A. Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of Female Orgasmic Disorder should be based on the clinician's judgment that the woman's orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The orgasmic dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
Female orgasmic disorder (FOD) is a woman who, despite normal physical condition, struggles to reach orgasm or cannot reach orgasm at all. It is important to note that to qualify for this disorder; they cannot meet criteria for other disorders such as an anxiety disorder or depression.
For suffers of FOD, attempting to reach orgasm is a struggle and becomes a stressful topic for them. This distress over orgasm difficulty, only makes future orgasms more difficult to achieve.
To truly qualify for FOD, the individual would need sexual excitement and intensity of stimulation that would trigger another woman to reach orgasm. If for any reason there is a factor that inhibits them from getting the normal level of sexual excitement, they would not qualify for FOD.
The occasional failure to be reach orgasm or dependence on a particular type of stimulation is not the same as FOD.
FOD is most often a primary or lifelong disorder, meaning that a woman has never achieved orgasm under any type of stimulation, including self-stimulation (masturbation), direct stimulation of the clitoris by a partner, or vaginal intercourse. Some women experience secondary FOD where they were once able to reach orgasm but have now lost it due to a life event or illness, medication or surgery
FOD can be generalized in that the woman will have difficulty reaching orgasm in all situations, or it can be situation-specific. In generalized FOD, the failure to have an orgasm occurs with different partners and in many different settings. In situational FOD, inability to reach climax occurs only with specific partners or under particular circumstances. FOD may be due either to psychological factors or a combination of physiological and psychological factors, but not due to physiological factors alone.
Physiological causes of FOD include:
Psychological causes of FOD include:
FOD is more likely to have a psychological, rather than a physical cause. Inadequate time spent in foreplay, inadequate arousal, lack of appropriate sexual stimulation, poor sexual communication with a partner, and failure to continue with stimulation for an adequate length of time may cause failure to climax, but are not considered causes of FOD.
Treatment for FOD should start with a consult with your primary care physician to rule out physical problems. Since there are so many different causes for FOD its important to look into all possible causes. If your physician finds no physical cause, psychotherapy is the next line of defense. However, chances are that a combination of treatment from your physician and from a mental health professional will have the best outcomes.