WORKING TO REMOVE PHYSICAL BARRIERS TO ORGASM

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THE FEMALE ORGASM:  Here we are looking at one of the more complex challenges in the area of human sexuality—the orgasm.

WHAT HAPPENS?  Orgasm is technically the moment when the muscles of your uterus, vagina, pelvic floor and anus involuntarily contract rhythmically and simultaneously, and then relax.   An orgasm can include roughly 1 – 12 contractions lasting about one second each, and the entire orgasm can last anywhere from a few seconds to a full minute.  During orgasm, the brain releases chemicals including oxytocin and dopamine, leading to a feeling of relaxation and well-being.

GETTING THERE:  If things are going well, then during foreplay, blood flow increases to your vagina and clitoris.  The vaginal walls secrete beads of lubrication.   As you become more turned on, blood flow continues to flood the pelvic area, breathing increases, as does heart rate, nipples become erect, and there is increased nerve and muscle tension build up in the genitals, pelvis, buttocks, and thighs.   After sufficient stimulation, your body involuntarily releases all that tension—in a series of contractions, which is the orgasm.

AREAS OF SEXUAL DIFFICULTY FOR WOMEN:  Sex therapists and sex researchers—the most well known of which include Masters and Johnson—have long studied the female orgasm.  We now understand there is wide variability in orgasmic responsiveness among women.   In keeping with growing understanding about resolving orgasmic difficulties, treatment has shifted from an inhibition-focused, intrapsychic perspective toward an interpersonal, systemic approach .

SEX THERAPY EXAMINES THE WHOLE PICTURE:  This means that in sex therapy, more emphasis is placed on the situational conditions that make orgasm possible.

These Include:

– The Adequacy of Arousal
Pain or Discomfort During Intercourse
Ability to Maintain a State of Arousal

CATEGORIES OF DIFFICULTY:  Sex therapists and researchers place the failure or difficulty in achieving orgasm into a few categories, including physical causes,  emotional causes, psychological causes and interpersonal causes.

PHYSICAL CAUSES OF ANORGASMIA:  Orgasmic ease in women falls along a normal bell curve.  At the extremes, we find a small percentage of women who cannot be successfully treated, and at the other extreme, a small percentage of women able to achieve orgasm through self-induced imagery alone!

INTERCOURSE IS NOT IDEAL:  For most women, however, the major physical cause of orgasmic difficulty is anatomy: the most effective way of providing the sensory stimulation that triggers orgasmic release in women is not penile thrusting.  But, even though male-active coitus is not always an effective way to bring about female orgasm, it characterizes the way most heterosexual couples have sex!

PSYCHOLOGICAL CAUSES OF ANORGASMIA:  Sex therapists and sex research show that while depression or a history of sexual trauma does not necessarily affect orgasmic ease, it can certainly affect desire and arousal.  Further related to sexual abuse is the woman’s tendency to protect herself against repeating the feeling of helplessness that was once felt in the abusive situation by controlling her adult sexual interactions.  This creates an overly intellectual approach to the sexual encounter which can cause orgasmic difficulty by preventing attention to bodily sensations.

INTERPERSONAL CAUSES OF ANORGASMIA:  Sex therapists, psychosexual therapists, and sexual health counselors confirm what the research shows: A woman’s sense of pleasure and safety in her relationship is related to her orgasmic response. 

MARRIAGE COUNSELING & SEX THERAPY WORK HAND-IN-HAND:  When we acknowledge that the relationship itself is the starting point for orgasmic success or failure, we can look to marriage counseling and sex therapy together as partners in understanding and cure.

WHAT HAPPENS IN SEX THERAPY?  When a couple comes for sex therapy, they have the chance to explain the problems in their sexual and emotional relationship to a trained clinician.  They have the chance to explore their sexual histories, practices and beliefs, and slowly and carefully discuss the specific details of their struggle.   The sex therapist will ask about arousal and foreplay, about sexual preferences and fantasies, and about each partners’ orgasmic response.  Emotional and physical issues will be addressed carefully in an environment of safety and respect.   Often the couple is assigned “homework” which they report on at their next session.  Discussion, questions and adjustments are made for the next time.  Slowly, the couple learn to deepen their sexual and emotional relationship, enhancing intimacy and pleasure.

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