Female Orgasmic Disorder

The main characteristic of Female Orgasmic Disorder is a chronic delay in, or absence of, orgasm after a sexual excitement phase.

The diagnostic criteria includes the following symptoms:

• 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.

• The disturbance causes marked distress or interpersonal difficulty.

• 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.

Subtypes

Subtypes are provided to indicate the onset, context, and etiological factors associated with the Sexual Dysfunctions.

Lifelong: This subtype applies if the sexual dysfunction has been present since the onset of sexual functioning.

Acquired: This subtype applies if the sexual dysfunction develops only after a period of normal functioning.

Generalized Type: This subtype applies if the sexual dysfunction is not limited to certain types of stimulation, situations, or partners.

Situational Type: This subtype applies if the sexual dysfunction is limited to certain types of stimulation, situations, or partners. The specific situational pattern of the dysfunction may aid in the differential diagnosis.

Due to Psychological Factors: This subtype applies when psychological factors are judged to have the major role in the onset, severity, exacerbation, or maintenance of the Sexual Dysfunction, and general medical conditions and substances play no role in the etiology of the Sexual Dysfunction.

Due to Combined Factors: If sexual dysfunction is attributed solely to substance abuse or a medical cause, Sexual Dysfunction Due to a General Medical and/or Substance-Induced Sexual Dysfunction is diagnosed. This subtype applies when 1) psychological factors are judged to have a role in the onset, severity, exacerbation, or maintenance of the Sexual Dysfunction; and 2) a general medical condition or substance use is also judged to be contributory but is not sufficient to account for the Sexual Dysfunction.

Associated Features

Sexual dysfunction may be associated with Mood Disorders and Anxiety Disorders (Obsessive-Compulsive Disorder, Panic Disorder With Agoraphobia, and Specific Phobia).

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.