Treatment Of Orgasmic Dysfunction Research Articles

Psychotherapeutic approaches and methods and their effectiveness in treating orgasmic dysfunction in women

Orgasmic dysfunction is a sexual disorder in which an orgasm does not occur or is delayed. The prevalence of orgasmic dysfunction ranges from 16% to 28% in Europe, America and mainland China, and from 30% to 46% in other Asian countries. The causes may be physiological, neurological and psychosocial. A literature review was conducted to examine which psychotherapeutic approaches and methods are used in the treatment of orgasmic dysfunction and to examine the results of their effectiveness. All resources linked in this paper have been taken from sources contained in the Scopus or EbscoHost research databases. Throughout this paper we have researched all relevant research papers, removed any duplicates and by applying all the necessary criteria, we have concluded with 15 research articles. The therapeutic approaches and methods with proven efficacy in the treatment of orgasmic dysfunction are: group sex therapy and couples sex therapy, behavioural approaches (Master and Johnson methods, systematic desensitisation), mindfulness-based programmes (Mindfulness-Based Cognitive Therapy - MBCT, Mindfulness-Based Behavioural and Cognitive Therapy), The Betty Dodson Method (a combination of short-term psychodynamic group therapy and self-stimulation methods) and self-help programmes based on video tracking, Cognitive Behavioural Therapy (CBT) and MBCT, and psychosexual therapy manuals. Some self-help programmes also include minimal contact with a therapist. There is an overlap between these approaches (e.g. sex therapy integrates behavioural methods). The results and the review serve as a basis for the application of effective interventions and opportunities for improvement in the treatment of orgasmic dysfunction.

Intracytoplasmic sperm injection outcomes in patients with orgasmic dysfunction and anejaculation by percutaneous epididymal sperm aspiration (PESA).

BackgroundOrgasmic dysfunction and anejaculation are two uncommon yet powerful factors of male infertility. The treatment of orgasmic dysfunction and anejaculation is especially important for men who desire paternity, who otherwise would have to undergo surgical sperm retrieval for use with intracytoplasmic sperm injection (ICSI). We evaluated the reproductive outcomes of percutaneous epididymal sperm aspiration (PESA) for ICSI in a cohort of infertile patients who had presented with orgasmic dysfunction and anejaculation in the past five years.MethodsWe conducted a retrospective study of 41 patients with orgasmic dysfunction and 55 patients with anejaculation who underwent surgical sperm retrieval for ICSI. The sperm was firstly aspirated from the cauda epididymis, and then from the caput of the epididymis. If aspiration attempts failed at both locations, testicular sperm aspiration (TESA) was performed. The ICSI outcomes following these collection methods were compared with those of patients with congenital bilateral absence of the vas deferens (CBAVD). The ICSI outcomes of PESA (fertilization rate, high-quality embryo rate, clinical pregnancy, and live birth rate) were recorded.ResultsOf all 96 participants, PESA was successfully performed in 91 patients (94.8%), and TESA was necessary for only 5 patients (5.2%). Of the 91 patients who received PESA, 90 succeeded in retrieving sperm from the cauda epididymis, and just 1 from the caput. Among the patients with anejaculation, there were 28 cases (28/55, 50.9%) of diabetes mellitus (DM). In 56 fresh transfer cycles, the clinical pregnancy rate and live birth rate were 57.1% and 51.8%, respectively, both similar to those of CBAVD (53.47% vs. 63.4%, P=0.483, 47.2% vs. 53.5%, P=0.393, respectively). The fertilization rate, transferable embryo rate, high-quality embryo rate, clinical pregnancy, early pregnancy loss, and the live birth rate did not show differences resulting from using fresh or frozen sperm in the two groups. The fertilization rate and high-quality embryo rate in patients with DM were lower than those of patients without DM (75.0% vs. 86.7%, P=0.002; 50.4% vs. 77.4%, P=0.028, respectively).ConclusionsLike TESA, PESA is an appropriate and convenient way to obtain sperm for ICSI for patients with orgasmic dysfunction and anejaculation. Performing ICSI with sperm from the cauda epididymis can achieve favorable clinical pregnancy and live birth rates in patients with orgasmic dysfunction and anejaculation.

Treatment of Orgasmic Dysfunction in Women

Treatment of Orgasmic Dysfunction in Women

Yohimbine in the treatment of orgasmic dysfunction

To study the effect of yohimbine in the treatment of men with orgasmic dysfunction. A 20-mg dose of yohimbine was first given to 29 men with orgasmic dysfunction of different aetiology in the clinic. Patients were then allowed to increase the dose at home (titration) under more favourable circumstances. The outcome and side effects were subsequently assessed. The patients were classified into three groups of orgasmic dysfunction: primary complete (13), primary incomplete (8) and secondary (8). Nocturnal emissions were present in 75%, 40% and 50% of patients in the above groups, respectively (overall average 62%). The men presented because of fertility problems (52%) or because they wanted to experience the pleasure of orgasm (48%). Of the 29 patients who completed the treatment, 16 managed to reach orgasm and were able to ejaculate either during masturbation or sexual intercourse. A further three achieved orgasm, but only with the additional stimulation of a vibrator. A history of preceding nocturnal emissions was present in 69% of the men in whom orgasm was induced but only 50% who failed treatment. Of the patients, two have subsequently fathered children (one set of twins) and another 3 men were also cured. Side effects were not sufficient to cause the men to cease treatment. Yohimbine is a useful treatment option in orgasmic dysfunction.

The pubococcygens and female orgasm: a correlational study with normal subjects.

The relationship of pubococcygeal condition to orgasmic responsiveness in 102 women from a university community was examined in a controlled, prospective investigation. Pubococcygeal strength was measured with a perineometer while responsiveness was assessed by a standardized interview yielding reliable measures of self-reported orgasmic response. Subjects whose responsiveness might have been impaired by such factors as alcohol consumption, inadequate stimulation, and high sexual anxiety were excluded from analyses. Excellent within-session but poor across-session test-retest reliability of the perineometer measures was noted. Initial Strength Contracting proved to be the most reliable measure. Though the majority of the parous women had performed Kegel exercises after delivery, parity was negatively related to pubococcygeal strength on most measures. Contrary to experimental hypotheses, pubococcygeal strength was not found to be positively related to frequency or self-reported intensity of orgasm. Furthermore, women with higher pubococcygeal strength did not report that vaginal stimulation contributed more to attainment of orgasm, nor did they rate vaginal sensations during coitus as more pleasurable. Only in the case of pleasurability of orgasm through clitoral stimulation was a significant, though low, relationship obtained. Possible factors contributing to the discrepancy between these findings and previous uncontrolled investigations are discussed, as are the implications of these findings for the use of Kegel exercises in the treatment of orgasmic dysfunction.

The role of masturbation in the treatment of orgasmic dysfunction.

This chapter reports on the use of masturbation in the treatment of women who have never experienced orgasm (primary orgasmic dysfunction). A nine-step program was developed by the authors that includes directed masturbation in conjunction with sensate pleasuring and other therapy procedures.