does not meet the recommended 6-month threshold.
For a woman to have a diagnosis of female or gasmic disorder, clinically significant dis-
tress must accompany the symptoms (Criterion C). In many cases of orgasm problems, the
causes are multifactorial or cannot be determined. If female org asmic disorder is deemed
to be better explained by another mental diso rder, the effects of a substance/medication,
or a medical condition, then a diagnosis of fe male orgasmic disorder  would not be made.
Finally, if interpersonal or significant contextual factors, such as severe relationship dis-
tress, intimate partner violence, or other signi ficant stressors, are present, then a diagnosis
of female orgasmic diso rder would not be made.
Many women require clitoral stimulation to  reach orgasm, and a relatively small pro-
portion of women report that they always ex perience orgasm during penile-vaginal inter-
course. Thus, a woman’s experiencing orgasm through clitoral stim ulation but not during
intercourse does not meet criteria for a clinic al diagnosis of female orgasmic disorder. It is
also important to consider whether orgasmic difficulties are the result of inadequate sex-
ual stimulation; in these cases, there may still be a need for care, but a diagnosis of female
orgasmic disorder would not be made.
Associated Features Supporting Diagnosis 
Associations between specific patterns of personality traits  or psychopathology and orgas-
mic dysfunction have generally not been su pported. Compared with women without the
disorder, some women with female orgasmic disorder may have greater difficulty com-
municating about sexual issues. Overall sexual satisfaction, however, is not strongly cor-
related with orgasmic experien ce. Many women report high le vels of sexual satisfaction