Management of orgasm difficulties in females

For a female with orgasm difficulties, provide information about sexual response and the potential contributing factors to difficulties with orgasm, including concurrent sexual symptoms. Some people are not sure whether they have experienced orgasm. Patient information is available from the Royal Women’s Hospital website and the Better Health Channel. Address underlying causes such as medications, underlying physical or mental health issues (particularly anxiety or depression) that could be affecting sexual response.

Testosterone improves orgasms, along with other measures of sexual satisfaction in postmenopausal females. Data are insufficient for recommendation in those who are premenopausal. See Management of low libido in females for more information on the use of testosterone for sexual symptoms.

Mindfulness interventions have shown benefit in acquired anorgasmia. Relationship counselling, cognitive behavioural therapy and supportive psychotherapy may be considered. Consider also referral to an accredited sexual therapist or clinic for therapies such as directed self-stimulation (a therapy for lifelong anorgasmia) or sensate focus therapy. The Australian Society of Sexologists and the Australian Psychological Society have national accreditation standards for quality and safety of practice and list accredited members.