The coital alignment technique (CAT): an overview of studies. J Sex Marital Ther 2000; 26:257.
- Hurlbert DF, Apt C. The coital alignment technique and directed masturbation: a comparative study on female orgasm. J Sex Marital Ther 1995; 21:21.
- Eichel EW, Eichel JD, Kule S. The technique of coital alignment and its relation to female orgasmic response and simultaneous orgasm. J Sex Marital Ther 1988; 14:129.
- Meston CM, Levin RJ, Sipski ML, et al. Women's orgasm. Annu Rev Sex Res 2004; 15:173.
- Charles Lobitz W, LoPiccolo J. New methods in the behavioral treatment of sexual dysfunction. J Behav Ther Exp Psychiatry 1972; 3:265.
- LoPiccolo J, Lobitz WC. The role of masturbation in the treatment of orgasmic dysfunction. Arch Sex Behav 1972; 2:163.
- Barbach LG. Group treatment of preorgasmic women. J Sex Marital Ther 1974; 1:139.
- Andersen BL. A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females. J Consult Clin Psychol 1981; 49:568.
- Morokoff PJ, LoPiccolo J. A comparative evaluation of minimal therapist contact and 15-session treatment for female orgasmic dysfunction. J Consult Clin Psychol 1986; 54:294.
- Riley AJ, Riley EJ. A controlled study to evaluate directed masturbation in the management of primary orgasmic failure in women. Br J Psychiatry 1978; 133:404.
- Dodge LJ, Glasgow RE, O'Neill HK. Bibliotherapy in the treatment of female orgasmic dysfunction. J Consult Clin Psychol 1982; 50:442.
- Masters WH, Johnson VE. Human Sexual Inadequacy, Little, Brown, Boston 1970.
- Everaerd W, Dekker J. Treatment of secondary orgasmic dysfunction: a comparison of systematic desensitization and sex therapy. Behav Res Ther 1982; 20:269.
- Fichten CS, Libman E, Brender W. Methodological issues in the study of sex therapy: effective components in the treatment of secondary orgasmic dysfunction. J Sex Marital Ther 1983; 9:191.
- Munjack D, Cristol A, Goldstein A, et al. Behavioural treatment of orgasmic dysfunction: a controlled study. Br J Psychiatry 1976; 129:497.
- LoPiccolo J, Heiman JR, Hogan DR, Roberts CW. Effectiveness of single therapists versus cotherapy teams in sex therapy. J Consult Clin Psychol 1985; 53:287.
- McCabe MP. Evaluation of a cognitive behavior therapy program for people with sexual dysfunction. J Sex Marital Ther 2001; 27:259.
- Husted JR. Desensitization procedures in dealing with female sexual dysfunction. Couns Psychol 1975; 5:30.
- Obler M. A comparison of a hypnoanalytic/behavior modification technique and a cotherapist-type treatment with primary orgasmic dysfunction females: some preliminary results. J Sex Res 1982; 18:331.
- Kilmann PR, Milan RJ Jr, Boland JP, et al. The treatment of secondary orgasmic dysfunction II. J Sex Marital Ther 1987; 13:93.
- Akbarzadeh M, Zeinalzadeh S, Zolghadri J, et al. Comparison of Elaeagnus angustifolia Extract and Sildenafil Citrate on Female Orgasmic Disorders: A Randomized Clinical Trial. J Reprod Infertil 2014; 15:190.
- KEGEL AH. Sexual functions of the pubococcygeus muscle. West J Surg Obstet Gynecol 1952; 60:521.
- Chambless DL, Sultan FE, Stern TE, et al. Effect of pubococcygeal exercise on coital orgasm in women. J Consult Clin Psychol 1984; 52:114.
- Roughan PA, Kunst L. Do pelvic floor exercises really improve orgasmic potential? J Sex Marital Ther 1981; 7:223.
- Primary female orgasmic disorder
- Secondary female orgasmic disorder
- GENERAL PRINCIPLES
- PATIENT EDUCATION
- PSYCHOSOCIAL INTERVENTION STRATEGIES
- Directed masturbation
- - Efficacy
- Sensate focus exercises
- - Efficacy
- Cognitive-behavioral sex therapy
- - Efficacy
- Systematic desensitization and exposure therapy
- - Exposure therapy
- - Efficacy
- Other psychosocial interventions
- OTHER INTERVENTIONS
- Kegel exercises
- Genital cosmetic procedures
- TREATMENT SELECTION
- SUMMARY AND RECOMMENDATIONS