Editing Orgasm (section)

== Medical aspects ==

=== Physiological responses ===

Masters and Johnson were some of the first researchers to study the sexual response cycle in the early 1960s, based on the observation of 382 women and 312 men. They describe a cycle that begins with excitement as blood rushes into the genitals, then reaches a plateau during which they are fully aroused, which leads to orgasm, and finally resolution, in which the blood leaves the genitals.<ref name="M&J" />

In the 1970s, Kaplan added the category of desire to the cycle, which she argues precedes sexual excitation. She states that emotions of anxiety, defensiveness, and the failure of communication can interfere with desire and orgasm.<ref>{{Cite journal |author = Kaplan HS |title = Hypoactive sexual desire |journal = [[Journal of Sex & Marital Therapy]] |volume = 3 |issue = 1 |pages = 3–9 |date = 1977 |pmid = 864734 |doi = 10.1080/00926237708405343 }}</ref> In the late 1980s and after, Rosemary Basson proposed a more cyclical alternative to what had largely been viewed as a linear progression.<ref>{{Cite news |first = Martin |last = Portner |title = The Orgasmic Mind: The Neurological Roots of Sexual Pleasure |date = May 15, 2008 |url = http://www.scientificamerican.com/article.cfm?id=the-orgasmic-mind |work = Scientific American |access-date = July 16, 2009 |url-status = live |archive-url = https://web.archive.org/web/20131102222534/http://www.scientificamerican.com/article.cfm?id=the-orgasmic-mind |archive-date = November 2, 2013 |df = mdy-all }}</ref> In her model, desire feeds arousal and orgasm and is in turn fueled by the rest of the orgasmic cycle. Rather than orgasm being the peak of the sexual experience, she suggests that it is just one point in the circle and that people could feel sexually satisfied at any stage, reducing the focus on climax as an end goal of all sexual activity.<ref>{{Cite journal |author = Basson R |title = The female sexual response: a different model |journal = [[Journal of Sex & Marital Therapy]] |volume = 26 |issue = 1 |pages = 51–65 |date = 2000 |pmid = 10693116 |doi = 10.1080/009262300278641 |doi-access = free }}</ref>

==== Females ====

A woman's orgasm may, in some cases, last a little longer than a man's.<ref name="Rathus" /><ref name=soc/><ref>{{Cite news |title = Women fall into 'trance' during orgasm |work = The Times |date = June 20, 2005 |url = http://www.timesonline.co.uk/tol/life_and_style/health/article535521.ece |archive-url = https://web.archive.org/web/20110715222511/http://www.timesonline.co.uk/tol/life_and_style/health/article535521.ece |archive-date = July 15, 2011 |access-date = August 6, 2012 |location = London }}</ref> Women's orgasms have been estimated to last on average approximately 20 seconds and to consist of a series of muscular contractions in the pelvic area that includes the vagina, the uterus, and the anus.<ref name="Levin">{{Cite journal |last = Levin |first = Roy J. |author2 = Gorm Wagner |author-link2 = Gorm Wagner |date = 1985 |title = Orgasm in women in the laboratory—quantitative studies on duration, intensity, latency, and vaginal blood flow |journal = Archives of Sexual Behavior |volume = 14 |issue = 5 |pages = 439–449 |doi = 10.1007/BF01542004 |pmid = 4062540 |s2cid = 6967042 }}</ref> For some women, on some occasions, these contractions begin soon after the woman reports that the orgasm has started and continue at intervals of about one second with initially increasing and then reducing intensity. In some instances, the series of regular contractions is followed by a few additional contractions or shudders at irregular intervals.<ref name="Levin" /> In other cases, the woman reports having an orgasm, but no pelvic contractions are measured at all.<ref>{{Cite journal |last = Bohlen |first = Joseph G. |author2 = James P. Held |author3 = Margaret Olwen Sanderson |author4 = Andrew Ahlgren |title = The female orgasm: Pelvic contractions |journal = Archives of Sexual Behavior |date = 1982 |pages = 367–386 |volume = 11 |issue = 5 |doi = 10.1007/BF01541570 |pmid = 7181645 |s2cid = 33863189 }}</ref>

Women's orgasms are preceded by the erection of the clitoris and moistening of the opening of the vagina. Some women exhibit a [[sex flush]], a reddening of the skin over much of the body due to increased blood flow to the skin. As a woman nears orgasm, the clitoral glans retracts under the clitoral hood, and the [[labia minora]] (inner lips) become darker. As orgasm becomes imminent, the outer third of the vagina tightens and narrows, while overall the vagina lengthens and dilates and also becomes congested from engorged soft tissue.<ref>{{cite web |title = Anatomic and physiologic changes during female sexual response |website = Clinical Proceedings |publisher = Association of Reproductive Health Professionals |url = http://www.arhp.org/healthcareproviders/cme/onlinecme/NYNCP/changes.cfm |archive-url = https://web.archive.org/web/20080708005232/http://www.arhp.org/healthcareproviders/cme/onlinecme/NYNCP/changes.cfm |archive-date = July 8, 2008 |access-date = February 1, 2007 }}</ref>

Elsewhere in the body, [[myofibroblast]]s of the nipple-[[Areolar connective tissue|areolar]] complex contract, causing erection of the nipples and contraction of the areolar diameter, reaching their maximum at the start of orgasm.<ref>{{cite journal |journal = [[Sexual and Relationship Therapy]] |volume = 21 |issue = 1 |pages = 237–249 |title = The Breast/Nipple/Areola Complex and Human Sexuality |date = May 2, 2006 |last = Levin |first = Roy |quote = Areola corrugation immediately after orgasm physically signals that orgasm has occurred |doi = 10.1080/14681990600674674 |s2cid = 219696836 |df = mdy-all }}</ref> A woman experiences full orgasm when her uterus, vagina, anus, and pelvic muscles undergo a series of rhythmic contractions. Most women find these contractions very pleasurable.

Researchers from the [[University of Groningen|University Medical Center of Groningen]] in the [[Netherlands]] correlated the sensation of orgasm with muscular contractions occurring at a frequency of 8–13&nbsp;Hz centered in the pelvis and measured in the anus. They argue that the presence of this particular frequency of contractions can distinguish between voluntary contraction of these muscles and spontaneous involuntary contractions, and appears to more accurately correlate with orgasm as opposed to other metrics like heart rate that only measure excitation. They assert that they have identified "[t]he first objective and quantitative measure that has a strong correspondence with the subjective experience that orgasm ultimately is" and state that the measure of contractions that occur at a frequency of 8–13&nbsp;Hz is specific to orgasm. They found that using this metric they could distinguish between rest, voluntary muscular contractions, and even unsuccessful orgasm attempts.<ref name = "Kortekaas 2008">{{Cite journal |vauthors = van Netten JJ, Georgiadis JR, Nieuwenburg A, Kortekaas R |title = 8–13 Hz fluctuations in rectal pressure are an objective marker of clitorally-induced orgasm in women |journal = Archives of Sexual Behavior |volume = 37 |issue = 2 |pages = 279–85 |date = April 2008 |pmid = 17186125 |doi = 10.1007/s10508-006-9112-9 |s2cid = 17498707 |url = https://eprints.qut.edu.au/93254/1/Van%20Netten%20Georgiadis%20ms_aseb-06-50.pdf |access-date = May 29, 2020 |archive-date = September 18, 2020 |archive-url = https://web.archive.org/web/20200918023850/https://eprints.qut.edu.au/93254/1/Van%20Netten%20Georgiadis%20ms_aseb-06-50.pdf |url-status = live }}</ref>

Since ancient times in Western Europe, women could be [[Medical diagnosis|medically diagnosed]] with a disorder called [[female hysteria]], the symptoms of which included faintness, nervousness, insomnia, fluid retention, heaviness in abdomen, muscle spasm, shortness of breath, irritability, loss of appetite for food or sex, and "a tendency to cause trouble".<ref name=Maines>{{cite book |author = Maines, Rachel P. |title = The Technology of Orgasm: "Hysteria", the Vibrator, and Women's Sexual Satisfaction |publisher = The Johns Hopkins University Press |location = Baltimore |date = 1998 |isbn = 978-0-8018-6646-3 }}</ref> Women considered to have the condition would sometimes undergo "pelvic massage:" stimulation of the genitals by the doctor until the woman experienced "hysterical paroxysm" (i.e., orgasm). Paroxysm was regarded as a medical treatment and not a sexual release.<ref name=Maines/> The disorder has ceased to be recognized as a medical condition since the 1920s.

==== Males ====

As a man nears orgasm during stimulation of the penis, he feels an intense and highly pleasurable pulsating sensation of [[Neuromuscular junction|neuromuscular]] [[euphoria]]. These pulsating sensations originate from the contractions of pelvic floor muscles that begin in the anal sphincter and travel to the tip of the penis, commonly described as a "throbbing" or "tingling" sensation. They eventually increase in speed and intensity as the orgasm approaches, until a final "plateau" (the orgasmic) pleasure is sustained for several seconds.<ref name="Dunn" />

During orgasm a male experiences rapid, rhythmic contractions of the [[Human anus|anal sphincter]], the prostate, and the [[bulbospongiosus muscle]]s of the penis. The [[sperm]] are transmitted up the [[vasa deferentia]] from the [[testicles]], into the prostate gland as well as through the [[seminal vesicle]]s to produce what is known as [[semen]].<ref name="Dunn" /> The prostate produces a secretion that forms one of the components of ejaculate. Except for in cases of a dry orgasm, contraction of the sphincter and prostate force stored semen to be expelled through [[External urethral orifice (male)|the penis's urethral opening]]. The process takes from three to ten seconds and produces a pleasurable feeling.<ref name="Mah" /><ref name="Dunn" /> Ejaculation may continue for a few seconds after the euphoric sensation gradually tapers off. It is believed that the feeling of "orgasm" varies from one man to another.<ref name="Mah" />  After ejaculation, a refractory period usually occurs, during which a man cannot achieve another orgasm. This can last anywhere from less than a minute to several hours or days, depending on age and other individual factors.<ref name="soc" /><ref name="Schacter" /><ref name="Weiner & Craighead" />

=== Brain ===

There have been very few studies correlating orgasm and brain activity in real time. One study examined 12 healthy women using a [[positron emission tomography]] (PET) scanner while they were being stimulated by their partners. Brain changes were observed and compared between states of rest, sexual stimulation, faked orgasm, and actual orgasm. Differences were reported in the brains of men and women during stimulation. Changes in brain activity were observed in both sexes, as regions associated with behavioral control, fear, and anxiety shut down. Regarding these, [[Gert Holstege]] said in an interview with ''[[The Times]]'', "What this means is that deactivation, letting go of all fear and anxiety, might be the most important thing, even necessary, to have an orgasm."<ref>{{Cite news |first = Mark |last = Henderson |title = Women fall into 'trance' during orgasm |date = June 20, 2005 |url = https://www.thetimes.com/uk/science/article/women-fall-into-trance-during-orgasm-q2vw29lpl0s |work = [[The Times]] |access-date = December 8, 2011 |location = London |archive-date = January 2, 2017 |archive-url = https://web.archive.org/web/20170102070253/http://www.thetimes.co.uk/tto/health/article1964119.ece |url-status = live }}</ref>

While stroking the clitoris, the parts of the female brain responsible for processing fear, anxiety, and behavioral control start to diminish in activity. This reaches a peak at orgasm when the female brain's emotion centers are effectively closed down to produce an almost trance-like state. Holstege is quoted as saying, at the 2005 meeting of the European Society for Human Reproduction and Development: "At the moment of orgasm, women do not have any emotional feelings."<ref>{{Cite news |first = Martin |last = Portner |title = The Orgasmic Mind: The Neurological Roots of Sexual Pleasure |date = May 15, 2008 |url = http://www.scientificamerican.com/article.cfm?id=the-orgasmic-mind |work = Scientific American |access-date = July 7, 2009 |url-status = live |archive-url = https://web.archive.org/web/20131102222534/http://www.scientificamerican.com/article.cfm?id=the-orgasmic-mind |archive-date = November 2, 2013 |df = mdy-all }}</ref> A subsequent report by Rudie Kortekaas, et al. states, "Gender commonalities were most evident during orgasm... From these results, we conclude that during the sexual act, differential brain responses across genders are principally related to the stimulatory (plateau) phase and not to the orgasmic phase itself."<ref name="Georgiadis" /> Research has shown that as in women, the emotional centers of a man's brain also become deactivated during orgasm but to a lesser extent than in women. Brain scans of both sexes have shown that the [[pleasure center]]s of a man's brain show more intense activity than in women during orgasm.<ref>''The Scientific American Book of Love, Sex, and the Brain: The Neuroscience of How, When, Why, and Who we love'', Judith Horstman (2011)</ref> Male and female brains demonstrate similar changes during orgasm, with brain activity scans showing a temporary decrease in the [[metabolism|metabolic]] activity of large parts of the [[cerebral cortex]] with normal or increased metabolic activity in the limbic areas of the brain.<ref name="Georgiadis" />

[[EEG]] tracings from volunteers during orgasm were first obtained by Mosovich and Tallaferro in 1954,<ref>{{cite journal |date = 1954 |title = Studies on EEG and sex function orgasm |journal = [[The Journal of Clinical Psychiatry|Diseases of the nervous system]] |volume = 15 |issue = 7 |pages = 218–20 |last1 = Mosovich |first1 = A. |last2 = Tallaferro |first2 = A. |pmid = 13182975 }}</ref> who recorded EEG changes resembling [[petit mal]] or the clonic phase of a [[grand mal]] seizure. Further studies in this direction were carried out by Sem-Jacobsen (1968), Heath (1972), Cohen et al. (1976),<ref>{{cite journal |date = May 1976 |title = Electroencephalographic laterality changes during human sexual orgasm |journal = [[Archives of Sexual Behavior]] |volume = 5 |issue = 3 |quote = Left and right parietal EEGs were recorded while seven subjects experienced sexual climax through self-stimulation |pmid = 952604 |doi = 10.1007/BF01541370 |last1 = Cohen |first1 = Harvey D. |last2 = Rosen |first2 = Raymond C. |last3 = Goldstein |first3 = Leonide |pages = 189–99 |s2cid = 23267494 }}</ref> and others.<ref>{{cite book |last1 = Niedermeyer |first1 = Ernst |first2 = Fernando Lopes da |last2 = Silva |title = Electroencephalography: Basic Principles, Clinical Applications, and Related Fields |edition = 5 |date = 2012 |publisher = [[Lippincott Williams & Wilkins]] |isbn = 978-1-4698-0175-9 |page = 183 |chapter = Polarity and Field Determination |chapter-url = https://books.google.com/books?id=OBCpFaNpm9kC&pg=PA161 |access-date = February 1, 2016 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055148/https://books.google.com/books?id=OBCpFaNpm9kC&pg=PA161 |url-status = live }}</ref><ref>{{cite book |last = Bancroft |first = John |title = Human Sexuality And Its Problems |edition = 3 |date = 2009 |publisher = [[Elsevier Health Sciences]] |isbn = 978-0-443-05161-6 |page = 88 |chapter = Sexual arousal and response the psychosomatic circle |chapter-url = https://books.google.com/books?id=bI-Jau14aLAC&pg=PA55 |access-date = February 1, 2016 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055149/https://books.google.com/books?id=bI-Jau14aLAC&pg=PA55 |url-status = live }}</ref> Sarrel et al. reported a similar observation in 1977. These reports continue to be cited.<ref>As examples, take:
*{{in lang|pl}} [[Kazimierz Imieliński]]. Zarys seksuologii i seksiatrii. [[Warsaw]] 1986, PZWL, {{ISBN|83-200-1047-0}} See also in the following Russian translation: Имелинский К.: Сексология и сексопатология (Sexology a. Sexopathology). [[Moscow]]: Медицина, 1986. — С. 57. (Chapter "Nervous system")
*{{in lang|ru}} [[Abram Svyadoshch]]. Женская сексопатология (Female sexopathology). — 3-е изд., перераб. и доп. — [[Moscow|Москва]]: Медицина, 1988. — С. 17 (the chapter entitled "Orgasm"). {{ISBN|5-225-00188-2}}
*{{in lang|ru}} [[Lev Shcheglov]]. Сексология. Врачу и пациенту. — [[Saint Petersburg]]: Олма-Пресс. — С. 81–82 (#4.3 "The main physiological processes ensuring sex function in humans"). {{ISBN|5-7654-1068-5}}, {{ISBN|5-224-02421-8}}</ref> Unlike them, Craber et al. (1985) failed to find any distinctive EEG changes in four men during masturbation and ejaculation; the authors concluded that the case for the existence of EEG changes specifically related to sexual arousal and orgasm remained unproven.<ref>{{cite journal |date = December 1985 |title = EEG during masturbation and ejaculation |journal = [[Archives of Sexual Behavior]] |volume = 14 |issue = 6 |quote = Examination of the literature shows little agreement among reported results of studies of EEG changes during orgasm. |pmid = 4084049 |last1 = Graber |first1 = B |last2 = Rohrbaugh |first2 = JW |last3 = Newlin |first3 = DB |last4 = Varner |first4 = JL |last5 = Ellingson |first5 = RJ |pages = 491–503 |doi = 10.1007/BF01541750 |s2cid = 31588348 }}</ref> So disagreement arises as to whether the experiment conducted by Mosovich and Tallaferro casts a new light on the nature of orgasm. In some recent studies, authors tend to adopt the opposite point of view that there are no remarkable EEG changes during ejaculation in humans.<ref>{{cite journal |last1 = Holstege |first1 = Gert |last2 = Georgiadis |first2 = Janniko R. |last3 = Paans |first3 = Anne M. J. |last4 = Meiners |first4 = Linda C. |last5 = Graaf |first5 = Ferdinand H. C. E. van der |last6 = Reinders |first6 = A. A. T. Simone |date = October 8, 2003 |title = Brain Activation during Human Male Ejaculation |journal = [[The Journal of Neuroscience]] |volume = 23 |issue = 27 |page = 9188 |format = PDF, HTML |doi = 10.1523/JNEUROSCI.23-27-09185.2003 |pmid = 14534252 |pmc = 6740826 |url = http://www.jneurosci.org/content/23/27/9185.full.pdf+html |url-status = live |archive-url = https://web.archive.org/web/20160101093636/http://www.jneurosci.org/content/23/27/9185.full.pdf%2Bhtml |archive-date = January 1, 2016 |df = mdy-all |doi-access = free }}</ref>

=== Health ===

==== General ====

Orgasm, and sexual activity as a whole, are physical activities that can require exertion of many major bodily systems. A 1997 study in the ''[[BMJ]]'' based upon 918 men aged 45–59 found that after a ten-year follow-up, men who had fewer orgasms were twice as likely to die of any cause as those having two or more orgasms per week.<ref>{{cite journal |title = Sex and Death: Are They Related? Findings from the Caerphilly cohort study |journal = [[BMJ]] |volume = 1997 |issue = 315 |pages = 1641–4 |doi = 10.1136/bmj.315.7123.1641 |date = December 20, 1997 |first1 = George |last1 = Davey Smith |author-link1 = George Davey Smith |first2 = Stephen |last2 = Frenkel |first3 = John |last3 = Yarnell |pmid = 9448525 |pmc = 2128033 }}</ref> A follow-up in 2001 which focused more specifically on [[cardiovascular]] health found that having sex three or more times per week was associated with a 50 percent reduction in the risk of heart attack or stroke. There is some research suggesting that greater resting heart rate variability is associated with orgasms through penile-vaginal intercourse without additional simultaneous clitoral stimulation.<ref name="Pappas" />

A small percentage of men have a disease called [[postorgasmic illness syndrome]] (POIS), which causes severe muscle pain throughout the body and other symptoms immediately following ejaculation. The symptoms last for up to a week.<ref name="Balon2005">{{cite book |title = Handbook of Sexual Dysfunction |publisher = Taylor & Francis |veditors = Balon R, Segraves RT |date = 2005 |isbn = 978-0-8247-5826-4 }}</ref><ref name="Wylie2015">{{cite book |url = https://books.google.com/books?id=oH64CAAAQBAJ&q=Post%20orgaasmic%20illness%20syndrome&pg=PA75 |title = ABC of Sexual Health |publisher = John Wiley & Sons |date = 2015 |page = 75 |isbn = 978-1-118-66556-5 |editor = Wylie KR |access-date = October 21, 2015 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055206/https://books.google.com/books?id=oH64CAAAQBAJ&q=Post%20orgaasmic%20illness%20syndrome&pg=PA75 |url-status = live }}</ref><ref name="GARD">{{cite encyclopedia |title = Postorgasmic illness syndrome |encyclopedia = Genetic and Rare Diseases Information Center (GARD) |publisher = [[National Institutes of Health]] |access-date = July 30, 2015 |date = 2015 |url = https://rarediseases.info.nih.gov/gard/10809/postorgasmic-illness-syndrome/resources/1 |url-status = dead |archive-url = https://web.archive.org/web/20160305193016/https://rarediseases.info.nih.gov/gard/10809/postorgasmic-illness-syndrome/resources/1 |archive-date = March 5, 2016 |df = mdy-all }}</ref> Some doctors speculate that the frequency of POIS "in the population may be greater than has been reported in the academic literature",<ref name="Ashby2010">{{cite journal |title = Postorgasm illness syndrome--a spectrum of illnesses |vauthors = Ashby J, Goldmeier D |journal = J. Sex. Med. |date = May 2010 |volume = 7 |issue = 5 |pages = 1976–81 |doi = 10.1111/j.1743-6109.2010.01707.x |pmid = 20214722 |df = mdy-all }}</ref> and that many people with POIS are undiagnosed.<ref name="McMahon2014">{{cite journal |url = https://www.statusplus.net/issm/saopaulo2014/presentations/082.pdf |title = Post-Orgasmic Illness Syndrome |author = McMahon CG |journal = 16th World Meeting on Sexual Medicine |date = October 2014 |url-status = dead |archive-url = https://web.archive.org/web/20160304110554/https://www.statusplus.net/issm/saopaulo2014/presentations/082.pdf |archive-date = March 4, 2016 |df = mdy-all |accessdate = August 11, 2015 }}</ref>

==== Dysfunction and satisfaction ====
{{Further|Orgasm gap}}

The inability to have an orgasm, or regular difficulty reaching orgasm after ample sexual stimulation, is called anorgasmia or inorgasmia.<ref name="Bullough">{{cite book |vauthors = Bullough VL, Bullough B |title = Human Sexuality: An Encyclopedia |publisher = [[Routledge]] |page = 32 |date = 2014 |access-date = December 6, 2014 |isbn = 978-1-135-82502-7 |url = https://books.google.com/books?id=-cqlAgAAQBAJ&pg=PA32 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055204/https://books.google.com/books?id=-cqlAgAAQBAJ&pg=PA32 |url-status = live }}</ref> If a male experiences erection and ejaculation but no orgasm, he is said to have [[sexual anhedonia]] (a condition in which an individual cannot feel pleasure from an orgasm) or ejaculatory [[anhedonia]]. Anorgasmia is significantly more common in women than in men,<ref name="Rosenthal 2">{{cite book |first = Martha |last = Rosenthal |title = Human Sexuality: From Cells to Society |publisher = [[Cengage]] |date = 2012 |page = 150 |access-date = October 22, 2013 |isbn = 978-0-618-75571-4 |url = https://books.google.com/books?id=d58z5hgQ2gsC&pg=PT170 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055213/https://books.google.com/books?id=d58z5hgQ2gsC&pg=PT170 |url-status = live }}</ref><ref name="Weiner2">{{cite book |vauthors = Weiner IB, Stricker G, Widiger TA |title = Handbook of Psychology, Clinical Psychology |publisher = [[John Wiley & Sons]] |date = 2012 |access-date = October 22, 2013 |pages = 172–175 |isbn = 978-1-118-40443-0 |url = https://books.google.com/books?id=A_NaK3cwQSsC&pg=PA172 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055236/https://books.google.com/books?id=A_NaK3cwQSsC&pg=PA172 |url-status = live }}</ref> which has been attributed to the lack of [[sex education]] about women's bodies, especially in [[Antisexualism|sex-negative]] cultures, such as clitoral stimulation usually being key for women to orgasm.<ref name="Weiner2" />

Approximately 25 percent of women report difficulties with orgasm,<ref name="Carroll 2">{{cite book |author = Janell L. Carroll |title = Discovery Series: Human Sexuality, 1st ed |publisher = [[Cengage]] |pages = 302–303 |isbn = 978-1-111-84189-8 |date = 2012 |access-date = August 25, 2013 |url = https://books.google.com/books?id=gU3SZSh-eXsC&pg=PT334 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055149/https://books.google.com/books?id=gU3SZSh-eXsC&pg=PT334 |url-status = live }}</ref> 10% of women have never had an orgasm,<ref name="Plotnik">{{cite book |author1 = Rod Plotnik |author2 = Haig Kouyoumdjian |title = Introduction to Psychology |publisher = [[Cengage]] |date = 2010 |page = 344 |isbn = 978-0-495-90344-4 |quote = Inhibited female orgasm refers to a persistent delay or absence of orgasm after becoming aroused and excited. About 10% of women never reach orgasm... }}</ref> and 40 percent or 40–50 percent have either complained about sexual dissatisfaction or experienced difficulty becoming sexually aroused at some point in their lives.<ref name="Knoepp">{{cite journal |vauthors = Knoepp LR, Shippey SH, Chen CC, Cundiff GW, Derogatis LR, Handa VL |title = Sexual complaints, pelvic floor symptoms, and sexual distress in women over forty |journal = [[The Journal of Sexual Medicine]] |volume = 7 |issue = 11 |pages = 3675–82 |date = 2010 |pmid = 20704643 |pmc = 3163299 |doi = 10.1111/j.1743-6109.2010.01955.x }}</ref> A 1994 study by Laumann et al. found that 75 percent of men and 29 percent of women always had orgasms with their spouse, while 40 percent of men and 80 percent of women thought their spouse always orgasmed during sex.<ref name="Laumann">{{cite book |isbn = 978-0-226-47020-7 |url = https://books.google.com/books?id=72AHO0rE2HoC&pg=PA130 |title = The Social Organization of Sexuality: Sexual Practices in the United States |last1 = Laumann |first1 = Edward O. |page = 130 |date = December 15, 2000 | publisher=University of Chicago Press |access-date = February 1, 2022 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055148/https://books.google.com/books?id=72AHO0rE2HoC&pg=PA130 |url-status = live }}</ref> These rates were different in non-marital straight relationships (cohabitational, long-term and short-term heterosexual relationships), with rates increasing to 81 percent for men and 43 percent for women orgasming during sex with their short-term partners, and 69 percent for men and 83 percent for women thinking their short-term partners always orgasmed.<ref name="Laumann" /> Women are much more likely to be nearly always or always orgasmic when alone than with a partner.<ref name="Kinsey Institute" /> In a 1996 study by Davis et{{nbsp}}al., 62 percent of women in a partnered relationship said they were satisfied with the frequency/consistency of their orgasms.<ref name="Kinsey Institute" /> Additionally, some women express that their most satisfying sexual experiences entail being connected to someone, rather than solely basing satisfaction on orgasm.<ref name="Wincze">{{Cite book |author = John Wincze |title = Enhancing Sexuality: A Problem-Solving Approach to Treating Dysfunction |date = 2009 |publisher = [[Oxford University Press]] |page = 60 |isbn = 978-0-19-971802-3 |url = https://books.google.com/books?id=8YxbeHsgiGMC&pg=PA60 |access-date = October 21, 2015 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055151/https://books.google.com/books?id=8YxbeHsgiGMC&pg=PA60 |url-status = live }}</ref><ref name="Gurian">{{cite book |author = Michael Gurian |title = The Wonder of Aging: A New Approach to Embracing Life After Fifty |publisher = [[Simon & Schuster]] |date = 2013 |page = 178 |access-date = December 9, 2014 |isbn = 978-1-4767-0671-9 |url = https://books.google.com/books?id=XyS5ebuXJWgC&pg=PT178 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055155/https://books.google.com/books?id=XyS5ebuXJWgC&pg=PT178 |url-status = live }}</ref>

Kinsey's 1953 ''[[Kinsey Reports|Sexual Behavior in the Human Female]]'' shows that over the previous five years of sexual activity, 78 percent of women had orgasms in 60–100 percent of [[Women who have sex with women|sexual encounters with other women]], compared with 55 percent for heterosexual sex.<ref>[[Alfred Kinsey|Kinsey, A.]]; [[Wardell Pomeroy|Pomeroy, W.]]; [[Clyde Martin|Martin, C.]], & [[Paul Gebhard|Gebhard, P.]] ''Sexual Behavior in the Human Female'', Philadelphia: Saunders (1953), {{ISBN|978-0-253-33411-4}}.</ref> Kinsey attributed this difference to female partners knowing more about women's sexuality and how to optimize women's sexual satisfaction than male partners do.<ref name="Weiten" /> Like Kinsey, scholars such as Peplau, Fingerhut, and Beals (2004) and Diamond (2006) found that lesbians have orgasms more often and more easily in sexual interactions than heterosexual women do,<ref name="Weiten" /> and that female partners are more likely to emphasize the emotional aspects of lovemaking.<ref name="Weiten" /> In contrast, research by Diane Holmberg and Karen L. Blair (2009), published in the ''Journal of Sex Research'', found that women in same-sex relationships enjoyed identical sexual desire, sexual communication, sexual satisfaction, and satisfaction with orgasm as their heterosexual counterparts.<ref>{{cite journal |title = Sexual Desire, Communication, Satisfaction, and Preferences of Men and Women in Same-Sex Versus Mixed-Sex Relationships |first1 = Diane |last1 = Holmberg |first2 = Karen Lyndsay |last2 = Blair |pages = 57–66 |doi = 10.1080/00224490802645294 |pmid = 19116863 |issn = 1559-8519 |journal = [[Journal of Sex Research|The Journal of Sex Research]] |volume = 46 |issue = 1 |date = 2009 |url = http://static1.squarespace.com/static/527403c4e4b02d3f058d2f18/t/52743826e4b08c252c719b66/1383348262856/Holmberg+%26+Blair+JSR+Vol+46+Iss+1+2009.pdf |url-status = live |archive-url = https://web.archive.org/web/20170125072622/http://static1.squarespace.com/static/527403c4e4b02d3f058d2f18/t/52743826e4b08c252c719b66/1383348262856/Holmberg%2B%26%2BBlair%2BJSR%2BVol%2B46%2BIss%2B1%2B2009.pdf |archive-date = January 25, 2017 |citeseerx = 10.1.1.533.9867 |s2cid = 26863933 }}</ref>

If orgasm is desired, anorgasmia may be attributed to an inability to relax. It may be associated with performance pressure and an unwillingness to pursue pleasure, as separate from the other person's satisfaction; often, women worry so much about the pleasure of their partner that they become anxious, which manifests as impatience with the delay of orgasm for them. This delay can lead to frustration of not reaching orgasmic sexual satisfaction.<ref name="Carroll 2" /> Psychoanalyst [[Wilhelm Reich]], in his 1927 book ''[[Die Funktion des Orgasmus]]'' (published in English in 1980 as ''Genitality in the Theory and Therapy of Neurosis'') was the first to make orgasm central to the concept of mental health, and he defined [[neurosis]] in terms of blocks to having [[orgastic potency]]. Although orgasm dysfunction can have psychological components, physiological factors often play a role. For instance, delayed orgasm or the inability to achieve orgasm is a common side effect of many medications.

Specifically, with simultaneous orgasm and similar practices, many sexologists claim that the problem of [[premature ejaculation]]<ref>{{cite web |url = http://www.sexarchive.info/IES/italy.html |title = The International Encyclopedia of Sexuality: Italy |publisher = .hu-berlin.de |date = January 1, 1999 |access-date = October 15, 2010 |url-status = dead |archive-url = https://web.archive.org/web/20160305193730/http://www.sexarchive.info/IES/italy.html |archive-date = March 5, 2016 }}</ref> is closely related to the idea encouraged by a scientific approach in the early 20th century when mutual orgasm was overly emphasized as an objective and a sign of true sexual satisfaction in intimate relationships. [[Menopause]] may involve loss of hormones supporting sexuality and genital functionality. Vaginal and clitoral atrophy and dryness affect up to 50–60 percent of postmenopausal women.<ref>{{cite journal |pmid = 10022110 |volume = 281 |issue = 6 |title = Sexual dysfunction in the United States: prevalence and predictors |date = February 1999 |journal = JAMA |pages = 537–44 |vauthors = Laumann EO, Paik A, Rosen RC |doi = 10.1001/jama.281.6.537 |doi-access =  }}</ref> Testosterone levels in men fall as they age. Sexual dysfunction overall becomes more likely with poor physical and emotional health. "Negative experiences in sexual relationships and overall well-being" are associated with sexual dysfunction.<ref>Laumann EO, Paik A, Rosen RC, "Sexual dysfunction in the United States: prevalence and predictors", ''JAMA'', 2007 August, {{cite web |url = http://www.medscape.org/viewarticle/561934 |title = Vaginal Atrophy: The 21st Century Health Issue Affecting Quality of Life |access-date = May 25, 2011 |url-status = live |archive-url = https://web.archive.org/web/20110101113135/http://www.medscape.org/viewarticle/561934 |archive-date = January 1, 2011 }}. Retrieved May 24, 2011</ref><ref>{{cite journal |vauthors = Yee LA, Sundquist KJ |date = 2003 |title = Older women's sexuality |url = https://www.mja.com.au/journal/2003/178/12/older-womens-sexuality#i1082816 |journal = The Medical Journal of Australia |volume = 178 |issue = 12 |pages = 640–643 |doi = 10.5694/j.1326-5377.2003.tb05393.x |pmid = 12797854 |s2cid = 33581540 |url-status = live |archive-url = https://web.archive.org/web/20170112032713/https://www.mja.com.au/journal/2003/178/12/older-womens-sexuality#i1082816 |archive-date = January 12, 2017 |df = mdy-all |url-access = subscription }}</ref>