Anorgasmia in women


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Preparing for your appointment

By Mayo Clinic staff

If you rarely or never experience orgasm from sexual activity and it's causing you distress, make an appointment with your doctor. You may feel embarrassed to talk about sex with your doctor, but this topic is perfectly appropriate. Your doctor knows that a satisfying sex life is very important to a woman's well-being at every age and stage of life.

You may have a treatable, underlying condition, or your may benefit from lifestyle changes, therapy or a combination of treatments. Your regular doctor may diagnose and treat the problem or refer you to a specialist who can.

Here's some information to help you prepare for your appointment, and what to expect from your doctor.

Information to write down in advance

  • Your symptoms. It will help your doctor to know whether you've ever had an orgasm, and if so, under what circumstances.
  • Your sexual history. Your doctor likely will ask about your relationships and experiences since you first became sexually active. He or she may also ask about any history of sexual trauma or abuse.
  • Your medical history. Write down any medical conditions with which you've been diagnosed, including mental health conditions. Also note the names and strengths of all medications you're currently taking or have recently taken, including prescription and over-the-counter drugs.
  • Questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Basic questions to ask your doctor
The list below suggests questions to raise with your doctor about anorgasmia. Don't hesitate to ask more questions during your appointment at any time that you don't understand something.

  • What may be causing my difficulty to orgasm?
  • Do I need any medical tests?
  • What treatment approach do you recommend?
  • If you're prescribing medication, are there any possible side effects?
  • How much improvement can I reasonably expect with treatment?
  • Are there any lifestyle changes or self-care steps that may help me?
  • Do you recommend therapy?
  • Should my partner be involved in treatment?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

What to expect from your doctor
Your doctor may ask a number of very personal questions and may want to include your partner in the interview. To help your doctor determine the cause of your problem and the best course of treatment, be ready to answer questions such as:

  • When did you first become sexually active?
  • For how long have you had difficulty reaching orgasm?
  • If you've had orgasms in the past, what were the circumstances?
  • Do you become aroused during sexual interactions with your partner?
  • Do you experience any pain with intercourse?
  • How much are you bothered by your lack of orgasm?
  • How satisfied are you with your current relationship?
  • Are you using any form of birth control? If yes, what form?
  • What medications are you taking, including prescription and over-the-counter drugs as well as vitamins and supplements?
  • Do you use alcohol or recreational drugs? How much?
  • Have you ever had surgery that involved your reproductive system?
  • Have you been diagnosed with any other medical conditions, including mental health conditions?
  • What were your family's beliefs about sexuality?
  • Have you ever been the victim of sexual violence?

What you can do in the meantime
While you wait for your appointment, be open with your partner about the situation. Continue to be active with intercourse, and also explore other ways of being intimate. Shifting the focus from orgasm to pleasure may be a helpful strategy in treating anorgasmia.

References
  1. Frank JE, et al. Diagnosis and treatment of female sexual dysfunction. American Family Physician. 2008;77:635.
  2. Kammerer-Doak D, et al. Female sexual function and dysfunction. Obstetrics and Gynecology Clinics of North America. 2008;35:169.
  3. Kingsberg SA, et al. Female sexual disorders: Assessment, diagnosis and treatment. Urologic Clinics of North America. 2007;34:497.
  4. Ferri FF. Ferri's Clinical Advisor 2012: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP&isbn=978-0-323-05611-3&uniqId=291436269-101. Accessed Jan. 9, 2012.
  5. Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed Jan. 9, 2012.
  6. Ginsberg TB. Aging and sexuality. The Medical Clinics of North America. 2006;90:1025.
  7. Shifren JL. Sexual dysfunction in women: Management. http://www.uptodate.com/home/index.html. Accessed Jan. 11, 2012.
  8. Shifren JL. Sexual dysfunction in women: Epidemiology, risk factors, and evaluation. http://www.uptodate.com/home/index.html. Accessed Jan. 11, 2012.
  9. IsHak WW, et al. Disorders of orgasm in women: A literature review of etiology and current treatments. Journal of Sexual Medicine. 2010;7:3254.
  10. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins - Gynecology. ACOG Practice Bulletin No. 119: Female sexual dysfunction. Obstetrics & Gynecology. 2011;117:996.
DS01051 Feb. 22, 2012

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