Disorders of Orgasm or Sexual Pain

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Disorders of Orgasm or Sexual Pain

What is a disorder of orgasm or sexual pain?

It is when an Individual can desire to have sex, become aroused during sexual activity, but not experience an orgasm. In addition, woman can experience significant pain or tightening of the pelvic muscles upon penetration (Nolen-Hoeksema, 2014).

  • Orgasmic disorder is the persistent or recurrent difficulty, delay, or absence of attaining orgasm after sufficient sexual stimulation and arousal (Elder & Braver , 2014).
  • Sexual pain disorder includes dyspareunia (genital pain associated with sexual intercourse); vaginismus (involuntary spasm of the vaginal musculature that causes interference with vaginal penetration), and non-coital sexual pain disorder (genital pain induced by non-coital sexual stimulation) (Elder & Braver , 2014).
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Possible cause of these disorders

Physical causes: Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause plus such chronic diseases as kidney disease or liver failure, and alcoholism or drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.
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Non-medical treatment

  • Talk and listen. Open, honest communication with your partner makes a world of difference in your sexual satisfaction. Even if you're not used to talking about your likes and dislikes, learning to do so and providing feedback in a nonthreatening way sets the stage for greater intimacy.
  • Practice healthy lifestyle habits. Go easy on alcohol — drinking too much can blunt your sexual responsiveness. Stop smoking — smoking restricts blood flow to your sexual organs, decreasing sexual arousal. Be physically active — regular physical activity can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy your sexual experience.
  • Seek counseling. Talk with a counselor or therapist who specializes in sexual and relationship problems. Therapy often includes education about how to optimize your body's sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises.
  • Use a lubricant. A vaginal lubricant may be helpful during intercourse if you experience vaginal dryness or pain during sex.
  • Try a device. Arousal improves with stimulation of the clitoris. Use a vibrator to provide clitoral stimulation. Although some women find clitoral vacuum suction devices helpful for enhancing sexual arousal, those devices can be cumbersome

Medical treatment

To treat sexual dysfunction tied to an underlying medical condition, your doctor might recommend that you:

  • Adjust or change medication that has sexual side effects
  • Treat a thyroid problem or other hormonal condition
  • Optimize treatment for depression or anxiety
  • Try strategies for relieving pelvic pain or other pain problems

Treating female sexual dysfunction linked to a hormonal cause might include:

  • Estrogen therapy. Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
  • Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower amounts of testosterone. Androgen therapy for sexual dysfunction is controversial, however. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction; other studies show little or no benefit.


Myth # 1: Women can achieve orgasm through penetration alone.

Many people believe that women are able to achieve an orgasm through penetration alone. While certainly some women have this ability, for a large number of women, this is not the case. Clitoral stimulation cannot always be achieved during penetration. Because of this unrealistic expectation, it is not uncommon for the heterosexual couple to feel like a failure if this is not achieved (Benuto, 2014).

Myth #2: He should be able to last longer.

There is definitely a debate regarding what defines premature ejaculation. On a more practical level we can simply look to the media to see that there is a large emphasis on how long a man can "last" during sex (Benuto, 2014).

You can overcome these common myths with educating yourself about the problems you are experiencing and seeking the proper help.

AASECT Requirements for Sex Therapist Certification

AASECT Code of Ethics

The applicant will have read the AASECT Code of Ethics. By signing the Code of Ethics form, the applicant agrees to be bound by the AASECT Code of Ethics.

Academic and Psychotherapy Experience
The applicant will have earned an advanced clinical degree that included psychotherapy training from an accredited college or university, and the following clinical experience as follows. Only coursework from accredited institutions and/or AASECT approved or sponsored courses will be accepted to fulfill content requirements for certification.

Master's degree plus two years of post-degree clinical experience.
- OR -
A Doctoral degree plus one year of post-degree clinical experience.

Clinical Certification
The applicant will hold a valid state regulatory license or certificate in one of the following disciplines: psychology, medicine, social work, counseling, nursing, or marriage and family therapy.

Applicants from outside the United States will document how their equivalent certification meets or compares to the AASECT requirements for certification.

Human Sexuality Education: Core Knowledge

The applicant will have completed a minimum of ninety (90) clock hours of academic coursework in sexuality education, covering general knowledge in the Core Knowledge areas listed below. Of these 90 clock hours of Core Knowledge, seventy-five (75) hours may be earned through E-learning. Education should be from an accredited university or college, may include some AASECT CE credits, or be a combination of both academic coursework and AASECT CEs.

How do I know if I have sexual dysfunction?

Sexual dysfunctions are defined as one or more disturbances in the sexual response cycle, or pain associated with arousal or intercourse. Lack of desire, difficulty becoming aroused, lack or delay in orgasm or pain during or after sex are all examples of sexual problems faced by women. Such problems can be occasional and seem to go away on their own. But when they are persistent or recurrent, disrupting your life or your relationships and causing you emotional upset, they may be dysfunctions that should be discussed with your health care professional.

What causes sexual dysfunctions?

Causes of sexual dysfunctions can be physical, psychological or related to interpersonal relationships or sociocultural influences.

How are sexual dysfunctions treated?

Treatment depends on the cause. If the cause is physical, the treatment will be aimed at correcting the medical or biological problem. Some medications can cause sexual problems, and changing prescriptions to those with fewer side effects can treat the problem. Regardless of the cause, counseling, ideally with a sexual therapist, is recommended and should include both partners together. Treatment can include both treating the physical or medical problem and counseling (Elder & Braver , 2014).


Benuto, L. (2014). Orgasmic disorders introduction and myths. Retrieved from http://www.sevencounties.org/poc/view_doc.php?type=doc&id=29701&cn=10

Elder, J., & Braver , Y. (2014). Female sexual dysfunction. Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/womens-health/female-sexual-dysfunction/

Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed.). New York: McGraw-Hill