title: Disorders of orgasm in women.
abstract: BACKGROUND
  Orgasm is a sensation of intense pleasure creating an altered consciousness state accompanied by pelvic striated circumvaginal musculature and uterine/anal contractions and myotonia that resolves sexually-induced vasocongestion and induces well-being/contentment. In 1,749 randomly-sampled U.S. women, 24% reported an orgasmic dysfunction.
  
  
  OBJECTIVE
  To provide recommendations/guidelines concerning state-of-the-art knowledge for management of orgasmic disorders in women.
  
  
  METHODS
  An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Disorders of Orgasm in Women Committee, there were four experts from two countries.
  
  
  METHODS
  Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.
  
  
  RESULTS
  Female Orgasmic Disorder, the second most frequently reported women's sexual problem is considered to be the persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase that causes marked distress or interpersonal difficulty (DSM-IV). Empirical treatment outcome research is available for cognitive behavioral and pharmacological approaches. Cognitive-behavioral therapy for anorgasmia promotes attitude and sexually-relevant thought changes and anxiety reduction using behavioral exercises such as directed masturbation, sensate focus, and systematic desensitization treatments as well as sex education, communication skills training, and Kegel exercises. To date there are no pharmacological agents trials (i.e., bupropion, granisetron, and sildenafil) proven to be beneficial beyond placebo in enhancing orgasmic function in women diagnosed with Female Orgasmic Disorder.
  
  
  CONCLUSIONS
  More research is needed in understanding management of women with orgasmic dysfunction.
authors.affiliation: Department of Psychology, University of Texas, Austin, TX 78712, USA. meston@psy.utexas.edu
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Meston
authors.forename: Elaine
authors.initials: E
authors.lastname: Hull
authors.forename: Roy J
authors.initials: RJ
authors.lastname: Levin
authors.forename: Marca
authors.initials: M
authors.lastname: Sipski
mesh_terms: D001521:Behavior Therapy / Q000379:methods; D003075:Coitus / Q000502:physiology / Q000523:psychology; D032921:Consensus; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008418:Masturbation / Q000503:physiopathology / Q000523:psychology; D009948:Orgasm; D017410:Practice Guidelines as Topic / Q000592:standards; D012702:Serotonin Antagonists / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*
chemical_list: D012702:Serotonin Antagonists