Female orgasmic disorder, sometimes called inhibited female orgasm or anorgasmia, is defined as the recurrent or persistent inhibition of female orgasm, as manifested by the recurrent delay in, or absence of, orgasm after a normal sexual excitement phase that a clinician judges to be adequate in focus, intensity, and duration. A woman with lifelong female orgasmic disorder has never experienced orgasm by any kind of stimulation. A woman with acquired orgasmic disorder has previously experienced at least one orgasm, regardless of the circumstances or means of stimulation, whether by masturbation or while dreaming during sleep. The incidence of orgasm increases with age. The overall prevalence of female orgasmic disorder from all causes is estimated to be 30 percent. A recent twin study suggests that orgasmic dysfunction in some females has a genetic basis and cannot be attributed solely to cultural differences. Numerous psychological factors are associated with female orgasmic disorder. They include fears of impregnation, rejection by a sex partner, and damage to the vagina; hostility toward men; and feelings of guilt about sexual impulses. Nonorgasmic women may be otherwise symptom free or may experience frustration in a variety of ways; they may have such pelvic complaints as lower abdominal pain, itching, and vaginal discharge, as well as increased tension, irritability, and fatigue. Decreased testosterone, oxytocin release and underlying primary psychiatric disorders are common in these patients. Hyperprolactenemia is also an important cause.
In male orgasmic disorder, sometimes called inhibited orgasm or retarded ejaculation, a man achieves ejaculation during coitus with great difficulty, if at all. Some researchers think that orgasm and ejaculation should be differentiated, especially in the case of men who ejaculate but complain of a decreased or absent subjective sense of pleasure during the orgasmic experience (orgasmic anhedonia). The incidence of male orgasmic disorder is much lower than the incidence of premature ejaculation or impotence. A general prevalence of 5 percent has been reported. In an ongoing relationship, acquired male orgasmic disorder frequently reflects interpersonal difficulties. The disorder may be a man's way of coping with real or fantasized changes in a relationship.
In premature ejaculation, men persistently or recurrently achieve orgasm and ejaculation before they wish to. No definite timeframe exists within which to define the dysfunction; the diagnosis is made when a man regularly ejaculates before or immediately after entering the vagina. Masters and Johnson conceptualized the disorder in terms of the couple and considered a man a premature ejaculator if he could not control ejaculation sufficiently long enough during intravaginal containment to satisfy his partner in at least half their episodes of coitus. This definition assumes that the female partner is capable of an orgasmic response. Premature ejaculation is the chief complaint of about 35 to 40 percent of men treated for sexual disorders. Some researchers divide men who experience premature ejaculation into two groups: those who are physiologically predisposed to climax quickly because of shorter nerve latency time and those with a psychogenic or behaviorally conditioned cause. Difficulty in ejaculatory control can be associated with anxiety regarding the sex act, or with negative cultural conditioning. In ongoing relationships, the partner has a great influence on a premature ejaculator, and a stressful marriage exacerbates the disorder.