Sexuality is a major concern in people, regardless of their sex or gender. Generally, the cycle of sexual response ends at orgasm. Therefore, living in a hypersexualized society and not having orgasms assiduously seems a sacrilege. But is this really a problem?
Different studies show that the definition of orgasm is not easy, since it is something that is experienced in a very subjective way. Broadly speaking, it can be said that it is a variable and transitory peak sensation of intense pleasure, which creates an altered state of consciousness accompanied by rhythmic and involuntary contractions of the pelvic muscles, with an induction of well-being and joy.
Any person who has experienced an orgasm can recognize it, even if the definition was different. But when it doesn’t happen, what happens? We are facing an orgasm disorder. This is defined as the permanent or recurring difficulty, delay or absence of reaching orgasm after sufficient sexual stimulation, causing personal distress. It is what is known as anorgasmia or absence of orgasms.
Possible causes of anorgasmia
The causes can be very different from one person to another, since psychological, cultural and physical factors influence orgasm.
Among the physical factors we can find hormonal disorders, such as the decrease in testosterone levels, the influence of other medications (mainly SSRIs) or any injury or alteration of both the genitalia and the parts of the body involved in the sexual response (injury bone marrow injury or pelvic floor musculature injuries). Age or chronic diseases also play a role.
On the other hand, psychological factors, as in other sexual dysfunctions, are very present in anorgasmia. Specifically, depressive and anxiety disorders decrease desire and arousal.
In addition, negative previous sexual experiences, stories of abuse and mistreatment, or traumatic or loss experiences are included in this group. Also, milder things such as the fear of letting go or anxiety about sexual performance, which taken to the extreme can make the person unable to reach orgasm by not avoiding these intrusive thoughts.
Finally, cultural factors can play a role. Among them, we find those that are interconnected with the present relationship, lack of communication or intimacy, insufficient erotic games, sexual encounters that end before the woman is aroused enough or problems in the relationship.
It is important to explain that there are also other cultural problems, mainly in the case of women, in which the sexual response is influenced by a negative cultural conditioning over the centuries, a scarce sexual education or a negative attitude towards sex .
But identifying the causes is not that simple. Anorgasmia, like most sexual dysfunctions, is usually not due to only one factor, but to a set of several at the same time. In the same way, it does not usually appear alone, as it is usually accompanied by other dysfunctions. If one phase of the cycle is disturbed, others are decompensated. Therefore, the treatments are usually varied.
Is there a treatment?
The types of treatment depend largely on the causes of the anorgasmia. The most common are psychosexual and pharmacological treatments.
Pharmacological treatments depend, to a great extent, on each person. Among the most common, is mainly the use of testosterone. Other drugs that are also used are phosphodiesterase 5 (PDE-5) inhibitors, as well as anxiolytics.
On the other hand, the most recommended option for anorgasmias caused by psychological and cultural factors are psychosexual therapies. As a starting point, sensory and sexual eroticization is recommended for both men and women with anorgasmia.
In the same way, it seeks to provide sexual information to counteract sexual myths and work on negative attitudes and thoughts. Self-stimulation and directed masturbation, personal or as a couple, are favored.
Sensory targeting programs are carried out, which are a type of systematic desensitization, psychological therapy applied to the sexual sphere. In them, the person is exposed to sensual and sexual situations with increasing levels of difficulty and anxiety.
Finally, erotic toys are used, among which are mostly clitoral suckers and vibrating male masturbators.
Based on the above, it can be said that anorgasmia has long been considered culturally and scientifically a sexual dysfunction of women, although it has been seen that this is not the case and that men can also suffer from it.
Based on the question we asked ourselves about whether it is a health problem or not, we can say that for it to be considered a problem, two essential characteristics must be given: that orgasm does not occur despite having adequate sexual stimulation and causing distress to the person. If you are in doubt but you do not meet these two requirements, then it is probably not for you.
Cristina Guerra Marmolejo, PDI. Nursing and Podiatry Department. Nurse and Sexologist, University of Malaga
This article was originally published on The Conversation. Read the original.
