Historically, this female sexual dysfunction was referred to as “frigidity,” which had negative implications about the woman. DSM-IV-TR defines female orgasmic disorder as a delay or absence of orgasm following a normal phase of sexual excitement. This is a common complaint among women, and studies have found that 24% of women have female orgasmic disorder (Laumann et al., 1994). Remember though, that the DSM definition does not indicate that orgasm must occur during sexual intercourse. In fact, the majority of women are unable to orgasm during sexual intercourse. If a woman is unable to orgasm during all sexual activities after a normal phase of sexual excitement, she may be experiencing orgasmic disorder. Some women who take certain psychotropic drugs, including many types of antidepressants, experience delayed or absent orgasms (Meston & Frohlich, 2000).
Primary orgasmic disorder describes a condition in which a woman has never had an orgasm. Secondary orgasmic disorder refers to a condition in which a woman was able to have orgasms previously but later has trouble reaching orgasm. Situational orgasmic disorder refers to a condition in which a woman can have orgasms only with one type of stimulation.
Women with orgasmic disorders, compared with orgasmic women, have more negative attitudes about masturbation, believe more myths about sexuality, and possess greater degrees of sex guilt (M. P. Kelly et al., 1990). They also have more difficulties in asking their partners for direct clitoral stimulation, discussing how slow or fast they want to go, or how hard or soft stimulation should be. Some women worry about what their partners might think if they made sexual suggestions or feel uncomfortable receiving stimulation (such as cunnilingus or manual stimulation) without stimulating their partners at the same time. Distracting thoughts, such as “his hand must be falling asleep” or “he can’t be enjoying this” can increase existing anxiety and interfere with orgasm (Birnbaum et al., 2001; M. P. Kelly et al., 1990).
If the woman displays no physical problems, most cases of orgasmic difficulties are presumed to be psychogenic (Andersen, 1981). Several psychological issues have been found to interfere with orgasmic response, including a lack of sex education and fear or anxiety related to sexuality (Kelly et al., 1990).
Physical factors can also cause female orgasmic disorder. Severe chronic illness and disorders such as diabetes, neurological problems, hormonal deficiencies, and alcoholism can all interfere with orgasmic response. Certain prescription drugs can also impair this response.