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Dr. Kate’s Female Sexual Dysfunction Series: ORGASM PROBLEMS (Pt 4 of 5)

Thu, Jan 20, 2011

Advice, What's Up Doc?

All this month Dr. Kate, an OB/GYN at one of the largest teaching hospitals in New York City, is dedicating her column on EMandLO.com to the topic female sexual dysfunction, since that’s what she seems to get the most inquiries about. Click here for all the installments of her five part series being published every Thursday afternoon in January.

Many women have the expectation that they’ll have an orgasm with intercourse, every single time. After all, that’s the expectation men have, right? But biology isn’t always fair, and our anatomy is not always on our side. For most women, clitoral stimulation is the most reliable (or only) path to orgasm, which doesn’t always happen with vaginal intercourse. I counsel my patients that all orgasms are good orgasms, and there’s no “right” way to get one. So if it’s pre-intercourse play or afterplay—i.e. stimulation by touch or by tongue—that gets you to climax instead of intercourse itself, fantastic. And if you want to achieve the elusive beast of orgasming at the same time as your partner, a well-placed vibrator may be a reliable way. Many couples, over time, figure out a repertoire of play that will lead to satisfaction for both of them.

So what’s normal about orgasms?

  • Taking longer than he does to climax.
  • Climaxing quickly one night…and not at all the next.
  • Having a more difficult time achieving orgasm in particular positions or situations.
  • Having an orgasm with minimal (or no) clitoral stimulation (you lucky girl).
  • Taking a longer time to climax if you’re having trouble staying in the moment.

When you never seem to achieve orgasm, though, it’s hard to enjoy any sex play. And the number of women who struggle with the ability to climax is staggering; according to the Association of Reproductive Health Professionals, 24 to 37 percent of women have problems reaching orgasm. These problems range from a long delay to climax after stimulation, to never achieving orgasm at all. There’s such a wide variability in the type of stimulation that triggers orgasm that it can be difficult to figure out why it’s not happening in a particular situation.

The treatment for problems achieving orgasm is basically the same as the treatment for arousal disorder: sex therapy. When you work with a qualified therapist (who may be a social worker, a psychologist, or a medical doctor), there are multiple techniques that can be tried — imagery and fantasy, sensate focus, mindfulness. Ask your gyno if she’s knowledgeable about these techniques, or if she can refer you to someone who is. While orgasms are not the be-all, end-all of your sexual functioning, you certainly deserve them.

– Dr. Kate
Gynotalk

dr_kate_100Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.

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