Female Orgasmic Disorder

is when a women has difficulty having an orgasm or has unsatisfying orgasms. Treatment will depend on the cause.

Female Orgasmic Disorder Overview

Reviewed: May 28, 2014

Female Orgasmic Disorder (FOD) is when a woman either can't reach orgasm (sexual climax), has difficulty reaching orgasm, or has unsatisfying orgasms.

Many factors can affect a woman's desire and sexual function including physical and psychological causes. Medications, illnesses, surgery, age, pregnancy and menopause can affect sex.

Treatment varies depending on the cause. Occasional sexual problems are not uncommon. If problems don't go away, or cause anxiety for you or your partner, you should see your healthcare provider.


Female Orgasmic Disorder Symptoms

Symptoms of female orgasmic disorder (FOD) include:

  • inability to reach orgasm (sexual climax)
  • difficulty reaching orgasm
  • painful or unsatisfying orgasms

There are generally 2 forms of orgasmic dysfunction, primary and secondary.

Primary orgasmic dysfunction is when a woman has never had an orgasm. This is the case in 10 to 15 percent of women. 

Secondary orgasmic dysfunction is when a woman who has previously been able to have orgasms is currently unable to have one. It is estimated that 33 to 50 percent of women are dissatisfied with how often they reach orgasm.


Female Orgasmic Disorder Causes

Many things can affect desire and function and lead to FOD including:

  • A history of sexual abuse or past negative sexual experiences
  • A history of rape
  • Poor body image
  • Fear of losing control
  • Certain prescription drugs, examples include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
  • Excessive alcohol use
  • Hormonal disorders
  • Hormonal changes due to menopause
  • Aging
  • Physical causes such as diabetes, heart disease, nerve disorders, or hormone problems
  • Vaginal infections
  • Pregnancy, childbirth, and breastfeeding
  • Extreme tiredness 
  • Work-related stress and anxiety
  • Negative attitudes toward sex (usually learned in childhood or adolescence)
  • Shyness or embarrassment about asking for whatever type of stimulation works best
  • Problems within the relationship between partners
  • Boredom with sexual activity
  • Depression

Female Orgasmic Disorder Diagnosis

Your healthcare provider may require a complete medical history, physical examination and a pelvic exam to understand the cause of your FOD.

You may also have a blood test to measure hormone levels as hormonal disorders, and hormonal changes due to menopause can cause FOD.



Female Orgasmic Disorder Treatments

A good first step in the treatment of FOD is understanding what is causing it.

Treatment may involve one or more of the following:

  • education
  • changing sexual routine (time of day, foreplay, stimulation, sexual positions)
  • treatment of underlying medical problems
  • changing existing medications or making dose adjustments
  • estrogen therapy for vaginal dryness

A sex therapist, in addition to medical treatment, can help with the emotional, physical, and interpersonal aspects of FOD. Therapy may involve:

  • cognitive behavioral therapy
  • teaching orgasm by focusing on pleasurable stimulation
  • directed masturbation
  • couple exercises to practice communication
  • building sexual confidence
  • help in understanding how past sexual experiences affect current sexuality



Female Orgasmic Disorder Other Treatments

Having a good understanding of your body and communicating your needs with your partner is important for a good sexual relationship.

Learn more about your body and how it works. Ask your healthcare provider about how medicines, illnesses, surgery, age, pregnancy or menopause can affect sex.