Anorgasmia

Anorgasmia - (lack of orgasm) is most often a manifestation of frigidity, caused by the disharmony of sexual relations (disgamy). It can arise, for example, as a result of premature ejaculation in the husband, interrupted sexual intercourse, inadequate psychoerotic preparation of the woman for rapprochement (due to lack of preliminaries), incorrectly chosen posture. In addition, a woman as a sexual partner is more dependent on a man who usually determines the frequency, rhythm, form of sexual intercourse, and social norms of behavior due to sex education do not always allow the woman to make adjustments to the partner's sexual behavior, resulting in erogenous zones Both genital and extragenital) do not receive sufficient stimulation. Thus, for example, in 25% of healthy women the highly sensitive erogenous zone is the clitoral region, while the vagina is insensitive; These women usually experience an orgasm with additional irritation of the clitoris. In many women, the outer third of the vagina is very sensitive, while the uterus and the deep vaginal sections are not very sensitive. The primary effect on these or those erogenous zones depends on the posture in which the rapprochement is carried out; Inappropriate posture can be one of the causes of disgamy.

The lack of orgasm and sexual attraction is often associated with a delay in puberty and psychosexual development (the so-called retardation frigidity). In this case, the attraction is immature: it stops at the erotic or platonic stages, and the lack of orgasm combines with satisfaction on an emotional level without any painful sensations.

Symptoms depending on the pathogenesis and duration of disorders vary widely: from a decrease in the brightness of sensations to complete frigidity (a triad - the absence of sexual desire, specific sensations in frictions and orgasm). So, with the development of depression, at first, only sexual desire can decrease and disappear, then the brightness of sensation becomes dulled and the orgasm becomes rare or disappears. If there is insufficient stimulation of erogenous zones, frigidity at first can be manifested only by the absence of orgasm, and in the future lead to the development of a neurotic state, a decrease in sexual desire and make the sexual act unpleasant. There is a complex variant of nymphomaniac frigidity, in which sexual desire is increased, but orgasm does not occur, despite prolonged stimulation and excitement. Genital function with frigidity is not impaired.

The diagnosis is based on complaints, anamnesis, the results of an objective examination; Laboratory methods of investigation have an auxiliary significance. When you combine frigidity with pronounced infantilism, reduction of hair and pigmentation, menstrual irregularities, infertility, fat metabolism disorders, acromegaly, autonomic disorders, including vascular crises, it is necessary to exclude endocrine diseases. When you combine frigidity with sleep disorders, depression, fixation on sexual dissatisfaction, with unusual unpleasant or painful sensations in the genital area (in the absence of organic changes found in gynecological or urological research) it is necessary to exclude mental illness. It should also exclude diseases of the genitals that complicate the sexual intercourse or make it painful, determine the sensitivity of the erogenous zones, the condition of the pelvic floor muscles. In most cases, it is desirable to examine the husband and determine the psychological climate in the family.

Treatment is ethiopathogenetic, complex, stage, strictly individual, aimed at creating optimal conditions for the manifestation of a woman's sexuality, eliminating sexual disorders in a partner, normalizing sexual intercourse. The leading role in the treatment belongs to rational psychotherapy, which takes into account the individual characteristics, interests and attitudes of both partners, is based on identifying and eliminating inhibitory moments and expanding the range of acceptable forms of influence on erogenous zones. In a number of cases a positive effect is provided by suggestive psychotherapy and autogenic training. From drugs use tranquilizers and antidepressants (with depressive states), stimulants and vitamins (for general asthenia), hormonal drugs (with endocrine pathology). When the sensitivity changes, local treatment is performed. From physiotherapy methods use hydrotherapy (cold and hot sedentary baths, ascending shower), electrical stimulation and vibromassage of the muscles of the pelvic floor. With anatomical defects and Cicatricial changes in the genitals, surgical treatment can be indicated.

Forecast. Absence or inferiority of one or all components of sexual intercourse in some cases does not cause severe feelings for women. In particular, with constitutional frigidity associated with delayed pubertal development, they seek medical help usually under the influence of the husband. Against the background of a regular sexual life in a marriage, the degree of severity of frigidity may decrease. However, in other cases, frigidity can lead to sexual disharmony of married couples, increasing the likelihood of divorce due to sexual dissatisfaction. The prognosis is more favorable with timely treatment of both partners. An aggravating prediction is the presence of depression, homosexual orientation of sexual desire or sexual disorder in the husband.