Orgasm

[Heather34]

Hi all. There is a very interesting chapter in ISSM (International Society of Sexual Medicine) Standard Committee Book, Standard Practice in Sexual Medicine, Blackwell, Oxford, UK, 2006, p. 334-341 written by Whipple B. Graziottin A. “Orgasmic disorders in Women.” http://www.alessandragraziottin.it/ew/ew_voceall/36/1532%20porst%20-%20orgasmic%20disorders.pdf

Excerpts include:

“The treatment of anorgasmic has been approached from psychoanalytic, cognitive-behavioral, systems theory and pharmacological approaches. According to Meston and colleagues, “cognitive behavioral therapy for anorgasmia focuses on promoting changes in attitudes and sexually-relevant thoughts, decreasing anxiety, and increasing orgasmic ability and satisfaction”.

In the 1970’s the small group format was suggested and there were a number of books and videos developed to give women permission to experience orgasm and to share ways in small pre-orgasmic groups that they found helpful to experience sensual and sexual pleasure.

Behavioral exercises include directed masturbation, with and without vibrators, which has been shown to be effective in groups and individually. If a woman is able to experience orgasm through masturbation, but not with a partner (if this is her desire), then couple therapy may be recommended, once issues of anxiety, communication, trust and past history have been addressed. Another behavioral approach often suggested is Kegel exercises. Graber and Kline-Graber found a positive correlation between the strength of a woman’s pelvic muscles and her orgasmic response. The women with very weak muscles were anorgasmic in their retrospective study. Perry and Whipple found that women who experienced female ejaculation have significantly stronger pelvic muscles than women who did not experience this phenomenon. Sensate focus exercises were developed by Masters and Johnson to reduce anxiety by using a series of body touching exercises, moving from sensual to increasingly sexual. These exercises are used by many health care providers today, although Meston and colleagues note that there has been no reported substantial improvement in orgasmic ability with these exercises.

There are no pharmacological agents that have been demonstrated to be effective for treating women with orgasmic disorders. However, a good history will determine if other medical conditions or medications taken may inhibit orgasmic response. A change of medication or taking buproprion with an SSRI or in place of the SSRI may help. More double-blind, placebo-controlled studies are needed here. There is an excellent review of psychosocial and pharmacological treatments for orgasmic disorders in the Annual Review of Sex Research, Volume XV, 2004.”

As always, I encourage you to read and welcome your comments and feedback here.