[Women's orgasmic disorders]

To evaluate the clinical presentation of women's orgasmic disorders (OD) and therapeutic options, suggested in the literature.

Review of articles published on this subject in the Medline (Pubmed) database, selected according to their scientific relevance, of consensus conferences and published guidelines.

At present it is thought that the orgasm is a potentiality which a woman can learn to develop with experience, and practice over time. Primary anorgasmia in young females (<35 years) is very often due to lack of experience or lack of skill in the partner or partners. Secondary anorgasmia is often linked to difficulties of live, more rarely to problems with the partner. In both cases, informed advice to the patient and her partner can provide simple ways of modifying and diversifying sexual practice, slight changes can be sufficient. For the woman, learning to "let go" is essential. Speaking to the partner can help to eliminate and diversify sexual behaviour which can be responsible for this problem. However, OD, particularly the secondary type, is less attributable to the male performance than to the emotional and affective aspect. Primary anorgasmia, if total, persisting in the mature woman, evokes more structural problems (body image, sexual abuse, guilt…) and requires specialized management.

Currently, female sexual desire is often evoked, however, one woman in four suffers from OD to a greater or lesser extent. Orgasmic dysfunction in women is frequent and is the second most common reason for consulting a sexologist. Evaluating the context is essential to differentiate primary from secondary OD, in order to give an appropriate treatment.