gasm throughout their lifetime. 
Development and Course 
By definition, lifelong female orgasmic disorder indicates that the orgasmic difficulties have
always been present, whereas the acquired subtype would be assigned if the woman’s or-
gasmic difficulties developed after a pe riod of normal orgasmic functioning. 
A woman’s first experience of orgasm can occur any time from the prepubertal period
to well into adulthood. Women show a more variable pattern in age at first orgasm than do
men, and women’s reports of having experien ced orgasm increase with age. Many women
learn to experience orgasm as they experien ce a wide variety of stimulation and acquire
more knowledge about their bodies. Women’s rates of orgasm consistency (defined as
“usually or always” experiencing orgasm) are higher during masturbation than during
sexual activity with a partner. 
Risk and Prognostic Factors 
Temperamental. A wide range of psychological factors, such as anxiety and concerns
about pregnancy, can potentially interfere wi th a woman’s ability to experience orgasm.
Environmental. There is a strong association betw een relationship problems, physical
health, and mental health and orgasm difficulties in women. Sociocultural factors (e.g.,
gender role expectations and religious norms)  are also important influences on the expe-
rience of orgasmic difficulties.
Genetic and physiological. Many physiological factors may influence a woman’s expe-
rience of orgasm, including medical conditio ns and medications. Conditions such as mul-
tiple sclerosis, pelvic nerve da mage from radical hysterectomy, and spinal cord injury can
all influence orgasmic functioning in women. Selective serotonin reuptake inhibitors are
known to delay or inhibit orgasm in women.  Women with vulvovaginal atrophy (charac-
terized by symptoms such as vaginal dryness, itching, and pain) are significantly more