What is a 'female orgasm'? Orgasm is really a reflex reaction that involves muscular, hormonal, blood flow, emotional, psychological variables, and petrochemicals all in one coordinated event. And it's actually a learned reflex response like how when you cross the street, you hear a car coming, it's a reflex to step back but the reason you know to step back is because you know the car will hit you. It's the same with Orgasm, its a learned reflex that generally occurs during puberty if not before. And if those brain-genital connections are not made, for whatever reason in a young child/prepubescent then its very difficult for an adult to all of a sudden learn how to have an Orgasm. Doctors see a lot of patients that have never experienced Orgasm throughout their entire life. It's like trying to learn Chinese when you're forty as opposed to three. It's much more difficult, not to say that it can't happen. What is 'female orgasmic disorder'? Female orgasmic disorder is defined as lack of or inability to achieve orgasm, decrease in the intensity of the orgasm, where they have a quote unquote, muffled feeling. Or change in the intensity of orgasm or the frequency where they're harder to achieve and less intense. So it's anywhere on that spectrum, from not being able to, to a change in the quality defines orgasmic disorder. What are some common medical reasons a woman can't reach orgasm? The most common medical reasons for changes in orgasmic function are related to aging and menopause, and that's due to changes in hormones, blood flow, changes in our brain chemistry, and that's probably the most common cause. Other causes can be prior pelvic surgery, hysterectomy, bladder surgery, childbirth, medications. The antidepressant medications clearly are probably one of the most common causes for orgasmic disorder. When should a woman see a doctor about her inability to reach orgasm? Generally, if the orgasmic disorder is medically based it does not occur in isolation. The woman will also be experiencing other symptoms related to aging and menopause most likely. When it has become problematic and when it is causing her personal distress is when she should seek medical attention. But I say the earlier the better. If you wait until you can't have an orgasm and your hot flashing all over the place and hate your husband, and are depressed and can't sleep then it is much harder to treat. It is better, you have a better result the earlier you come in and the earlier you address these issues. Can women on anti-depressants be treated for orgasmic disorder? A lot of times women will get put on antidepressants because they're depressed they can't have an orgasm or depressed due to mood changes associated with menopause, and if they had been adequately evaluated and treated and received hormonal balance, dietary changes, and lifestyle changes, they might not need the antidepressants. So doctors should always determine, is this something you have a long standing history of depression, or is this something that happened acutely, you know recently. And then to evaluate in working with whoever their psychiatrist or provider is in providing the type of antidepressant with the least sexual function side effects, of which, by the way, there aren't many which is part of the problem. And then once we've exhausted all those possibilities we can give things such as Viagra to enhance sexual arousal and orgasms and topical genital sensation enhancing cream in addition to testosterone, oxytocin and things along those lines. Can Kegel exercises improve a woman's ability to climax? Kegel exercises help to enhance power for a time and during sexual intercourse contracting the pelvic forward muscles can help to enhance sensation and arousal and hence encroachment and hence directional pressure on the G spot and in some cases help to orgasm. Are 'sex toys' good ways for women to orgasm? I definitely encourage women to explore sex toys, alone, and or with a partner. And there's nothing to be ashamed about, there's nothing wrong with that, the only thing that I say is be conscientious of how there used, of cleaning them, of what the material is, if whether they can go in water or not go in water. But it is definitely an adjunct to the sexual relationship and over time when you feel comfortable with something, that is perfectly fine to incorporate into your relationship. Which vibrators help a woman to orgasm best? There are vibrators now that provide vaginal stimulation, vaginal pressure along with clitoral stimulation, those can be the next phase, but the pure vaginal stimulator, G-spot stimulators, require some degree of knowledge and time and effort. If a woman doesn't orgasm for several years, can she lose her ability to do so? If a woman doesn't achieve orgasm for several years, I would have hoped that she would have talked to her doctor about it. But there is the, use it or lose it phenomenon, that we refer to in men, also applies to women. The more sexually active we are, the more sexual stimulation we have. The more blood flow to the genital area, the more arousal stimulation we have. The better the health of our genital area, the better our sexual health. So this, whatever the problem, it's not something that you should wait over months or for that matter years to address.