Anorgasmia is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with "adequate" stimulation. Anorgasmia is far more common in females than in males and is especially rare in younger men. Sexual problems, also called sexual dysfunction or sexual malfunction, are defined as difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. ... The Scream, the famous painting commonly thought of as depicting the experience of mental illness. ... An orgasm, also known as a sexual climax, is a pleasurable physical, psychological or emotional response to prolonged sexual stimulation. ...

A common cause of anorgasmia, in both men and women, is the use of anti-depressants, particularly the selective serotonin reuptake inhibitors (SSRIs). Though reporting of anorgasmia as a side-effect of SSRIs is not precise, it is estimated that 15-50% of users of such medications are affected by this condition. Some popular SSRIs are Effexor, Lexapro, Paxil, Prozac and Zoloft. Frequently this side effect will lessen in degree, or disappear altogether, during the first few weeks or months after starting treatment with such drugs. Sometimes the condition is permanent, such that it persists even after the drugs are discontinued. The chemical amantadine has been shown to cure SSRI-induced anorgasmia in some people, though not in all people. An antidepressant is a medication used primarily in the treatment of clinical depression. ... Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants for treating depression, anxiety disorders and some personality disorders. ... Venlafaxine hydrochloride is a prescription antidepressant first introduced by Wyeth in 1993, and marketed under the tradename Effexor®. It is used primarily for the treatment of depression, generalized anxiety disorder, and social anxiety disorder in adults. ... Escitalopram oxalate (also known as LexaproTM and CipralexTM) is a medication developed by the Danish pharmaceutical company Lundbeck, that acts as a selective serotonin reuptake inhibitor or SSRI. It is typically used as an antidepressant to treat depression associated with mood disorders although also may be used in the treatment... Paroxetine (paroxetine hydrochloride; trade names Paxil® (United States), Seroxat® (UK), Aropax® (Australia)) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. ... Background Fluoxetine hydrochloride (brand names include Prozac®, Symbyax® (compounded with olanzapine), Sarafem®, Fontex® (Sweden), Fluctine (Austria, Germany), Prodep (India), Fludac (India)) is an antidepressant drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, and many other disorders. ... Sertraline hydrochloride (Zoloft®, Lustral®, Apo-Sertral®, Asentra®, Gladem®, Serlift®, Stimuloton®) is an orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. ... Amantadine, 1-aminoadamantane, is an antiviral drug that was approved by the FDA in 1976 for the treatment of influenza type A in adults. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ...

One proposed—and disputed—cause of anorgasmia during intercourse in younger men is a particular masturbation style—according to two doctors and one psychologist who have coined the term traumatic masturbatory syndrome. The word intercourse in its broadest sense refers to any kind of human communication and interaction. ... Masturbation is the manual excitation of the sexual organs, most often to the point of orgasm. ... Traumatic masturbatory syndrome (TMS) is a proposed sexual dysfunction suggested by Lawrence I. Sank, Ph. ...

The rest of this article primarily discusses anorgasmia in women, since male anorgasmia has had very little study compared to female anorgasmia.

Two types of anorgasmia have been defined, primary anorgasmia and secondary anorgasmia.

Primary Anorgasmia

Primary anorgasmia is a condition where one cannot physically orgasm. This is by far most common in women, although it can occur in men who lack the gladipudendal reflexes.

Women with this condition can sometimes achieve a relatively low level of sexual excitement and may think of intercourse or other sexual activities as pleasant. They may get most of their reward from touching, holding, kissing, caressing, attention, and approval. However, women who regularly achieve high levels of sexual response without orgasmic release of tension may find the experience frustrating. Emotional irritability, restlessness, and pelvic pain or a heavy pelvic sensation may occur because of vascular engorgement. The word intercourse in its broadest sense refers to any kind of human communication and interaction. ...

Women who have not yet had an orgasm usually have some combination of the following:

• Sociocultural inhibitions that interfere with normal sexual response.
• Unresolved feelings towards a traumatic sexual expierience as in sexual abuse or rape.
• A lack of knowledge about sex and sexuality, which interferes with normal sexual development.
• A lack of opportunity to practice in a safe, secure, socially acceptable, and private atmosphere (alone or in a relationship) in a situation that offers approval and support.
• A partner who ejaculates prematurely.
• A partner who has primary or secondary difficulty in achieving an erection.
• Dyspareunia, or painful intercourse.
• Genital mutilation ("female circumcision") that removes part or all of the clitoris, scars the genital area, or constricts the opening to the vagina. Often, vaginal intercourse is painful not only because of scarring from this procedure but also because of associated infection.

Often, though, there is no obvious reason why orgasm is unreachable. Regardless of having a caring, skilled partner, having adequate time and privacy, and having no medical issues which would affect sexual satisfaction, some women are unable to orgasm. This situation is extremely frustrating because with no discernible cause, a plausible solution is difficult to discover. Sexual abuse is a relative cultural term used to describe sexual relations and behavior between two or more parties which are considered criminally and/or morally offensive. ... Illustration of the human male anatomy. ... Dyspareunia is painful sexual intercourse, due to medical or psychological causes. ... Female circumcision (including excision) refers to a number of procedures performed on the female genitalia and which are generally of a cultural, rather than medical nature. ...

In many contexts, anorgasmia whatever the physical factor can be solved through a mental process of conditioning, and as such hypnosis is a common and effective treatment for anorgasmia.

Primary male anorgasmia is very uncommon, and thus has been studied very little. Given the social climate where males are just expected to be able to orgasm, it is possible that they feel ashamed, and refuse to discuss it, or distance theirselves sexually. Either way, primary anorgasmia is largely considered a "female only" condition, which could certainly cause frustration to a male, who is left alone by an affliction that few if any acknowledge.

Secondary Anorgasmia

Secondary anorgasmia is the loss of the ability to have orgasms. The cause may be alcoholism, depression, grief, medication, illness, estrogen deprivation associated with menopause or an event that has violated the patient's sexual value system. Alcoholism is a multifactorial illness based upon possibly both genetic and environmental factors which is best explained as a continued detrimental use of alcohol or other sedatives despite ones best interest. ... Clinical depression is state of sadness or melancholia that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... A funeral in Sarajevo, in 1992-1993. ... Estrogens (also oestrogens) are a group of steroid compounds that function as the primary female sex hormone. ... Menopause (also known as the Change of life or climacteric) is a stage of the human female reproductive cycle that occurs as the ovaries stop producing estrogen, causing the reproductive system to gradually shut down. ...

Secondary anorgasmia is also very common among males recieving a prostatectomy, being close to 50%; ^[1] with a rate as high as 80% with a radical prostatectomies. ^[2] This is very alarming considering that radical prostatectomies are usually given to younger males who are expected to more easily recover from the entire removal of their prostate.

Situational Anorgasmia

Women who are orgasmic in some situations may not be in others. A woman may have an orgasm from one type of stimulation but not from another. Or a woman may achieve orgasm with one partner but not another, or have an orgasm only under certain conditions or only with a certain type or amount of foreplay. These common variations are within the range of normal sexual expression.

Doctors believe that a woman with situational anorgasmia should be encouraged to explore alone and with her partner those factors that may affect whether or not she is orgasmic, such as fatigue, emotional concerns, feeling pressured to have sex when she is not interested, or her partner's sexual dysfunction.

The same doctors believe that family planners should consider recommending the female-above position for penile-vaginal intercourse, as it may allow for greater stimulation of the clitoris by the penis or symphysis pubis or both, and it allows the woman better control of movement. Bridging is the combining of a successful method for sexual stimulation with a desired technique so that the body learns to associate orgasm with that technique. If, for example, the woman is readily orgasmic with manual stimulation but not with penile-vaginal thrusting, she is encouraged to combine those two regularly until her body has learned to associate high levels of excitement and orgasm with penile-vaginal thrusting.

Random Anorgasmia

Some women are orgasmic but not in enough instances to satisfy their sense of what is appropriate or desirable. Often such women have trouble giving up control and allowing themselves to respond fully. Therapy can be aimed at helping them give up the need to keep their sexual feelings under control at all times.

References

• ^ [[|Dunsmuir WD, Emberton M, Neal DE, on behalf of the steering group of the National Prostatectomy Audit, ]],  () ({{{Month}}} ). [ There is significant sexual dissatisfaction following TURP]. British Journal of Urology  (77): 161A. .
• ^ [[|Koeman M, Van Driel MF, Weijmar Schultz WCM, Mensink HJA, ]],  () ({{{Month}}} ). [ Orgasm after radical prostatectomy]. British Jounal of Urology  (77): 861–864. .

The original text for this article is taken from the public domain CDC text at http://www.cdc.gov/nccdphp/drh/Africa_pdf/Chap_10.pdf The public domain comprises the body of all creative works and other knowledge—writing, artwork, music, science, inventions, and others—in which no person or organization has any proprietary interest. ...