Article 45: Analysis of the Causes and Comprehensive Treatment of Female Orgasm Deprivation
11. Lack of orgasm
A female orgasm is marked by a sudden cessation of physical tension, followed by a prominent sensation of pleasure originating from the clitoris and radiating rapidly throughout the lower abdomen and the entire body. Simultaneously, there may be a momentary feeling of dizziness, uncontrollable moaning, and some women may even experience temporary fainting due to the intensity of the sexual pleasure. Moments later, a warm wave flows from the genitals to the whole body. Finally, the genital muscles spasm and twitch. The so-called lack of orgasm refers to the inability or difficulty achieving orgasm during sexual intercourse in adult women.
Causes of Lack of Orgasm
The lack of orgasm in married women can be caused by organic lesions, such as various inflammations, tumors, injuries, and anatomical variations of the vulva, vagina, uterus and adnexa, bladder and urethra, and pelvic cavity. Additionally, spinal cord lesions that disrupt the sexual arousal pathway can also prevent orgasm.
Aside from organic factors, the causes of lack of orgasm are more often psychological. Specifically, they include the following aspects:
(1) Sexual psychological repression
Many women, from childhood and adolescence into adulthood, receive oppressive sex education filled with falsehoods and a lack of scientific understanding. This leads them to harbor misunderstandings and prejudices about sex, fearing that their behavior during sex might be inappropriate. Therefore, they try their best to suppress their sexual desires and behaviors to demonstrate their "propriety" and "chastity." This psychological self-restraint and repression often results in feelings of inhibition, self-blame, and anxiety during sex, delaying or interrupting the process of sexual arousal and preventing orgasm.
(2) Marital discord
A lack of emotional communication between couples, mutual dissatisfaction, distrust, or disagreements about sex can not only strain their relationship and reduce intimacy, but also lead to disharmony in their sex life, especially causing female orgasm.
(3) Poor sexual skills
Some couples have a monotonous and unchanging sex life. The husband doesn't know how to arouse his wife's sexual excitement, nor does he have the patience to provide sufficient caresses and foreplay, making it difficult for the wife to reach orgasm.
(4) Unsuitable sexual environment
Some women are very sensitive to their sexual environment, such as when the bed makes noise, the light is too bright or too dim, or there are slight changes in the room, they cannot reach orgasm; some women are not affected by the room, but they cannot reach orgasm when the timing of their sexual activity changes; and some women cannot reach orgasm due to changes in sexual position or posture.
Treatment for lack of orgasm
The treatment methods for lack of orgasm are basically the same as those for frigidity. For example, it is important to have a correct view of sexual pleasure and remove self-repression and restraint in sexual life; to establish a harmonious marital relationship and strengthen emotional communication, understanding, and cooperation in sexual life; to learn and appropriately use sexual techniques to enrich the content of sexual life; and to improve physical fitness and promptly treat physical illnesses that hinder orgasm, etc.
Finally, it's important to point out that traditional morality denigrates sexual desires, while modern civilization sometimes exaggerates the role of sex. For contemporary married women, while acquiring as much sexual knowledge as possible, it's crucial to maintain a clear mind and avoid blindly applying external standards. Ultimately, orgasm is simply the peak of sexual pleasure, and the experience varies from person to person. As long as one feels satisfied, relaxed, comfortable, and drowsy after intercourse, one can be said to have achieved orgasm. Furthermore, if the couple has a harmonious relationship, enjoys their sex life, and is satisfied with their current sexual experience, then whether or not there is an orgasm is generally considered normal, and there's no need to feel anxious about it.
12. Psychological adjustment for non-ejaculation
Non-ejaculation refers to a condition where a person has a history of nocturnal emission, and during intercourse, although the penis remains erect and can penetrate the vagina, they do not reach orgasm or ejaculate.
Some causes of anejaculation are organic, such as congenital malformations of the urogenital system, spinal cord injury, or sequelae of lumbar sympathectomy. Others are caused by temporary medications, such as drugs that affect sympathetic nerve tone, like guanethidine and phenothiazines.
Another cause is improper sexual position. Due to an improper position, the penis thrusts in and out of the vagina less frequently or with less range of motion, resulting in insufficient friction and stimulation between the vaginal mucosa and the glans penis, preventing orgasm and thus preventing ejaculation. Generally, adopting an appropriate sexual position will resolve the problem.
The causes of functional anejaculation include:
(1) Low sexual arousal
(2) Psychological factors Some religions believe that sexual intercourse is a sinful act and that the vagina is an unclean place, and therefore they are unwilling to have sexual intercourse or ejaculate into the vagina.
(3) Dislike of the woman
(4) Painful experiences are also a common cause of this condition. Dissatisfaction or failure during the first sexual intercourse can leave psychological trauma, and fear of failure again, coupled with the woman's negative language or behavior affecting the man's sexual behavior, can lead to impotence and anejaculation; or, if the man is too affectionate towards the woman and fears that intercourse will cause her discomfort, pain, gynecological diseases, pregnancy, etc., he will actively limit the amplitude and frequency of penile thrusting during intercourse and intentionally refrain from ejaculation.
Psychotherapy and sexual guidance for non-ejaculation
(2) Sexual intercourse guidance. Use appropriate sexual positions, such as woman-on-top, side-lying, or the man standing with his hips flexed at 90° to support his body. The penis should move and rub inside the vagina with a certain amplitude, frequency, and duration, supplemented by contractions of the gluteal muscles and anus. The woman should cooperate accordingly to complete the entire sexual intercourse process. Supporting the testicles with her hands can promote ejaculation and orgasm during periods of high arousal.
(3) Sex therapy. The patient's wife can be relied upon to induce ejaculation. Sensate focus training can be used to help the man become aware of his own bodily sensations, improve non-verbal communication, and relieve sexual tension.
13. Vaginismus
Vaginismus refers to the involuntary reflexive spasm or contraction of the muscles around the vagina when attempting sexual intercourse or anticipating penile penetration, making intercourse impossible. Although patients may have normal libido and often experience pleasure and satisfaction outside of sexual activity, they suffer distress due to psychological factors such as fear of sexual intercourse, making sexual arousal difficult or preventing intercourse. They exhibit a reflexive resistance to intercourse, constituting a psychosomatic syndrome. If it recurs repeatedly and is left untreated, it may lead to psychosomatic sexual disorders, causing significant suffering for both partners.
Treatment and management of vaginismus
(1) Receive sex education and acquire sex science knowledge
To understand sexual physiology and psychology, one should read books or watch videos on sex, thus eliminating feelings of mystery and fear surrounding sex. It's important to recognize that sexual intercourse is a normal physiological act and that the vagina is fully capable of accommodating the penis.
(2) Eliminate irrational understandings about sex
Only after changing mindsets and adopting a correct attitude can further learning of sexual techniques and sex therapy be possible. One must realize that sex is a pleasure, not a burden. Sexual activity is a natural function, and sexual response is a natural physiological instinct. Once the factors causing vaginismus are eliminated, its naturalness can be fully restored.
(3) Learning sexual intercourse techniques
Communication skills. Couples should talk face-to-face about their feelings and needs regarding sex, especially the woman should boldly reveal her worries, concerns, and fears to her husband.
Try selective intercourse techniques. For women with mild vaginismus, they can choose to try suitable non-traditional intercourse methods that can reduce the intensity of vaginismus or stimulate and increase the intensity of sexual pleasure, such as hand-genital or oral-genital methods.
(4) Psychotherapy
Cognitive behavioral therapy. This therapy is very effective. Specifically, it includes: a. eliminating the mystification of sex and other irrational beliefs about sex through reading relevant materials; b. using auditory and visual stimulation for vicarious learning, and absorbing previously avoided sexual activities (such as medically available films containing masturbation and different sexual positions), thereby further changing the patient's attitude towards sex; c. the therapist exerting influence to evoke positive expectations about sex in the patient.
Direct, rapid treatment for two partners. This is a highly effective sexual treatment method. The specific method is as follows: At the beginning of treatment, explain to both partners that vaginismus is an involuntary, abnormal muscle contraction. Have the husband accompany the patient during a vaginal examination and encourage the patient to observe herself using a mirror. Teach the patient to perform "tightening and relaxing" exercises of the perineal muscles, gradually inserting fingers into the vagina and using a plastic vaginal speculum. When practicing at home, continue to focus on "sensory concentration" and verbal communication, and use a vaginal speculum with lubricant. When using a speculum from thin to thick, up to size 4 (note: the number here specifically refers to the speculum size), if there is no discomfort, intercourse can begin, with the woman on top position.