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Orgasmic Disorders

Female Orgasmic Disorder (FOD) is defined by the delay of orgasm or inability to reach orgasm, even after sufficient arousal. Primary Female Orgasmic Disorder refers to when a woman has never experienced an orgasm. Secondary Female Orgasmic Disorder refers to when a female has achieved orgasm in the past, but then loses the ability to reach climax.

The experts in the Skyline Urology Women’s Health program will work with you to evaluate your condition, apply the most advanced diagnostic techniques to discover if the cause is psychological or physical in nature, and will personalize your care to improve your sexual and reproductive health.


Common symptoms of Orgasmic Disorders in women includes:

  • Painful intercourse
  • Lack of sufficient lubrication
  • Lack of interest in sexual activity
  • Inability to have an orgasm even with adequate stimulation


Like with many sexual and reproductive issues in women, the causes of Female Orgasmic Disorders are not entirely understood, but are believed to be primarily psychological in origin. Almost all women have difficulty achieving orgasm at times, but when the problem becomes pervasive and is causing distress the condition should be evaluated for a potential physical cause.

Physiological causes of FOD include:

  • Damage to the blood vessels of the pelvic region
  • Spinal cord lesions
  • Damage to the nerves in the pelvic area
  • Illicit substance abuse
  • Side effects of medications (antipsychotics, antidepressants, narcotics)
  • Female genital mutilation, or removal of the clitoris

Psychological causes of FOD include:

  • History of rape or other trauma
  • Fear of pregnancy
  • Self-image issues
  • Relationship problems with partner
  • Stress
  • A mental health concern such as depression

Evaluation and Diagnosis:

In order to evaluate FOD, your physician will conduct a complete physical examination, and will evaluate your medical and psychological history to determine if the condition is primary or secondary. FOD is often found in conjunction with other female sexual and reproductive health conditions such as decreased sexual desire or sexual dysfunction. To be diagnosed with FOD, the lack of orgasmic response must occur regularly over an extended period of time, and it causes emotional distress or relationship difficulties for the woman.  FOD is also not diagnosed if it is a symptom of another major psychological disorder, such as depression.


Treatment for orgasmic dysfunction depends on the cause. You may need to:

  • Treat any underlying conditions
  • Switch antidepressant medications
  • Try some form of talk therapy, such as cognitive behavioral therapy or sex therapy, perhaps with your partner
  • Utilize estrogen hormone therapy to improve desire and blood flow to the genitals