Anorgasmia in Women – Diagnosis and Treatment
Diagnosis
A healthcare provider, such as a primary care doctor or gynecologist, first reviews the patient’s medical history to find out if someone has an orgasmic disorder like anorgasmia.
The provider also performs a physical and pelvic examination to rule out any medical causes that might affect sexual functioning or lead to sexual pain disorders.
Providers often give patients a questionnaire to gather information about their sexual experiences, including:
- Recent and past sexual activities
- Feelings about sexual pleasure and satisfaction
- Details about partners and types of stimulation
- History of sexual problems or sexual dissatisfaction
Providers might meet with partners separately to better understand the situation. These steps help assess the incidence of female orgasmic disorders and guide further treatment.
Treatment
Changes to Daily Habits and Therapy Support
Improving anorgasmia often begins by looking at daily habits and talking with a healthcare provider. Learning about sexual health can help people understand how the body works.
Professionals might start with a clear discussion using diagrams or handouts to answer questions and provide guidance for what helps during sex.
Practical Skill Building:
- Masturbation Exercises: Guided exercises at home help people get more familiar with their body and what kind of touch works for them, building confidence.
- Sensate Focus for Couples: Partners follow simple steps that start with nonsexual touch, slowly moving to more intimate types of contact. This lets couples focus on what feels good without pressure for immediate results.
- Trying New Positions: Changing sexual positions, especially those that focus on clitoral stimulation, can help with reaching orgasm.
- Using Devices: Sexual devices like vibrators or clitoral pumps can increase sensation. Some create a gentle suction to boost blood flow. These can be used alone or with a partner.
- Behavioral Therapy: A counselor can help individuals or couples improve how they view sex. Therapies like cognitive behavioral therapy help people talk about worries, set goals, and change habits that may be holding them back.
- Strengthening Pelvic Floor Muscles: Doing Kegel exercises can strengthen these muscles, which may make orgasms easier to achieve.
Addressing Related Conditions:
- Dyspareunia: If pain during sex is present, addressing the cause is important for comfort and confidence.
- Vaginismus: Therapy or specific exercises can help relax the pelvic muscles, making sexual activity less uncomfortable.
Working Through Emotional Barriers:
- Addressing stress, anxiety, or past trauma is also important. Psychotherapy may help with concerns like low sexual desire (hypoactive sexual desire disorder) or arousal problems.
Medical Approaches and Prescription Options
Doctors may recommend medical treatments if lifestyle changes and therapy do not provide enough improvement. Providers discuss these options to make sure they are safe and appropriate.
Possible Medication Choices:
| Medicine Type | Use Case | Notes |
|---|---|---|
| Estrogen Therapy | Menopausal symptoms, vaginal dryness, arousal | Available as cream, pill, or suppository; monitor side effects carefully |
| Testosterone Therapy | Menopausal women with low testosterone | May improve sexual desire/arousal; watch for unwanted hair, acne, cholesterol issues |
| Bupropion | Sometimes used for low sexual desire/disorder | An antidepressant that may be tried to help with low libido |
| Selective Serotonin Reuptake Inhibitors (SSRIs) | Used for other conditions but may cause problems | These antidepressants can lower sexual desire or cause trouble reaching orgasm |
- Hormone-related treatments can help improve sexual arousal and comfort for some people, but they come with possible risks. For example, long-term estrogen can raise the risk for breast cancer or heart problems.
- Not everyone will benefit from these medicines. Discussion with a health professional is important to check for risks, benefits, and possible side effects.
- Some antidepressants, like SSRIs, can make anorgasmia worse. In that case, changing to a different medicine like bupropion might be considered.
Managing Other Issues:
- Providers address other sexual disorders like sexual arousal disorder or low libido as needed, which may require additional treatments.
- Managing pain (dyspareunia) or anxiety during sex is also part of the treatment plan.
Key Steps:
- Regular check-ins with a professional help tailor the treatment and address all concerns.
- Providers usually combine medicine-based options with therapy and self-care for best results.
Alternative Options for Natural Remedies
Some natural supplements, like products with L-arginine or Russian olive tree extract, are advertised to help women with sexual concerns.
| Natural Product | Possible Use |
|---|---|
| L-arginine | Supports blood flow |
| Russian olive tree extract | Used for sexual wellness |
These options often appear as a mix of herbs, vitamins, or are used along with other treatments. However, research is very limited, so it is not clear if these remedies actually work.
Important Points to Remember:
- Side effects are possible.
- They can interact with other medicines.
- Always speak to a healthcare provider before starting.
Getting Ready for Your Visit
Steps You Can Take Before the Appointment
Bringing the right information can help make the visit more useful. It is recommended to write down:
- Symptoms: Note when the trouble with orgasm began, what seems to make it better or worse, and any patterns noticed.
- Sexual History: List past and present relationships and any important experiences, such as sexual abuse or trauma.
- Medical Background: Give details about current and past illnesses, especially those that could affect sexual health, like diabetes, multiple sclerosis, arthritis, breast cancer, or urinary incontinence.
- Mental Health Concerns: Mention anxiety, depression, or other psychological issues.
- Medicines and Supplements: Include everything being taken, like dosages for prescriptions, over-the-counter items, vitamins, and herbal products. Some drugs may increase risk or cause changes in sexual function.
- Questions and Concerns: Make a list of questions to ask, including concerns about intimacy, emotional closeness, or changes noticed during menopause or aging.
Here is a table to organize information:
| Category | Example Details |
|---|---|
| Symptoms | Start date, triggers, impact on quality of life |
| Medical Conditions | Diabetes, vascular disease, chronic illnesses |
| Psychological Issues | Anxiety, depression, history of abuse |
| Medications | Names, dosages, how long taken |
| Sexual History | Relationship details, history of trauma |
What Your Clinician May Ask and Do
Health professionals may ask detailed questions to better understand the situation:
- Are you currently sexually active? With how many partners?
- What is your sexual orientation or your partnerโs gender identity?
- What specific sexual activities do you take part in?
- Do you become sexually aroused? Have you ever had an orgasm, either alone or with a partner?
- Any pain with sexual activity or difficulty with intimacy?
- Has your satisfaction with your sexual relationship changed over time?
- Are there issues with hormone levels, menopause, or chronic illnesses?
- What is your level of alcohol or drug use?
- What cultural or family beliefs did you learn about sex growing up?
- Is there a history of medication use that could impact sexual health, like antidepressants or treatments for breast cancer?
Your provider might also suggest a physical exam, such as a pelvic exam, to rule out medical causes. Some questions may feel private, but open and honest answers help the provider give the best care.
