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Key points
- Sexual satisfaction is now considered an important factor contributing to overall well-being by the WHO.
- It is widely acknowledged that the most important single predictor of sexual satisfaction for women is orgasm.
- Thirty to fifty percent of women worldwide report some level of orgasm difficulty.
It is widely acknowledged that the most important single predictor of sexual satisfaction for women is orgasm. The ability to experience sexual satisfaction is now considered by the World Health Organization as an important factor contributing to overall well-being and impacting global health. Because this is so critical, I have addressed this issue in a previous post where I share tools for working through obstacles to experiencing orgasm. Here, I give an update about new developments in the field of sexology.
Thirty to fifty percent of women worldwide report some level of orgasm difficulty (OD), a statistic that has not changed in 50 years. Studies show that although women may not be formally diagnosed with OD, about half still indicate moderate to high distress regarding their condition. It is the second most frequently reported sexual problem (with lack of sexual desire coming in at number one).
A conversation with a pioneer in sexual wellness
In this post, I share the highlights of my conversation with Suzanne Mulvehill, founder of the Female Orgasm Research Institute (for the full interview, see here).
We discuss the correlation between mental health conditions and OD in women and highlight the importance of relaxation and focus during sexual experiences. Last but not least, we discuss how research has shown that cannabis may be of help.
Orgasm difficulty in women can have various underlying psychological and physical factors
The most frequently mentioned reasons for OD are (in order) stress/anxiety, arousal difficulty, sex-specific anxiety, and issues with their partner.
The use of antidepressant and antipsychotic medications, illness, sexual trauma, and stigmatization can also contribute to sexual dysfunction and OD.
The psychological toll of orgasm challenges
The feelings reported by women with OD include frustration, feelings of inadequacy, relationship issues, familial discord and divorce, and a negative impact on general mental health.
The loop of stress leading to sexual and general frustration can lead to more feelings of inadequacy, brokenness, and loss of self-esteem which in turn creates more stress. The feeling of brokenness for women about their sexuality is common.
These difficulties can be influenced by multiple factors such as age, hormonal status, sexual experience, history of physical or psychological trauma, general mental health, type of stimulation, and the nature of the sexual activity.
A recent study by Mulvehill found that women diagnosed with OD reported 24% more mental health issues than non-OD women, 52% more PTSD, and 29% more depressive disorders.
Three types of OD
OD can be broken down into three categories: primary, acquired and situational. (Anorgasmia is the technical term for problems experiencing orgasm.) Primary OD is when the person has never ever had an orgasm. Acquired or secondary anorgasmia is when one could previously orgasm but is no longer able to do so. Situational OD refers to particular circumstances in which one is unable to orgasm (for example during partnered sex vs. masturbation).
What you can do if you are experiencing OD
First and foremost: Don't panic. It is not unusual for our ability to experience orgasm to come and go (pun intended). It is precisely when people start to panic about not experiencing orgasm that it becomes a thing. As I like to say, "A watched orgasm never boils." Once we become self-conscious about orgasm, we tend to get into our heads about it. Good sex starts with being in our bodies and our sensations. When we can be in our sensations, sex tends to be sensational.
I advise clients who report ongoing symptoms of OD to learn to take a stand for what they need and want to increase the probability that they will experience orgasm, whether it's with a partner or solo.
Mulvehill says we need to become friends with our sexual style (and yes, we all have unique erotic fingerprints, which is how we inhabit and express our own sexuality and relate to lovers) We also need to know what relaxes us, helps us focus and turns us on. She emphasizes the importance of feeling safe and understood by our partners.
New report: Cannabis and OD
Recently, for her doctoral dissertation, Mulvehill studied the use of cannabis before sex by women with OD. In her study, women who reported a history of sexual abuse had a more positive orgasm experience when using cannabis before partnered sex. Another recent study found that women who use cannabis are twice as likely to experience orgasm.
Mulvehill, together with Jordan Tischler, a Harvard Medical School professor and cannabis specialist who treats sexual issues are behind efforts to get OD on the list of conditions for which medical cannabis can be prescribed.
This important new research into this aspect of women's sexual wellness deserves more attention and study.
Related conditions and how to navigate OD
An experience related to OD is a lack of spontaneous sexual desire. Although lack of desire might be a factor that contributes to orgasm disorders, in my clinical experience I see many women who orgasm easily but report no spontaneous sexual desire.
My advice for women experiencing OD is to communicate, explore, practice masturbation, and Kegel, Kegel, Kegel. A Kegel practice can be a powerful part of tuning up the orgasm machinery. Remember you can't play in a band unless you've already learned how to play your own instrument!
Further, if you have shame about sex or have traumas large or small, you should talk to a therapist. It will allow you to unpack and reevaluate old learning around sex and update your map.
We need to radically accept what is while at the same time celebrating our bodies, our senses, and our sexual selves.
In conclusion
It is important to know that orgasms, while not the be-all-end-all of the sexual world, can become more available when we say "Yes!" to the experience we are having. When we can simply allow the sensations to feel good, without striving for an orgasm or bigger or better sexual experiences, paradoxically we can release ourselves into the sensations, and feel more connected to ourselves and our partner. What we know from individuals who report sexual satisfaction over a lifetime is that good sex is sex that is about connection.
References
Mulvehill, S. (2023). Cannabis for the Management of Female Orgasm Difficulty/Disorder: An Observational Study (Doctoral dissertation, Florida Atlantic University).
Wise, N. (2020). Why good sex matters: Understanding the neuroscience of pleasure for a smarter, happier, and more purpose-filled life. Houghton Mifflin.
