A physical examination is almost always normal. If the onset of the problem coincided with beginning to use a medication, this should be discussed with the prescribing physician. Interviewing of the couple by a qualified specialist in sex therapy is most likely to elicit useful information about the causes. Treatment Treatment thorough education about the principles cited above has been found to be helpful. In the treatment of primary anorgasmia, the initial objective is to be able to obtain an orgasm under any circumstances.
Most women require clitoral stimulation to reach an orgasm.
Incorporating this into sexual activity may be all that is necessary. This may then be followed by a series of couple assignments that minimize performance anxiety and pressure, and maximize communication, increasingly varied and more effective stimulation, and playfulness. Gradually, these assignments make it possible for the person to achieve orgasm with their partner. Similar task assignments are usually part of the therapy of the woman with secondary or situational anorgasmia, but masturbation has not generally been found to be helpful as a treatment component with these problems. In secondary dysfunction, marital difficulties sometimes play a role, and thus treatment may also sometimes need to include communication training and relationship enhancement work.