Female Orgasmic Disorder

The symptoms of FOD can vary from individual to individual. However, a few common signs may help you identify if you have FOD. One of the main symptoms of FOD is the inability to reach a vaginal or clitoral orgasm, which may occur even if a person experiences sexual desire or arousal and engages in sexual activities.

Another symptom is a significant delay in reaching orgasm. People experiencing FOD might take longer than usual to reach orgasm, which could cause frustration or anxiety during sexual activities. 

In addition, individuals with FOD may experience a decrease in the intensity of orgasms. When they do achieve orgasm, it may be weaker or less pleasurable than before. This decreased orgasmic sensation may lead to frustration and distress in both personal and sexual relationships.

Some people with FOD may display the following psychological symptoms:

• Anxiety or stress around sex
• Avoidance of sexual activities
• Fear of judgment or stigma from others due to their sexual difficulties
• Feelings of shame or guilt regarding sexual experiences
• Frustration, irritability, or anger related to their sexual challenges
• Loss of confidence in their ability to experience pleasure or achieve sexual satisfaction
• Lower self-esteem and body image concerns
• Fear of intimacy or difficulty forming emotional connections with partners
• Avoidance of conversations about sex or reluctance to seek help for their condition

The symptoms of FOD must be present for at least six months for an accurate diagnosis. If an individual experiences a pattern of difficulty in achieving orgasm, delays in reaching orgasm, or decreased orgasmic intensity that persists over time, it may be helpful to seek medical guidance, especially if these problems cause emotional distress.

FOD stems from an interplay between physical elements, such as hormonal imbalances and medication effects, and psychological factors including past trauma² and stress, all of which collectively influence the individual's sexual function.

Psychological causes 

Some common psychological factors that can contribute to FOD include:

• Anxiety or stress
• Depression
• Past traumatic experiences
• Low self-esteem or poor body image
• A history of sexual trauma or abuse
• Negative attitudes toward sex or sexuality 
• Cultural or religious beliefs affecting sexual attitudes 
• Lack of emotional intimacy
• Fear of losing control during sex
• Negative attitudes toward sex, possibly due to upbringing or cultural beliefs
• Relationship problems, such as lack of trust or communication with a partner

Physical causes 

Physical and medical causes for FOD may involve hormonal imbalances, certain medications, or other health conditions. Some examples may include:

• Menopause and decreased estrogen levels
• Medications like antidepressants, antihypertensives, or antipsychotics
• Medical conditions like diabetes, thyroid disorders, multiple sclerosis, or neurological disorders
• Substance use or addiction problems
• Surgical or gynecological interventions affecting sexual function

A diagnosis of FOD is not solely dependent on one factor but rather a combination of factors that vary from person to person. Identifying the specific causes for an individual may be necessary to determine the appropriate treatment for FOD. Consult a healthcare professional or sex therapist for an appropriate diagnosis based on the factors contributing to this condition.

The goal of treatment for FOD is to improve sexual satisfaction and overall emotional health. Treatments for FOD, tailored to the individual's unique circumstances, often combine therapy, medical interventions, and self-care strategies to address both the symptoms and underlying causes of FOD. Psychological treatment has been shown to be effective in helping people with FOD to gain or regain the ability to have orgasm.

Medication

There are no medications specifically approved to treat FOD. However, treating underlying medical conditions or adjusting existing medications may affect sexual response. For example, fixing hormonal imbalances or adjusting antidepressants known to cause sexual dysfunction may be part of a viable treatment plan. In addition, vaginal estrogen therapy for postmenopausal individuals experiencing vaginal dryness and discomfort during sex may also be helpful.

Some mental health professionals may prescribe selective serotonin reuptake inhibitors (SSRIs) to address female orgasmic disorder by increasing serotonin levels, which may help alleviate symptoms and improve sexual stimulation. These medications might also address psychological factors related to female orgasmic disorder.

On occasion, doctors may suggest off-label use of medications that have been shown to improve orgasmic function, such as bupropion or sildenafil. However, the efficacy of these medications varies, and they may not be suitable for every individual.

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The above information is not a replacement for medical advice or diagnosis. 

Other treatment options

In some cases, alternative treatment options may be explored to address FOD and improve sexual response. These can include:

• Pelvic floor physical therapy to improve muscle tone and control
• Use of vibrators or other stimulation devices to facilitate orgasm
• Acupuncture, an ancient Chinese technique that may improve blood flow and stimulate nerve function

Self-care

Self-care may be another aspect of managing FOD, as it could help individuals better understand their bodies and sexual preferences. Some self-care strategies might include:

• Regular exercise to improve mood, reduce stress, and increase blood flow
• Mindfulness and relaxation techniques, such as deep breathing, meditation, or progressive muscle relaxation, to lower stress and anxiety surrounding sexual experiences
• Masturbation to explore desires and orgasmic responses in a safe and comfortable environment
• Open communication about sexual needs and preferences with a partner to ensure a mutual understanding and supportive atmosphere

Each individual's experience with FOD is unique, and what works for one person may not be effective for another. Treatment plans may be tailored to an individual's specific needs and adjusted over time to achieve the best results.

There are various resources available to support those living with FOD. For example, online platforms like BetterHelp offer online therapy services that may be an option for those seeking support with FOD. A professional therapist may be able to help individuals explore the potential underlying causes of FOD and use various techniques to improve sexual functioning. 

In addition to therapy platforms, there are several resources available for individuals experiencing FOD. The National Institute of Mental Health (NIMH) provides information on mental health disorders, including FOD, and may be a helpful starting point for understanding the condition.

Support groups can also be beneficial in providing a safe space for those with FOD to share experiences and ways to cope. The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) is an organization that can help individuals find qualified professionals and support resources in their area.

HealthyWomen.org is a comprehensive resource for women's health, providing information on various topics, including sexual health. Their sexual health section provides information on sexual dysfunction, as well as tips for improving communication with partners. The website also offers a directory of healthcare providers and support resources for women seeking additional help.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. 

Please see our Get Help Now page for more immediate resources.

Recent research has investigated the available psychological and behavioral treatments for FOD. One study highlights the efficacy of psychological treatments in helping women with FOD regain the ability to have orgasms. The most successful treatments were directed masturbation, sensate focus, and psychotherapy, while systematic desensitization, bibliotherapy, and coital alignment technique training had little evidence of efficacy. The author calls for more innovation in FOD treatment, which has seen little progress since the 1980s.

A recent review of 11 various studies examined the efficacy of bupropion in treating female sexual dysfunction. The review found that bupropion improved sexual desire and interest in individuals with sexual dysfunction. In addition, seven out of 11 studies in the analysis found that bupropion significantly enhanced the ability to achieve orgasm. Further research is needed to explore the effectiveness of bupropion in treating this aspect of female sexual dysfunction.

10% to 15% of women have never had an orgasm, but support is available

According to a study in MedlinePlus, 10% to 15% of women have never had an orgasm, and over 50% of women who have had an orgasm are not satisfied with how often they achieve it. However, there is hope, and experts note that lifestyle changes, self-care, therapy, and medical intervention may be beneficial for those hoping to increase their number of orgasms independently or with a partner.¹

¹MedlinePlus

Below are more statistics on female orgasmic disorder:

• In a randomly selected group of 1,749 women from the United States, 24% indicated that they were unable to reach orgasm for numerous months during the previous year.
• In a study conducted in the United States, it was found that 65% of straight women, in contrast to 95% of straight men, stated that they typically or constantly achieve orgasms with their partners. The same research indicated that 86% of women identifying as lesbians confirmed that they frequently or consistently experience orgasms with their partners.
• A clitoral vacuum device called the Eros Therapy Device may improve orgasm in 55% of women using the treatment for three months.