Orgasmic Disorders in Women in .NET

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Orgasmic Disorders in Women
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De nitions
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Orgasm
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There are many de nitions of orgasm, from Ford and Beach [1], through Kinsey [2], Masters and Johnson [3,4], Kothari [5], and others, to the Second International Consultation on Sexual Medicine, held in Paris in July 2003 Most of these de nitions address subjective sensations and pelvic muscle contractions Members of the Paris consultation offer the following de nition of women s orgasm: An orgasm in the human female is a variable, transient peak sensation of intense pleasure creating an altered state of consciousness usually with an initiation accompanied by involuntary, rhythmic contractions of the pelvic striated circumvaginal musculature often with concomitant uterine and anal contractions and mytonia that resolves the sexually-induced vasocongestion (sometimes only partially) and myotonia usually with an induction of well-being and contentment [6, p 66] None of these de nitions account for the report of orgasms experienced from imagery alone, or in women with complete spinal cord injury A more comprehensive de nition of orgasm would be Orgasm is a peak intensity of excitement generated by: (a) afferent and re-afferent stimulation from visceral and/or somatic sensory receptors activated exogenously and/or endogenously, and/or (b) higher-order cognitive processes, followed by a release and resolution (decrease) of excitation [7, p 71] By this de nition, orgasm is characteristic of, but not restricted to, the genital system
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dif culty, delay in or absence of attaining orgasm following suf cient sexual stimulation and arousal, which causes personal distress [8, p 890] We prefer to use the word experiencing orgasm rather than attaining orgasm, because experiencing does not connote sexual response in women as being linear or goal oriented In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), female orgasmic disorder is de ned as: Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm The diagnosis of Female Orgasmic Disorder should be based on the clinician s judgment that the woman s orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives [9(30273)] The Second International Consultation on Sexual Medicine de ned women s orgasmic disorder as Despite the self-report of high sexual arousal/excitement, there is either lack of orgasm, markedly diminished intensity of orgasmic sensations or marked delay of orgasm from any kind of stimulation [10, p 10] This panel developed the new de nition because the old de nitions ignored the criterion of high or adequate sexual arousal This current de nition incorporates the criterion that the woman has no problem becoming aroused It is considered to be a disorder only if the woman is distressed by the problem [11]
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Prevalence
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Anorgasmia is a common problem that is reported to affect an estimated 24 37% of women [12] In a review of 34 studies, the rates of anorgasmia, orgasmic dif culty, or orgasmic disorders ranged from below
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Orgasmic disorder
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The First International Consensus panel in 1998 de ned orgasmic disorder as the persistent or recurrent
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Orgasmic Disorders in Women 20% to as high as 50% [13] Findings from the National Social and Health Life Survey of 1749 US women suggest that orgasmic problems are the second most frequently reported sexual problem in women In this random sample, 24% reported a lack of orgasm in the past year for at least several months or more [14] With aging, orgasms may be shorter in duration and less intense than when a woman was younger [15] If sexual arousal is high, none of the data indicate that problems experiencing orgasm increase with age [16] Anorgasmia can be divided into primary orgasmic disorder, in which a woman has never experienced orgasm through any means of stimulation, and secondary orgasmic disorder, in which a woman is anorgasmic after having been orgasmic Secondary anorgasmia can be classi ed as situational (eg when a woman can experience orgasm via masturbation but not with a partner) or generalized [11]
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