Anorgasmia

Anorgasmia is the lack of ability to have an orgasm. This article discusses anorgasmia in women.

Primary Anorgasmia

Some women are orgasmic during their first sexually exciting experience, and others never learn to have an orgasm. Women who have primary anorgasmia sometimes achieve a relatively low level of sexual excitement and may think of intercourse or other sexual activities as pleasant. They may get most of their reward from touching, holding, kissing, caressing, attention, and approval. However, women who regularly achieve high levels of sexual response without orgasmic release of tension may find the experience frustrating. Emotional irritability, restlessness, and pelvic pain or a heavy pelvic sensation may occur because of vascular engorgement.

Women who have not yet had an orgasm usually have some combination of the following:

Sociocultural inhibitions that interfere with normal sexual

response.

A lack of knowledge about sex and sexuality, which interferes

with normal sexual development.

A lack of opportunity to practice in a safe, secure, socially

acceptable, and private atmosphere (alone or in a relationship) in a situation that offers approval and support.

A partner who ejaculates prematurely.
A partner who has primary or secondary difficulty in achieving

an erection.

Genital mutilation (circumcision) that removes part or all of

the clitoris, scars the genital area, or constricts the opening to the vagina. Often, vaginal intercourse is painful not only because of scarring from this procedure but also because of associated infection.

Secondary Anorgasmia

Secondary anorgasmia is the loss of ability to become orgasmic. The cause may be alcoholism, depression, grief, medication, illness, estrogen deprivation associated with menopause, or an event that has violated the patient's sexual value system. Situational Anorgasmia. Women who are orgasmic in some situations may not be in others. A woman may have an orgasm from one type of stimulation but not from another. Or a woman may achieve orgasm with one partner but not another, or have an orgasm only under certain conditions or only with a certain type or amount of foreplay. These common variations are within the range of normal sexual expression.

Encourage a woman with situational anorgasmia to explore alone and with her partner those factors that may affect whether or not she is orgasmic, such as fatigue, emotional concerns, feeling pressured to have sex when she is not interested, or her partner's sexual dysfunction.

Family planners should consider recommending the female-above position for penile-vaginal intercourse, as it may allow for greater stimulation of the clitoris by the penis or symphysis pubis or both, and it allows the woman better control of movement. Bridging is the combining of a successful method for sexual stimulation with a desired technique so that the body learns to associate orgasm with that technique. If, for example, the woman is readily orgasmic with manual stimulation but not with penile-vaginal thrusting, she is encouraged to combine those two regularly until her body has learned to associate high levels of excitement and orgasm with penile-vaginal thrusting.

Random Anorgasmia

Some women are orgasmic but not in enough instances to satisfy their sense of what is appropriate or desirable. Often such women have trouble giving up control and allowing themselves to respond fully. Therapy can be aimed at helping them give up the need to keep their sexual feelings under control at all times.

The original text for this article is taken from the public domain CDC text at http://www.cdc.gov/nccdphp/drh/Africa_pdf/Chap_10.pdf