Research Paper on "Female Orgasmic Disorder"

Research Paper 12 pages (3545 words) Sources: 8

[EXCERPT] . . . .

Female Orgasmic Dysfunction

Female orgasmic disorder (FOD) has been a controversial and often confusing issue in the annals of medicine and especially with regard to counseling treatment. Over the years the condition has been associated with a highly medicalized ideology and has also been discounted by some in its entirety. (Lavie-Ajayi, 2005) to step away from the debate regarding the disorder, by accepting that the disorder exists to the extent that it affects lives and can require therapeutic counseling intervention is the point of this work, rather than to debate the existence, non-existence or the physical clinical nature of the disorder. For the purpose of this work a basic definition of the disorder will be offered, to illuminate the scope of the disorder.

The basic definition of Female Orgasmic Disorder is the reported and actual inability of a female to achieve orgasm during the sexual act, either alone or with a partner or the inconsistency of ability to achieve orgasm or finally the inability to recognize orgasm when and if it does occur and therefore to enjoy it to the degree that she believes she should. (Kelly, Strassberg, & Turner, 2006) the severity and type of the disorder can range anywhere from the total lack of ability to achieve orgasm, i.e. The inability of completion of the sexual response cycle, referred to as primary orgasmic dysfunction (Andersen, 1983) to an inability to achieve orgasm with only vaginal or coital, intercourse associated stimulation. In the strictest sense primary female orgasmic disorder refers to the inability to achieve orgasm with any stimulation and is estimated to affect 10-15% of the female population (McMulle & Rosen, 1979, p. 912) with percentages increasing to up to 75% when the definition of FOD expands to its broadest point. (Sotile & Kilmann, 1977, p. 619)

Furthermore, from a counseling perspective the degree of affect has almost entirely to do with the perception on the part of the woman as to how this lack of achievement affects her and her relationships;

…the absence of orgasm in the lives of self-defined inorgasmic women is experienced by them not simply as an absence of physical sensation. For them it also carries profound personal and relational meanings, which are of central importance to their sense of self and subjectivity. (Lavie-Ajayi, 2005, p. 59)

Additionally, it must be noted that there are many women who do not seek counseling or other intervention when FOD is present, in large part related to the subjectivity of the affect of the disorder and the degree to which it affects their lives. In one article, associated with self-report interviews of women who report with and without self determined "problems" with Orgasm the researcher found that;

The consequences that problems with orgasm had on their lives varied from one woman to another. For some of them, it played a meaningful role in their lives. With others, its importance was negligible. However, all of the women interviewed drew, almost universally, on the dominant social discourse to make sense of their sexual lives. (Lavie-Ajayi, 2005, p. 61)

Furthermore, female orgasmic disorder can be related to a physical condition, though this is rare, (McMulle & Rosen, 1979) or it can be associated with psychological and/or communication issues within a sexual relationship (Kelly, Strassberg, & Turner, 2006) or many times it is associated with the lack of knowledge of the body and/or nature of the sexual response cycle on the part of the female or her partner or any combination of the above. In other words the FOD can be something that is easily resolved with education on the part of the woman (and possibly her partner) or it could be something much more persistent that fundamentally affects the woman and her intimate relationships. Again the degree of affect is subjective and it is likely that those who seek counseling intervention see the presence of the disorder as affective enough to be addressed and possibly to work toward a resolution.

It is also important at this stage to understand more completely the nature of the sexual response cycle as any interruption and/or delay in the cycle can create the real or potential experience of FOD and can have profound effects on the counseling treatment intervention offered to the individual. As one can see form the following diagram the cycle consists of four main segments; excitement, plateau, orgasm and resolution. If the excitement phase is inactive and/or lacking then the individual will be unlikely to move on to the plateau phase and if the plateau phase is lengthened or interrupted orgasm may not be achieved and finally if the resolution period is interrupted (say by continued rigorous stimulation) the perception of orgasm may be lacking. Again, one must point out that this is a purely physiological diagramming, of a highly subjective, individual and potentially emotional experience, but again the phase of interruption or interference can effect education and/or communication of the individual and/or her partner in a counseling treatment plan. The most important message here is that a great deal of the sexual response cycle is dependent on the psychological state of the individuals involved and therefore any given phase of physical response may interrupt and create a failure of the ability of the woman to achieve and/or perceive an orgasm, which may or may not be important to her fundamental satisfaction regarding sex and/or intimacy. (Lavie-Ajayi, 2005) Yet, again if there is no perceived, problem the individual woman is unlikely to seek out counseling intervention.

From a counseling perspective one of the first goals will be to assess the degree, etiology and potentially the resolutions of the disorder to create an appropriate and logical treatment plan be it individual education, couples communication counseling, group therapy or any combination of the above. Finally it must also be made clear that sex and sexuality are often highly personal and emotionally charged issues and a proper patient history and diagnosis of the individual or compounded difficulties must be achieved for every individual woman. This full and complete assessment will be addressed later in this work as an important aspect of the literature review, as research in this area is limited and assessment tools are minimal but absolutely essential in this area of treatment. Tools such as the Female Sexual Function Index or FSFI are not only accessible to the clinician but are necessary for the development of a full diagnosis and treatment plan, including but certainly not limited to recognizing medical and/or health issues that though rare might exist and be in need of address by a medical doctor. (Meston, 2003)

Review of Literature

The approach of this literature will be to address each body of work chronologically, as it is important to understand that the counseling issues associated with FOD are fundamentally interlaced with the logical progression of the perception of disorder over time. Barring a reinvestment in a more that perfunctory mention of the fact that the disorder has been highly controversial the progression over the last four decades as to the seriousness and/or nature of the disorder is important on a broader scale, as this progression affects the individuals' perception of the disorder and its importance. Though this approach to a literature review is fundamentally unorthodox the ability of the research to both affect the issue in a clinical manner and to specifically contribute in both the positive and negative to the counseling treatment modalities of the disorder over time creates a desire in this author to approach the research in this manner.

Sotile & Kilmann in Treatments of Psychogenic Female Sexual Dysfunction (1977) begin with a discussion of the contemporary lack of concensus with regard to the definitions and standards associated with research as well as treatment modalities for the broader disorder known at the time as female sexual dysfunction. The period marked much expeiementation and the utilization of research and treatment modalities that were untested and unfounded and the diagnosis was compleletly lacking in definative standards which clearly did not meet the needs of the growing female popualtion seeking treatment and intervention for many of the various forms of female sexual dysfunction. Ultimately, the period was marked by a transistion that was leaving the old ideologies of "frigidity" which was a nealy all inclusive term associated with female sexual dysfunction to defining and characterizing different types of disorders and attempting to coem to some concensus on just how wide spread these types of disorders were. According to Sotile & Kilmann the only real concensus was that there were two distincly different types odf sexual dysfunction in women, psychogenic and physiological. The authorsmthen go on to review research regarding treatment modalities in seven different categories; individual verbal psychtherapy, couple reeducation, systematic desensitization, extensive retaining programs, combination approaches, group therapy, and vaginal exercise.What the researchers found was disturbing in its scientific reliabilty but the most important finidng of the review is that the various types of disfunction are better addressed by different counseling treatment modalities, orgasmic dysfunction was most effectively… READ MORE

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