Orgasmic Disorder

Orgasmic disorder—sometimes called anorgasmia—is a diagnosis outlined in the Diagnostic and Statistical Manual of Mental Disorders. According to the DSM-IV, orgasmic disorder interferes with a person’s ability to orgasm during sexual intercourse or other sexual interactions.

What is Orgasmic Disorder?
Both men and women can be diagnosed with an orgasmic disorder; men are diagnosed with male orgasmic disorder while women are diagnosed with female orgasmic disorder. The symptoms of both conditions are similar and include:

• Inability to reach orgasm on a regular basis despite adequate stimulation
• The inability to reach orgasm is not better explained by another mental health condition and is not a drug or alcohol side effect
• The inability to reach orgasm causes personal distress, embarrassment, shame, or problems in personal relationships

What Causes Orgasmic Disorder?
While orgasmic disorder is commonly classified as a mental health problem, some physical health problems—including diabetes, spinal cord injuries, pelvic disorders, traumatic pelvic injuries, cardiovascular disease, and vulvodynia—can contribute to the inability to orgasm.

Primary orgasmic disorder occurs when a person has never had an orgasm, and secondary orgasmic disorder occurs when a person suddenly stops being able to have an orgasm. Feelings of shame about sex, sexual trauma, and cultural messages about sexuality can all contribute to the development of orgasmic disorders.

How is Orgasmic Disorder Treated?
The first step in treating orgasmic disorder is ensuring proper diagnosis of the condition. A diagnosis of orgasmic disorder is given to individuals for whom a lack of orgasm is an expressed problem and/or causing significant disturbances in their interpersonal relationship(s). If a lack of orgasm is not viewed as problematic by the individual experiencing it or does not negatively impact their relational satisfaction, orgasmic disorder may not be an appropriate diagnosis.

Treatment for orgasmic disorder will almost always involve examining causes. Particularly among women, who orgasm primarily via clitoral stimulation, it is important to ensure that the lack of orgasm is not caused by inadequate or insufficient stimulation; some women mistakenly believe that the inability to orgasm from intercourse alone indicates an orgasmic disorder. Treatment varies greatly depending upon the cause of the condition, but may include psychotherapy, sex education, and couples counseling. Hormonal treatments to increase sexual desire may also help in certain cases.

The Ongoing Debate About Orgasmic Disorder
The diagnosis and treatment of orgasmic disorder is not just a medical or mental health issue; it is also a cultural and sociological one. While many people struggle with frustrations over their inability to orgasm, others may feel stigmatized and ignored by the focus on orgasm. Not all people want an orgasm to be the end result of each sexual contact, and some people have no desire for an orgasm at all. In many cases, sexual relationships are not just about sexual pleasure, but also about closeness and connection.

Not all sexual contact is explicitly directed toward an orgasm, and some people may be interested only in non-orgasmic forms of sexuality. Some advocates have argued that the DSM’s use of orgasmic disorder makes orgasm the primary goal of sexual interaction and ignores other facets of sexuality, including the importance of connection, mutual respect, and touch. They also argue that the emphasis on orgasm ignores the broad continuum of sexual desires and goals. A person who does not orgasm during sex might have an orgasmic disorder, or might simply be uninterested in orgasming.

One recent study published in the “Archives of Sexual Behavior” emphasized the importance of arousal and touching as part of sex. Some people diagnosed with an orgasmic disorder may simply be insufficiently aroused. Others might not be getting the kind of sexual stimulation they want or need, because no single sexual recipe works for all people.

The diagnosis of orgasmic disorder also overlooks an increasingly vocal minority—asexual people. Asexual people are people who either feel no sexual desire or who have no desire to engage in sexual relationships, and current estimates are that people who are asexual constitute about one percent of the total population. Asexual people argue that their disinterest in sex is not due to trauma or biological abnormalities; instead, it should be treated as a valid sexual orientation. For people who identify as asexual and for whom a lack of orgasm does not cause disturbances, a diagnosis of orgasmic disorder would likely be inappropriate.

References:

1. Female and male orgasmic disorders. (n.d.). Psych Central. Retrieved from http://psychcentral.com/disorders/sx58.htm
2. Female orgasmic disorder. (n.d.). Mind Disorders. Retrieved from http://www.minddisorders.com/Del-Fi/Female-orgasmic-disorder.html
3. Female orgasms: Myths and facts. (n.d.). SOGC. Retrieved from http://www.sogc.org/health/health-myths_e.asp
4. Herbenick, D. (2012, October 15). It’s not an orgasm problem. Salon.com. Retrieved from http://www.salon.com/2012/10/16/its_not_an_orgasm_problem/
5. Study: One in 100 adults asexual. (2004, October 14). CNN. Retrieved from http://www.cnn.com/2004/TECH/science/10/14/asexual.study/index.html?_s=PM:TECH

Last Updated: 08-17-2015