Many things can impact one's ability to have an orgasm. Having a negative body image, low self-esteem, or having a psychological disorder are just a few things that can impact orgasmic ability. Dove and Wiederman (2000) have focused on how cognitive interference (thoughts during sex) may effect orgasmic response. They have concluded that concerns about sexual performance and body appearance can greatly interfere with a women's orgasmic response. Therefore, if a woman is focused on how she is performing ("Am I doing a good job?") or how she looks ("Is the light amplifying my flaws?") it may be difficult for her to reach orgasm.
When considering orgasmic disorders it is important to keep in mind gender differences. As with many other areas of sexuality, orgasmically speaking, what is considered a dysfunction for a man may not be considered a dysfunction for a woman and vice versa. There are also gender differences in terms of how orgasm can be achieved. For most men, achieving an orgasm through penetration alone is rarely problematic, whereas for women this may not be the case. Additionally, there are also gender differences in time frame: men tend to reach orgasm much more quickly than women. Moreover, women can have multiple orgasms whereas most men cannot. This brings us to two common myths surrounding orgasm.
Myth # 1: Women can achieve orgasm through penetration alone.
Many people believe that women are able to achieve an orgasm through penetration alone. While certainly some women have this ability, for a large number of women, this is not the case. In fact, many women require clitoral stimulation to achieve orgasm. In March 2009, the popular magazine, Psychology Today carried the intriguing headline: "The Most Important Sexual Statistic" and the article began; "Only 25% of women are consistently orgasmic during vaginal intercourse alone." Clearly the myth remains. Estimates range between 40 to 70% of women will never orgasm via intercourse alone and will require clitoral stimulation to climax. Clitoral stimulation cannot always be achieved during penetration. Because of this unrealistic expectation, it is not uncommon for the heterosexual couple to feel like a failure if this is not achieved. The man may feel upset or inadequate because he cannot bring his partner to orgasm during penetration. And, the woman may also feel like a failure; as though something is wrong with her. It is important to recognize that this type of expectation may be unrealistic and unhealthy. It can cause distress at an individual level and introduces conflict into the relationship. It is important to keep in mind that orgasm can be achieved many different ways and the act of penetration can be pleasurable and arousing, despite the absence of orgasm. In fact, stimulation of the so-called G-spot (named after Dr. Grafenberg), located about 1-3 inches on the anterior wall of the vagina, is thought to cause intense sexual pleasure and mind-blowing orgasms; however, experts are divided about whether such a "spot" even exists.
Myth #2: He should be able to last longer.
There is definitely a debate regarding what defines premature ejaculation. On a more practical level we can simply look to the media to see that there is a large emphasis on how long a man can "last" during sex. It is not uncommon for heterosexual couples to begin therapy, shamefully whispering the reason for their visit is because he "suffers" from premature ejaculation. Upon further investigation, the clinician may discover that the man does not have premature ejaculation at all but rather the expectations of the couple have been set too high. In fact it is not uncommon for couples to complain because the man is "only" lasting 15-20 minutes during penetration. It is important to know, that 15-20 minutes is (way) above average. In fact, 3-8 minutes is considered average, normal, and healthy whereas 20 minutes or longer is considered average, normal, or healthy for women.
So why might this myth exist? Well, we certainly live in a culture where "more is better" and making sex last longer apparently falls under this rubric. With the media dictating through movies, songs, pornography etc. that men should be able to "last a long time" it is no wonder that we have unrealistic expectations. The other side of coin may be related to yet another gender difference in sexuality. Throughout this document we have discussed the many ways in which male and female sexuality are different. In fact, we have discussed how the sexual response cycle is different for men and women. It should come as no surprise that the "end" of the cycle is different as well. In effect, it seems that women take longer to get aroused than men. If orgasm is defined as a "peak" in arousal and women take longer to get aroused than men, it seems intuitive to realize that the rates at which men and women can reach orgasm are going to be different. In effect, it is going to take women longer to reach an orgasm than men. As discussed above, it seems that society places an emphasis on women orgasming from penetration alone, when in reality many, if not most, cannot. Thus, this may be in part related to the emphasis on the man lasting longer. If only HE could last long enough, then SHE could orgasm through penetration. Sometimes a clinician "solves" an orgasm problem for a couple merely by debunking these myths! But let's examine the true orgasmic disorders.