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Orgasm is achieved by a complex interplay of emotional, physical and physiological factors. It is a reflex action and needs intact nerves in the genital area. Sexual stimulation is associated with an increase in the level of hormones like prolactin, vasopressin, adrenaline, oxytocin and others. Orgasm is accompanied by several physiological changes in the body like increase in heart rate, blood pressure, breathing rate, vaginal and clitoral blood flow and rhythmic contractions of the vaginal area.
Orgasmic dysfunction is said to occur when a female is persistently unable to attain an orgasm even after sufficient stimulation and arousal. It is difficult to define, as the degree of stimulation and arousal needed to achieve orgasm varies from woman to woman. There are a lot of other factors that can affect achievement of an orgasm during sexual activity. Feelings towards the partner, level of comfort, trust and well being would affect an orgasm.
Orgasmic dysfunction can be caused by emotional factors such as physical or sexual abuse, traumatic sexual experiences in the past, poor relationship with the partner. Poor physical or mental health, like depression or anxiety, can also impair achievement of an orgasm. In some cases drugs or alcohol may also be responsible. Another important factor in the ability of woman to achieve an orgasm is the sexual performance of her partner. If he suffers from premature ejaculation or erectile dysfunction this may prevent arousal and so affect her orgasm. As women grow older they need more foreplay and stimulation to achieve an orgasm.
Management of orgasmic difficulties involves a combined medical and psychological approach. Psychological approach involves cognitive behavioral therapy. The couple are taught relaxation techniques which they can practice at home. The woman is encouraged to explore her body and directed masturbation is encouraged. Vibrators may be used for arousal. The counsellor will also educate and inform the woman about her sexuality. He will encourage the couple to be sensitive to each others need and find ways to show affection thus promoting their relationship.
Hormonal therapy may be used to treat orgasmic dysfunction though they may have side effects.
EROS, a device applying vacuum intermittently to the clitoris, helps makes the clitoris more sensitive.
Creams available over the counter increase sensitivity in the genital area and may help a woman reach orgasm.
Whatever the problem help is available and should be sought.