Female orgasmic disorder (FOD) is the persistent or recurrent inability of a woman to have an orgasm (climax or sexual release) after adequate sexual arousal and sexual stimulation. According to the handbook used by mental health professionals to diagnose mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (also known as the DSM-IV-TR), this lack of response can be primary (a woman has never had an orgasm) or secondary (acquired after trauma), and can be either general or situation-specific. There are both physiological and psychological causes for a woman's inability to have an orgasm. To receive the diagnosis of FOD, the inability to have an orgasm must not be caused only by physiological problems or be a symptom of another major mental health problem. FOD may be diagnosed when the disorder is caused by a combination of physiological and psychological difficulties. To be considered FOD, the condition must cause personal distress or problems in a relationship. In earlier versions of the Diagnostic and Statistical Manual of Mental Disorders,FOD was called "inhibited sexual orgasm."
FOD is the persistent or recurrent inability of a woman to achieve orgasm. This lack of response affects the quality of the woman's sexual experiences. To understand FOD, it is first necessary to understand the physiological changes that normally take place in a woman's body during sexual arousal and orgasm.
Normally, when a woman is sexually excited, the blood vessels in the pelvic area expand, allowing more blood to flow to the genitals. This is followed by the seepage of fluid out of blood vessels and into the vagina to provide lubrication before and during intercourse. These events are called the "lubrication-swelling response."
Body tension and blood flow to the pelvic area continue to build as a woman receives more sexual stimulation; this occurs either by direct pressure on the clitoris or as pressure on the walls of the vagina and cervix. This tension builds as blood flow increases. When tension is released, pleasurable rhythmic contractions of the uterus and vagina occur; this release is called an "orgasm." The contractions carry blood away from the genital area and back into general circulation.
It is normal for orgasms to vary in intensity, length, and number of contractions from woman to woman, as well as in a single individual from experience to experience. Unlike men, woman can have multiple orgasms in a short period of time. Mature women, who may be more sexually experienced than younger women, may find it easier to have orgasms than adolescents or the sexually inexperienced.
In FOD, sexual arousal and lubrication occur. Body tension builds, but the woman is unable or has extreme difficulty reaching climax and releasing the tension. This inability can lead to frustration and unfulfilling sexual experiences for both partners. FOD often occurs in conjunction with other sexual dysfunctions. Also, lack of orgasm can cause anger, frustration, and other problems in the relationship.
Tish Davidson A.M., The Gale Group Inc., Gale, Detroit,