Anorgasmia, also known as Coughlan’s syndrome, is a form of sexual dysfunction. The primary symptom of anorgasmia is the failure to climax during sexual intercourse. Some patients may also experience a decreased intensity of orgasms, take a longer time than usual to achieve orgasms, and experience pain in lower abdomen or pelvic region during sexual intercourse. These symptoms can produce marked distress for the individual.

Anorgasmia is diagnosed when there is a markedly reduced intensity or frequency of orgasms for at least six months that causes significant distress. When there is consistent difficulty in eliciting an orgasm, Female Orgasmic Disorder (FOD) may be diagnosed. This condition is more commonly seen in women, especially those in the post-menopausal age group. According to studies, this occurs anywhere from 10% to 33% of women.

Experts classify anorgasmia into several different types. Primary anorgasmia, or lifelong anorgasmia, is the type wherein an individual has never experienced an orgasm. Meanwhile, secondary anorgasmia, or acquired anorgasmia, is difficulty in achieving an orgasm in an individual that has previously had normal sexual function. Situational anorgasmia is the most frequently encountered type, wherein an individual can only reach orgasm in specific instances or with specific partners. Finally, general anorgasmia is the type wherein an individual cannot achieve an orgasm, regardless of the circumstances or partner.

Orgasm is a complex psychological and physiological process. While there is rarely a single root cause for FOD.

anosgarmia

There are many potential factors that can keep a woman from reaching orgasm consistently or with satisfying intensity. Stress of any kind is often a major contributing factor to a reduction in the frequency or intensity of orgasms.

The following considerations may contribute to female anorgasmia:

Medical

Illnesses and medical conditions of any kind can impact psychological and physical health in a way that impedes orgasm.

Psychological

Stress and anxiety are major impediments to experiencing the relaxation necessary for sexual release. Mental health diagnoses, such as mood disorders, can impact the ability to orgasm. Shame or guilt around sexual activity, body image issues, or a history of trauma or abuse may also be factors in female anorgasmia.

Relational

Unresolved conflict, such as broken trust or infidelity, may make it difficult to achieve sexual connection and satisfaction. A lack of clear communication around sexual preferences may also contribute to FOD.

Substance Use

Consuming alcohol, cigarettes, or other controlled substances can interrupt the process of orgasm by impacting neurological function or blood flow to the genitals. 

Aging

Physiological changes over the lifespan can alter a woman’s ability to orgasm reliably. Anatomical and hormonal shifts through pregnancy, childbirth, and lactation may impact the ability to orgasm. Reduction in estrogen levels during perimenopause and menopause decreases blood flow to the genitals and may contribute to FOD.

Treatment of Female Orgasmic Disorder (FOD)

Treatment for FOD will vary depending on the underlying causes and how long female anorgasmia has been a problem. The first step will be consulting with your doctor about potential FOD, they will typically perform a medical examination, which includes a pelvic exam, in order to rule out any anatomical reasons for lack of orgasm. Your doctor will also take a detailed medical history to explore possible causation.

Be prepared to answer questions about your sexual history, including any sexual trauma, when and how you have experienced orgasm (if ever) and when your experience of orgasm began to change. Bring a list of any past or current medical conditions and medications, including dosage and duration.

There are several methods of treatment that may help when dealing with female anorgasmia. These include:

Lifestyle Changes

Diet, exercise, and stress levels can all impact sexual function. Your doctor may ask you to engage in practices that improve these areas of health.

Physical Therapy

If pelvic tension or muscular laxity is a contributor to orgasmic issues, physical therapists that specialize in pelvic dysfunction may be an appropriate referral.

Sex Education

A better understanding of anatomy and sexual technique can help you discover your own sexual response patterns and improve the frequency and intensity of orgasm.

Estrogen Therapy

Typically for postmenopausal women, estrogen in the form of a pill, patch, or gel may reduce menopausal symptoms and improve sexual response. Local estrogen such as a vaginal cream or ring can also increase blood flow to the area and improve the frequency and quality of orgasm.

Testosterone Therapy

Although the exact mechanism is not known, testosterone plays a role in healthy female sexual function. Testosterone replacement therapy can improve the frequency and quality of orgasm. However, side effects such as acne, excess body hair, and male-pattern baldness can occur.

Medication Adjustment

Many over-the-counter and prescribed medications can impact sexual function. Your doctor may adjust your medication levels or replace your current medication with a chemically similar compound that could result in a reduction of sexual side effects.