Definition: Known as "anorgasmia" in medical terms, female orgasmic problems are defined as a sexual difficulty involving the absence of orgasm in women. The important thing to realize is that it is only "absent" and it can become present by learning about the problem and taking the necessary steps to solve it.

There are two types of female orgasmic problems:

1. Generalized, lifelong anorgasmia
   >>A female who has never experienced orgasm by any means.

2. Situational anorgasmia
   >>A female who experiences orgasm rarely. An example of this would be a female who could orgasm while masturbating herself, but not from stimulation provided by her partner.

Statistics:

• 5-10 percent of adult women in the U.S. have never experienced orgasm by any means of self or partner stimulation.
• According to the famous studies done by Alfred Kinsey on female sexuality, only about 30% percent of women regularly reach orgasm by penile-vaginal intercourse alone.
• In a survey of 100 happily married couples, 48% of the women reported they sometimes had difficulty in getting sexually aroused, 46% reported intermittent difficulties in reaching orgasm, and 15% were completely unable to have an orgasm.

Important Facts: 

• During penile-vaginal intercourse, women only receive indirect stimulation, making it harder for them to reach orgasm. 
• The clitoris needs more direct stimulation during lovemaking in order for a woman to achieve orgasm. 

Four Origins of Female Orgasmic Disorder:

1. Cultural Influences
   1. Negative childhood learning can play a major role.
      • Example: We may learn from our parents, religion, school, and culture that sex is sinful, that genitals are dirty, and/or that masturbation is bad. Sex education in schools rarely discuss or encompass the joys of sex or how to have a healthy and satisfying sex life.
        • *This creates negative feelings about sex that inhibit a woman's sexual response. Inadequate sex education can lead to pain, embarrassment, fear of pregnancy, and fear of being caught, which may increase tension and reduce pleasure.
   2. Q: Do you have a positive attitude about sex? Do you enjoy sexual pleasure and believe you deserve it? Are you comfortable with your body?
      • A: If you answered "no" to any of these questions, it is possible that negative childhood learning could be one of the causes relating to your current orgasm difficulties.
   3. Sexual Double Standard.
      • Example: "Women are encouraged to be sexually cautious to avoid acquiring a reputation of being loose, but part of stereotypical masculine sexual success is 'scoring'" (Crooks & Baur, 1999:447). Women are also not allowed to be sexually assertive because it is not considered feminine.
        • *This inhibits women because they feel they are not allowed to be sexual, and therefore they may not take the necessary steps needed to become orgasmic with their partners, such as verbally expressing how they want to be touched.
   4. A Narrow Definition of Sexuality
      • Example: In our society, sex is narrowly viewed as only penile-vaginal intercourse.
        • *This contributes to inadequate stimulation for women and men, leading to a less enjoyable sexual response, or for some women, none at all.
2. Performance Anxiety
   1. Example: Some women feel pressured to have an orgasm with their partner, and it becomes the goal of intercourse. The pressure is sometimes so strong that some women may fake their orgasms.
   • *This causes performance anxiety, inhibiting sexual arousal and release for some women.
3. Individual Factors
   1. Inadequate Sexual Knowledge and Negative Attitudes
      • Example: Many women know little about the function of the clitoris in sexual arousal and may be fearful of sexual pleasure.
        • *This contributes to the inability to have an orgasm and also inhibits the sexual desire that could aide in producing it.
   2. Self Concept
      • Example: Some women feel uncomfortable with their body and are unable to take an active role in lovemaking because they may feel they are not entitled to sexual pleasure.
        • *This leads to low self-esteem, which can contribute to lower sexual satisfaction and anorgasmia.
   3. Emotional Difficulties
      • Example: Many women experience problems such as anxiety, stress, and depression.
        • *This leads to a lack of sexual interest and inhibits the sexual response.
   4. Sexual Abuse and Assault
      • Example: Many women experience childhood sexual abuse (such as incest or molestation) or adulthood assault (such as rape).
        • *These traumatic experiences can greatly interfere with sexuality and can cause several sexual problems such as anorgasmia.
4. Relationship Factors
   1. ​Ineffective Communication
      • Example: According to the sexual double standard, women are supposed to be submissive.
        • *Because of this gender stereotype, many women feel it is not right to tell their partner what they want during lovemaking and many times their sexual needs are never met.
   2. Unresolved Relationship Problems
      • Example: "Unresolved resentment, a lack of trust, inability to combine love and sexual desire, dislike of a partner, lack of attraction, poor sexual skills, boredom, or fear can easily lead to sexual dissatisfaction or disinterest" (Crooks & Baur, 1999:451).
        • *All of these problems are examples of how sexual dissatisfaction or disinterest may occur.
   3. Worry About Pregnancy or STI's
      • Example: Women are anatomically more susceptible to STI's and they must also carry the responsibility of using contraception if their partner does not do so himself.
        • *This might cause a lot of fear and anxiety for a woman, which can block her sexual response.
   4. Sexual Orientation
      • Example: Some women would rather be with a partner of the same sex.
        • *This may be one reason why a woman would not experience sexual satisfaction in a heterosexual relationship.
5. Organic Factors
   1. ​Medication That Effects Sexual Functioning
      • Example: Several prescription and non-prescription medications can have negative side effects on sexuality. A few examples are antidepressants (used as psychiatric medications) and antihypertension medications (used to lower high blood pressure).
        • *Many women experience a lack of desire or arousal, and a delay or absence of orgasm due to such medications.
   2. Chronic Illness and Disabilities
      • Example: Illnesses such as multiple sclerosis or disabilities such as deafness are two examples that can affect the sexual response.
        • *These are special cases that require specific therapeutic approaches.

Therapy and Enrichment for Orgasmic Difficulties:

1. Masters and Johnson
   • Key concepts:
     • Self-Awareness
     • Masturbation
     • Good Communication
     • Sensate Focus
     • Sexual Position with the Woman on Top
2. Five Easy, Non-Threatening Steps to Learn Self Pleasuring
   1. These exercises can be done in the privacy of your bedroom (with candles and soft music if you like!)
      • Practice extended masturbation (to orgasm if possible)
      • Have your partner watch you masturbate
        • Have your partner try to imitate you
      • Try to get sexually aroused
        • Touch parts of your body that feel arousing
      • Get comfortable with your body and explore it with your hands
        • Look at your body alone in detail. Use a mirror to inspect and become more familiar with your genitals
      • Vibrators
        • Vibrators can be an easy way to achieve your first orgasm and help you learn what feels good. You can also integrate it into lovemaking with a partner. Be careful not to rely on it however, because it may decrease your ability to fantasize and can cause jealousy or resentment from your partner if they feel they are unable to satisfy you without a vibrator.
   2. Other Tips
      • Learn how to give yourself an orgasm through masturbation. 
      • Include healthy fantasies with your masturbatory therapy. 
      • Move in ways that provide you with the best stimulation.
      • Stay focused on sexual feelings and practice "Sensate Focus" to avoid negative feelings that may inhibit your response. 
      • Experiment with oral stimulation, manual stimulation, and body rubbing in addition to penile-vaginal intercourse. 
      • Tighten your legs and thighs to increase myotonia (muscle tension), which helps trigger orgasm.
      • Do Kegel exercises.
      • Help your partner last longer by using premature ejaculatory therapy if needed, such as the "Squeeze/Tease Technique." 
      • Try the "woman on top" sexual position.
3. Books To Read:
   1. Our Sexuality by Robert Crooks and Karla Baur
   2. Becoming Orgasmic by Julia Heiman and Joseph Lopiccolo
   3. Ultimate Pleasure: The Secrets of Easily Orgasmic Women by M. Meshorer and J. Meshorer
   4. All About Sex Therapy by P.R. Kilmann and K.H. Mills (featuring the work of Masters and Johnson, Kaplan, and other well-known sex therapists.)
   5. Sexual Fantasy Guides:
      • Pleasures: Women Write Erotica by L. Barbach
      • My Secret Garden and Forbidden Flowers: More Women's Sexual Fantasies by N. Friday