Female orgasmic disorder

Female orgasmic disorder Signs and Symptoms

• Persistent or recurrent delay in, infrequency of, or absence of orgasm.
• Reduced intensity of orgasmic sensations.
• Distress or interpersonal difficulties due to orgasmic dysfunction.

Medical History – What Should Be Assessed?

• Chronic and acute medical conditions, including psychiatric issues.
• Current and past medications, supplements, or OTC drugs.
• Any substance abuse patterns.
• Sexual complaints or concerns.

Physical Examination

• First, explain the rationale for inquiring about sexual topics, while sympathizing with the patient reluctance to discuss intimate topics
• Next, ask open-ended, general questions about the overall level of sexual interest and satisfaction
• Gradually introduce the topic of sexual issues
• As rapport improves, ask more specific, closed-ended questions that address the details of sexual activity Physical examination includes the following:
• General examination
• Cardiac, pelvic, and neurologic examinations to eliminate any coexisting medical conditions that might be contributing to the orgasmic dysfunction
• Mental status examination (usually normal in primary FOD; mild, anxious, or depressed mood or effect should be investigated)

Diagnosis – Criteria for Female Orgasmic Disorder

• No other disorder explains the orgasmic dysfunction better than FOD.
• Dysfunction is not caused solely by substances (medications or drugs).
• Dysfunction is not caused solely by another medical condition.

Laboratory Workup

• Complete Blood Count (CBC)
• Chemistry panel
• Vitamin B12 and folate levels
• Hormone Panel:

An informative hormone panel should include the following:

• Thyroid test (thyroid-stimulating hormone [TSH] and free T4)
• Estradiol
• Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
• Prolactin
• Testosterone (total and free) only in monitoring testosterone therapy