Female orgasmic disorder

Question 1

Definition

Answer 1

ICD: Orgasm either does not occur or is markedly delayed

DSM: There is a marked delay in or marked infrequency of or absence of orgasm. There may also be a markedly reduced intensity of orgasmic sensations.

Question 2

Physiological causes

Answer 2

Chronic medical conditions:
o CVD, DM, neurological disorder, renal/liver problems

Hormonal disorders:
o oestrogen and/or androgen insufficiency, hypothyrpidism

Pelvic floor weakness or damage

Ageing (causes pelvic floor weakness)

Prescribed medication especially SSRIs

Question 3

Psychological causes

Answer 3

Mental health conditions:
o depression, anxiety, substance misuse

Previous abuse

Couple script problems

Couple relationship problems

Cultural and religious issues

Lack of understanding

Environmental factors

Stress

Question 4

Ix

Answer 4

Bloods - FBC, thyroid screen, diabetes screen, hormone screen

Physical examination

Question 5

Medical tx

Answer 5

Topical oestrogen

Question 6

Psychological tx

Answer 6

Individual psychotherapy with sex therapy focus – promote changes and attitudes in sexually relevant thoughts and couples therapy through guided meditation

Question 7

Behavioural tx

Answer 7

education

personal sexual growth programme

guided masturbation

lubricant and vibrators

kegel exercises

relaxation

mindfulness