Problems In the Bedroom: Orgasmic Disorder

Posted by Frank Gillespie MA

After discussing desire phase disorders and sexual arousal disorders in our four-part series this article is addressed to orgasmic disorders. Luckily, there is help for these problems too.

Sex therapist (usually a psychologist or psychotherapist) is a person who can help you solve these problems using the methods of psychotherapy, couples therapy and sex therapy. The assistance is based on discussions, homework, and sometimes demonstrations with certain aids. The key to success is in the hands (and in the feelings and thoughts) of the clients. The therapist will help you find the way to a happy sexual life. During the discussions the couple talks in detail about their problems encountered during sex. It is important that the couple clarifies between each other what they want to achieve and they also say it out loud. The therapy makes sense only if the couple aims to develop together and be happy together.

The male and female orgasm

Men and women experience orgasm in very different ways. First of all there is an obvious evidence for male orgasm, usually. Not so obvious in case of women though. Also, in case of women professionals rather talk about a scale with a very pleasant peak-phase at one end and the real orgasm the other end.

Several studies have shown that women are not always able to clearly distinguish these two phases, their experience is often somewhere between the two.

What types of orgasm exist?

There is a debate about vaginal and clitoral orgasm. Based on some beliefs, standards or expectations a lot of people think that vaginal orgasm is superior to the clitoral orgasm. This is not true, both sensations are equivalent (if it makes sense to talk about values at all, because these are experiences which do not necessarily need to be compared at all costs). Statistics show that 80% of women can only reach clitoral orgasm while only 20% can experience satisfaction vaginally. In fact, the same process occurs in the brain in both cases, so there aren`t really different types of orgasmic experience. Of course, one or the other skill can be acquired according to individual needs (trainings exist for learning how to achieve vaginal orgasm), but the inability to achieve vaginal orgasm is not a symptom of orgasmic dysfunction.

Female orgasmic disorder

Delayed orgasm is when the orgasm occurs persistently or recurrently very long after the sexual arousal phase. We can talk about inhibited orgasm (or anorgasmia, the inability to achieve orgasm) when the orgasm doesn’t occur at all.

According to some studies, 10-15% of women never experienced any orgasm in their lives. The same percentage only achieve sexual satisfaction very rarely. However half of all women experience `La petite mort` (`little death`) regularly.

Female orgasmic disorder may be caused by many factors. If a woman is struggling with feelings of inferiority, if she has a negative self- and body image, she will be unable to feel attractive, and enjoy sexuality freely. The more of a `good girl` a woman, the more characterized by obedience and passivity the more likely the occurrence of orgasmic disorders. Fear of losing control is also a common cause. Severe past traumas, sexual violence or abuse may also be in the background. Incorrect communication within the relationship, inability to adapt, lack of reciprocity all could worsen the situation.

Solution for women

After exploring the causes your therapist may give you `homework`. If you are not aware of your own anatomy, first you have to gain experiences about yourself. In some cases your therapist may offer you tools to help you achieve orgasm which can also be helpful for men to learn what is pleasant for their partner. With the so called orgasm training you can learn how to achieve sexual satisfaction- because it is not only your partner`s responsibility.

Finding the solution is much easier for those couples who can communicate with each other openly in bed too. Many women try to `solve problems` by faking orgasm. In this case the problem remains hidden and unsolved because the partner may feel everything is fine as it is. The couple`s sex life is now scarred with dishonesty.

Men in hurry

Male orgasmic disorder is characterized by two extremes: the orgasm either occurs too early or too late. Premature ejaculation (ejaculatio praecox) is the uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. In a broader sense, premature ejaculation is considered premature when the person ejaculates before he or his partner wishes. Ejaculatio praecox is the most common male orgasmic disorder, affecting at least 25% of men.

Causes of premature ejaculation are almost always psychological (except maybe one biological subtype when the glans is extremely sensitive). Inexperienced young men who are unfamiliar with how to control ejaculation reach orgasm typically quicker than more experienced men. But the main factor is mostly stress. Either work problems or relationship problems can make a man feel like `Let`s get it over with!` Mild and short-term stress can be stimulating but increased and long-term stress can destroy sexual function.

Late men

The other extreme is inhibited or delayed ejaculation. This means a man is unable to achieve orgasm (or just very late) despite of right sexual desire and excitement. This problem is fairly rare affecting only 1-3% of men. It is typically caused by anxiety or some kind of fear: guilt induced by rigid religious rules, fear of unwanted pregnancy, pressure to perform, or previous sexual trauma. Inhibited orgasm can also be caused by physical or chemical factors, for example low testosterone level, certain drugs or medications that inhibit the activity of the sympathetic nervous system. Many men who experience similar sexual dysfunction due to medications stop taking it without discussing it with their physician, causing serious diseases remaining without adequate treatment. If you have sexual complaints due to medications, talk to your doctor who will modify your treatment!

Solution for men

How to stop premature ejaculation? With practice. During the so-called sensory –motor training you can learn how to delay ejaculation. During masturbation stopping at the state near to the orgasm but before ejaculation can lower the level of excitement. Then you can start stimulating again and stop again and so on. The so-called acclimatization technique (or start & stop method) is based on the same method only this is exercised by the couple: after the intercourse stop when close you feel close to the orgasm, then continue when the feeling of excitement is decreased. Constriction techniques can be also effective (applying pressure on the base of the glans can delay ejaculation) or withholding the testicles (preventing the elevation).

Experts warn though, there are many sexual therapy techniques to be found on the internet or in magazines, but it doesn’t mean that everybody should or can use them. It is better if the treatment is controlled by a professional therapist, who can determine after how much `practice` a couple or the individual can move forward to the next level. The therapist also asks the couple about their experiences: how did they feel, what did they think in a certain situation. Communicating about each other’s sexual behavior and getting to know each other better can enhance the sexual experience. It is only worth to proceed if the new skill has already been imprinted.

The Masters and Johnson technique:

The sensate focus exercises are built on successive phases:

1. The partners can touch, stroke, or kiss each other except the breasts and genital areas. 2. The partners can touch each other everywhere but cannot attempt intercourse, or touching that leads to orgasm. 3. Intercourse may happen at this stage, the woman can have orgasm but not yet the man. 4. Both of the parties can reach orgasm

The sensate focus exercises are built on successive phases:

Orgasm, the little death

The sensate focus exercises are built on successive phases:

A few centuries ago it was considered that too much sex can cause death. Our ancestors had a logical conclusion from the signs of orgasm that it could be some kind of death. This is why we call orgasm `little death` following the French expression `la petite mort`. Indeed, the experience of the peak of sexual pleasure is similar to a sort of `coma`. Experts examining women`s brain function with PET device found that in those few seconds of sexual pleasure the brain gets into a very deep and relaxed state while the area responsible for fear, concern and anxiety turns off completely. Perhaps this calm, relaxed phase is also the key to successful fertilization.

Frank Gillespie MA

Frank Gillespie has a Master's Degree in Counseling from LaSalle University in Philadelphia. He is a nationally Certified Counselor (NCC). He has provided therapy for over 23 years. During his career, he has helped more than 10,000 people move past their obstacles towards reaching their potential and fulfillment in their lives. He practices Cognitive Behavioral Therapy with a warm and nurturing approach. In addition to being a therapist, Frank has been an adjunct college professor teaching social work, a clinical consultant, a clinical director, and a seminar speaker. Frank has recently retired from his full time practice to focus on a part time online practice. He is married. He enjoys listening to music, watching sports, power walking, swimming, reading and writing.


- Dating - Relationships - Anxiety - Addictions - Anger Management - Bipolar Disorder - Codependency - Depression - Domestic Abuse - Self Esteem - Behavioral Issues - Coping - Divorce - Grief
Talk with Frank Gillespie