Causes and risk factors
Anorgasmia is usually classified in three types – as primary, secondary, or situational. Primary anorgasmia is one that the woman has never achieved orgasm at any point in her life. Secondary anorgasmia means that the woman was consistently able to get orgasms at one time, but is no longer able to achieve them. Situational anorgasmia refers to women who can get orgasm in certain sexual situations, but never in other specific situations. For example, a woman who can orgasm through masturbation but never during sexual intercourse. Other possible causes of anorgasmia are dryness of vagina, anxiety, early ejaculation in the partner, impotency, some psychiatric disorder, lack of sexual education, strong religious upbringing, weakness of pubococcygeus muscle, history of sexual abuse in childhood or past.
Clinical presentation
A doctor comes to the diagnosis of female sexual dysfunction when the female is not able to fully and pleasurably experience the stages of sexual activity. Due to anorgasmia the female complaints of no desire for sex due to lack of interest in sex, boredom of sexual routine, lack of enthusiasm, pain during sexual intercourse, painful involuntary spasm of muscles surrounding vagina [vaginismus], sexual phobia .
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. A gynaecologist may perform a pelvic exam to rule out other causes. An advice of sex therapist is recommended.
Treatment
Treatment depends upon the underlying cause. Medications include hormonal therapy, use of a local lubricant in case of dryness of vagina. Doctor may advise some pelvic floor exercises or kegel exercises for muscle strengthening and tightening. In most cases counselling by a sex therapist, psychologist or psychiatrist plays an important role. Counselling includes that of the patient as well as the partner. Stress in relationships and mental trauma can be overcome by psychotherapy.
Other Modes of treatment
The other modes of treatment can also be effective in treating anorgasmia. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating anorgasmia.