Orgasmic Anhedonia/ PDOD: Treatment

Content Written By: Irwin Goldstein, MD

Psychologic approaches to improving orgasmic function focus on the woman exploring psychologic factors such as hypoactive sexual desire disorder, depression, poor arousal, anxiety, fatigue, emotional concerns, past trauma and abuse history, cultural and religious prohibitions feeling excess pressure to have sex, or a partner's sexual dysfunction such as erectile dysfunction or premature ejaculation. Sex therapy includes teaching the use by couples of manual or vibrator stimulation during intercourse, or using the female-above position as it may allow for greater stimulation of the clitoris and it allows the woman better control of movement. Sex therapy may focus on mindfulness strategies and yoga exercises. Sex therapy also assist the woman examine and realign expectations of orgasm. Emotional intelligence, or knowledge of one’s own mood or sense of being is important for orgasm function.

Off Label Treatment options:

Physiologic approaches to improving orgasmic function focus on ruling out contributing medical causes, such as switching medications if appropriate. Medications that may help with orgasm function include dopamine agonists (drugs that raise dopamine), oxytocin, phosphodiesterase type 5 inhibitors and alpha-2 receptor blockers such as yohimbine hydrochloride.

In many cases the combined psychologic and physiologic approaches to resolving the pleasure dissociative orgasmic disorder or orgasmic anhedonia make the most sense.

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