In neurotic suppression of orgasm, orgasmic dysfunction in women is more often secondary, developing after a period of relatively normal sexual functioning. In these cases, sexual desire persists for a long time or slightly decreases, and the erogenous zones are sensitive. Women celebrate erotic dreams with orgasm, masturbation orgasm is possible. The disorder is relative, manifesting itself selectively with a certain partner, in the absence of anorgasmia with another man, who is able to adequately meet the emotional and sexual needs of a woman. Erotic stimulation leads to a high level of sexual arousal, but, according to women, “something prevents to finish”, “something does not work” and instead of discharge she experiences sexual frustration, although she was previously able to orgasm with the same partner. Psychogenic factors that led to the disappearance of orgasm require clarification and appropriate psychotherapeutic correction.
M.V. Ekimov (1999), along with the neurotic suppression of orgasm, highlights another option for female anorgasmia – due to “inadequately developed sexuality.” In these cases, women complain that they feel almost nothing, they cannot get aroused. Sexual frustration is mild or absent. They have a significant discrepancy between individual preferences and real sex. This discrepancy may concern both the sexual scenario and mechanical stimuli. The nature of some forms of masturbatory stimulation (with rhythmic squeezing of the thighs, under the stream of the soul) is so specific that it is impossible to reproduce them with coitus, therefore the woman is not able to achieve her usual feelings and orgasm with her sexual partner. If a woman is not able to experience an orgasm at all or does not reach it through sexual contact, considering this to be a serious problem in her personal life, the help of a sexologist is required. Orgasm is a complex psycho-vegetative reflex. Normally, the formation of orgasmic skills occurs independently, as one of the processes of psychosexual development.
But if the mechanisms of orgasm themselves have not been formed, or there is a rigid fixation on one of the forms of masturbation (for example, under the shower), it is necessary to help the woman develop adequate orgasmic skills. Until now, it has not been definitively established why some women never have an independent formation of orgasm mechanisms. Perhaps a certain role is played by the constitutional-biological predisposition. However, sex-therapeutic treatment, which does not directly affect biological factors, in many cases allows a woman to learn how to reach orgasm.
There are a number of transitional options between the two main forms of anorgasmia. So, if during neurotic suppression of an orgasm, the situation does not have a happy outcome, against the background of increasing discomfort from persistent sexual frustration, psychological defense works and the stimuli that previously aroused a woman, but did not lead to orgasm, cease to be so. A woman begins “in a familiar way” not to get excited in those situations and from those influences that previously acted as exciting, as is the case with “inadequately developed sexuality”.
Persistent lack of orgasm in men is uncommon and may be due to both psychological and organic causes. Since men’s orgastic experiences are closely related to ejaculation, the vast majority of cases of male anorgasmia are associated with an inability to ejaculate through sexual contact and / or masturbation. Disruption of the ejaculation process with intact orgasm is possible in cases of retrograde ejaculation, when, due to organic pathology, sperm are thrown into the bladder, and also due to hormonal insufficiency, when so little ejaculate is produced that it is not thrown out. The organic causes of an erased orgasm or its absence in men are damage to the conductive nerve pathways from the genitalia to the cortical centers, as well as colliculitis, i.e., inflammation of the seed tubercle.
According to W. Masters and W. Johnson, an inability to experience orgasm and ejaculate in the vagina from the very beginning of sexual life is observed in about two thirds of patients with complaints of lack of ejaculation and orgasm with coitus. Such psychogenic anejaculatory disorders are due to psychosexual delays. As a result, in men, the formation of sexual desire is delayed for a long time at the erotic stage, and they begin to have sex life much later than others (after 20–22 years). When they are close, they enjoy the greatest affection of mutual affection, and coital frictions are only slightly pleasant and are held mainly for the woman. A man, painlessly for himself, can at any time interrupt coitus at the request of a partner or on his own initiative. Incomplete (without ejaculation) sexual intercourse provokes nocturnal emissions, which are the only source of ejaculation. Anorgasmia, as well as the complete absence of sexual activity, are easily tolerated by such patients, and the main reason for seeking help from specialists is infertility in marriage. A psychogenic anejaculatory disorder may be relative in nature when it is associated with a strong fixation on specific sensations during masturbation or other types of stimulation, for example, oral-genital stimulation. At the same time, a man is able to achieve ejaculation and orgasm in the usual way, but he does not have ejaculation during intercourse or, in milder cases, requires extraordinary effort. Other psychological reasons for the inhibition of ejaculation and orgasm in a man include sex with a partner, which does not cause sexual attraction or inhibits its erotic emotions with its coldness, a frank demonstration of unwillingness of intimacy. Organic disorders of the ejaculatory reflex include spinal injuries and other neurological disorders, some operations (prostatectomy, sympathectomy), and pituitary tumors. Ejaculation and orgasm can be blocked by taking certain psychotropic drugs or antihypertensives, as well as the use of a man drug.
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