When a person is frequently unable to experience a normal sexual response, leading to frustration and distress.

Normal: majority in their reference group. Vast cultural differences.

Not all "experts" agree. Historical changes. e.g.: clitoral orgasm only, not vaginal.

e.g. Victorian era: women who experienced orgasm with their husbands were "sluts".

Historical (Individual) Context

Women - 43%

Men - 30%

Young Women: mostly psychosocial

Old Men: mostly organic


Organic Causes of Erectile Disorder:

Causes of Painful Intercourse (Women) or Dispareunia - 14-15% (vs. males 3%)

Psychological causes:

Depression: interferes with sexual desire and orgasmic capacity.

Antidepressants: ditto

Other psychological causes:

Biological factors:

- other biological factors:

Common Drugs that affect sexual response:



Medical Treatments:

Masters and Johnson's Sex Therapy:

Therapeutic steps for anorgasmic women: (women who can't have orgasms)

  1. Education, information.
  2. Self-exploration.
  3. Kegels.
  4. Self-touching and self-stimulation. Masturbation.
  5. Assertive thoughts, giving self permission.
  6. Use of fantasy, books, videos, audiotapes.
  7. Focus on sensations, not on goal.
  8. Bring in partner. Nondemanding sensate focus exercises - no intercourse.
  9. Partner stimulates women manually or orally to orgasm following her directions
  10. Intercourse when she is ready.

Biological treatments for erectile dysfunction:

Surgery: to unblock vessels that supply blood to penis.

Hormones: testosterone, if abnormally low (men and women) MIGHT help.

Injections: muscle relaxants, into corpus cavernosum. Allows blood vessel muscles to relax and blood flows in.

Suppositories: muscle relaxant into penis.

Vacuum pump: increases blood flow into penis

Penile implants: permanent

Pills: Viagra (sildenafil) and Vasomax (phentolamine) relax blood vessel muscles. Spontane (apomorphine) works at brain level to trigger erection.

Side effects of Viagra (dose dependent):

Vasomax fewer side effects.