Female Orgasmic Disorder

Yes, this is what it is called in the DSM 5, the most recent reference guide that therapists use to diagnose different types of mental and emotional issues.  However, is it a disorder?  The problem with this kind of language is that it leads to more of a woman feeling inadequate if she has this problem or “disorder.”  The truth is that there are many possible factors whether they are physical, emotional or relational that can contribute to blocks to female orgasm.  Just like in many other aspects of human sexuality, there is a lot we do not know.  When we do not know, we tend to pathologize variance in sexual response.  This can lead to more unnecessary pressure for the woman just like a man who has erection issues.

First, for many women, they are not built to have vaginal orgasms, and only can have clitoral orgasms.  That is very common and it is just a variance and not a disorder.  Second other physical reasons can contribute to difficulty in having either type of orgasm including hormonal issues and medication side effects.  For many women, when the underlying physical issues are addressed, they can successfully have orgasm.

Second, it can mean that there are trust issues.  Sometimes, past trauma and family of origin anti-sexual messages can contribute to feelings of fear and distrust.  I have helped a number of women recently who have had sexual issues due to past traumas or they came from sexually rigid families.  As they resolved those issues and freed themselves of these past limitations, they were able to experience more of their sexuality including orgasms.  Sometimes, the trust issues have to do with current relationship issues such as poor communication, emotional volatility or past breaches of trust.  In these cases, the couple can change patterns and “grow up” so that trust can be restored.  As trust is restored, the woman can open her heart and could lead to more orgasmic capacity with the partner.

The key, however, in working with this issue is to take the pressure off the often times hyper focusing on orgasm.  This leads to performance anxiety and feelings of inadequacy similar to erectile difficulties of men.  As the couple learns to make their connection more important than the female’s orgasm and as the couple learns to enjoy all the other pleasurable aspects of their sexuality, they are free to enjoy their sex life.  Some sex therapists will suggest the use of vibrators to help the female experience orgasm, which can be very helpful; however even in this case, the focus needs to be on the process and not the outcome.  As the couple focuses on the enjoyment of the process regardless of outcome, the by-product of this can be the experience of orgasm by the female.


  • Carol Cordier-Carpenter says:

    Vibrators can definitely help a woman experience pleasure and/or orgasm. However, the long term use of high powered vibrators such as the Hitachi Wand can make the clitoris insensitive to everything but the vibrator, thus intensifying the reason they started using the vibrator. When recommending vibrators for women who have problems experiencing pleasure and/or orgasm during intercourse I would warn them not to use high powered vibrators. Small battery operated vibrators can be effectively utilized to stimulate the clitoris during intercourse, with generally good results.

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