Orgasmic Dysfunction

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Causes, incidence, and risk factors

Primary orgasmic dysfunction, wherein the woman has never experienced an orgasm, appears to characterize about 10% to 15% of women. Surveys generally suggest that somewhere between 33% to 50% of women experience orgasm infrequently and are dissatisfied with how often they reach orgasm.

Performance anxiety is believed to be the most common cause of orgasm problems, and 90% or more of orgasm problems appear to be psychological in nature.

Some drugs may sedate and impair orgasmic responsiveness, including alcohol. SSRI antidepressants (fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), etc.) are a very common cause of lack of orgasm, delayed orgasm, or unsatisfying orgasm in both women and men.

Infrequently, medical conditions that affect the nerve supply to the pelvis (such as multiple sclerosis, diabetic neuropathy, and spinal cord injury), hormonal disorders, and chronic illnesses that affect general sexual interest and health may be factors.

Negative attitudes toward sex related to childhood experiences may inhibit responsiveness, as may unresolved feelings associated with experiences of sexual abuse or rape.

In situations where the woman used to reach orgasm regularly, but is not reaching orgasm currently, the problem may be related to marital strife and lack of emotional closeness, which may also cause low sexual desire.

Boredom and monotony in sexual activity may also contribute to secondary anorgasmia. Frequently, women are too shy or too embarrassed to ask for the kind of stimulation (and the timing of stimulation) that works best for them and this, too, can lead to this condition.