Female Orgasmic Disorder 431
despite rarely or never experiencing orgasm . Orgasmic difficulties in women often co-
occur with problems related to  sexual interest and arousal.
In addition to the subtypes “lifelong/acquired” and “generalized/situational,” the fol-
lowing five factors must be considered during assessment and diagnosis of female orgas-
mic disorder given that they may be relevant to etiology and/or treatment: 1) partner
factors (e.g., partner’s sexual problems, partner’s health status); 2) relationship factors
(e.g., poor communication, discre pancies in desire for sexual activity); 3) individual vul-
nerability factors (e.g., poor body  image, history of sexual or  emotional abuse), psychiatric
comorbidity (e.g., depression, anxiety), or st ressors (e.g., job loss, bereavement); (4) cul-
tural/religious factors (e.g., inhibitions relate d to prohibitions against sexual activity;
attitudes toward sexuality); and 5) medical fact ors relevant to prognosis, course, or treat-
ment. Each of these factors may contribute differently to the presenting symptoms of dif-
ferent women with this disorder. 
Prevalence 
Reported prevalence rates for female orgasmic problems in women vary widely, from 10%
to 42%, depending on multiple factors (e.g., ag e, culture, duration, and severity of symp-
toms); however, these estimates do not take into account the presence of distress. Only a
proportion of women experiencing orgasm di fficulties also report associated distress.
Variation in how symptoms are assessed (e.g., the duration of symptoms and the recall pe-
riod) also influence prevalence rates. Approx imately 10% of women do not experience or-