The DSM IV-TR defines both female and male orgasmic disorder as a persistent delay or absence of orgasm after a normal excitation phase. Because the orgasm can be quite variable, it is important to note the factors that might impact orgasm. Even though an individual may report high sexual arousal and excitation they may report a lack of orgasm, decreased intensity of orgasm, or delay of orgasm when stimulated. Thus, it is not recommended that Orgasmic Disorder be diagnosed without considering the individual's age, sexual experience, and amount of sexual stimulation received.
As discussed above, many believe that women can achieve orgasm through penetration alone. It is not uncommon for men to incorrectly believe it must somehow be their fault, and their inadequate "technique," that prevents their female partner from achieving an orgasm through penetration alone. Women may also feel like a failure. For many women, clitoral stimulation is a must when it comes to achieving an orgasm. Thus, a woman that cannot orgasm through intercourse alone, but is able achieve an orgasm when clitoral stimulation is present, would not be considered to have Female Orgasmic Disorder.
When considering Female Orgasmic Disorder it is important to keep in mind that for some women this problem may be lifelong and occurs in all situations. For these women psychoeducation regarding sexuality may be helpful as well as a directed masturbation program whereby women receive instructions on how to masturbate. When a woman reports that she is able to have an orgasm through solitary masturbation, but is unable to achieve an orgasm in the presence of her partner, it may be worthwhile to consider whether she trusts her partner enough to orgasm in his presence. Orgasm can be considered a momentary loss of control. If a woman has difficulty trusting her partner, she may not feel safe and comfortable enough to loose control (orgasm) in the presence of her partner. In such situations therapy may prove beneficial (Basson et al., 2004).