Orgasms, Testosterone, and the Causes of Anorgasmia
Channel: BioBalance Healthcast
Date: 2021-01-25

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Summary:   Doctors traditionally divide the female and male orgasms into four stages as though all were the same and progressed identically along the same pathways.  After more than three decades of helping women with their sexual issues and a little over one decade of treating men for similar problems, I can tell you that the classic approach could hardly be more incorrect.  This underscores one of the deficiencies in medical training.  Doctors are taught very little about human sexuality; and, as a consequence, most don’t feel, and maybe aren’t, qualified to diagnose or treat a not uncommon problem – lack of an orgasm.

Unsurprisingly, many real-life women find it difficult to describe an orgasm in objective terms because an orgasm, by its very nature, is explicitly subjective.  And they almost never depict any “stages” of their sexual experience.  Some women, though, have never had an orgasm.  This condition is called anorgasmia.  Anorgasmic women often feel incomplete and as if they are only going through the motions when they engage in sex with their partners.  In some cases, they become frustrated to the point of giving up on sex because there is no bonus for them. 
 
This podcast is designed to increase your understanding of the female orgasm, to inform you of the hormone that is necessary for an orgasm, and to educate you about anorgasmia.

TRADITIONAL STAGING OF ORGASM

Masters and Johnson conducted years of clinical research of the sexual act, some of it in St. Louis at Washington University School of Medicine, and decided there are four stages of having an orgasm.

1.  Excitation is stimulating the “hot spots” that prepare the brain and body for orgasm.  Normal people call this foreplay.  It can begin with the mere suggestion that your partner wants to have sex in the near future; or it may be stimulated by you or your partner sexually touching the clitoris, labia, vagina or cervix; or, lastly, sexual visualization and pornography have been known to aid arousal.  This phase is accompanied by an increase in heart rate, blood flow to the skin and dopamine secretion in the brain.
2. Plateau is the stage in which observable physical bodily changes take place.  This may include involuntary dilation of the vagina, blood flow to the pelvis, and swelling of the labia.  One’s focus is tunneled to the area being stimulated.
3. Orgasm is the stage where sexual tension is released.  Surges of dopamine and serotonin are produced in the brain.  Muscles throughout the body may contract or jerk.  Kind of the whole point, really.
4. Resolution is the relaxing stage where blood flow, heart rate and neurotransmitters go back to normal.  Women generally enjoy the ability to have shorter resolution periods than men.  Women have the potential to have repeated orgasms where the resolution phase is very short and they reenter the excitation phase.  

If you have great orgasms, be thankful for yourself and your partner.  There is not a better way to enjoy sex and bond.  But certainly not all women are alike, and not all orgasms are alike.  Various studies have shown the rate of anorgasmia among women of child bearing age to be somewhere between five and ten percent with the degree of the condition ranging from women who have never had an orgasm (primary anorgasmia) to those who only infrequently fail to have one.  This rate increases dramatically as women age if they fail to address the hormonal deficiencies that come with aging.

 Recently I had two patients on the same day who had never had an orgasm.  This coincidence was a little surprising to me given the rather low rate of occurrence for primary anorgasmia.  Both women had experienced all the necessary stimulation and had partners who were cooperative and supportive of their efforts.  Let me tell you my approach to treating these two patients.   
One of the first steps was to take a detailed medical and social history.  Psychological problems stemming from past sexual abuse as well as spousal conflict, severe fatigue and medications (antidepressants and some blood pressure meds) can impair a woman’s ability to achieve an orgasm.  But these women had no such negative historical experiences and had attentive partners.

Both patients were in menopause and one had had a hysterectomy.  But because their anorgasmia predated the hysterectomy and the menopause, I was able to dismiss these as contributing factors.