From the Guidelines
Sexual anhedonia and anorgasmia are distinct sexual dysfunctions, with sexual anhedonia characterized by the ability to reach orgasm without experiencing pleasure, and anorgasmia defined as the inability to reach orgasm despite adequate sexual stimulation and arousal. The key difference between these two conditions lies in the physical and emotional response to sexual stimulation. Sexual anhedonia occurs when the physical response of orgasm is present, but the emotional and pleasurable component is absent 1. On the other hand, anorgasmia is marked by the inability to achieve the physical climax of orgasm, despite adequate stimulation and arousal.
Causes and Risk Factors
Both conditions can have psychological causes, such as stress, anxiety, depression, and trauma, as well as physical origins, including medication side effects, hormonal imbalances, and neurological conditions 1. Certain medications, including antidepressants (particularly SSRIs like fluoxetine and sertraline), antipsychotics, and some blood pressure medications, may contribute to either condition.
Treatment Approaches
Treatment approaches for these conditions differ slightly. Anorgasmia may respond to changing sexual techniques or addressing underlying physical causes, while sexual anhedonia might require more focus on neurochemical or psychological factors affecting the pleasure response 1. In some cases, normalization of serum testosterone levels may be considered for patients with delayed ejaculation and testosterone deficiency. Additionally, clinicians may offer treatment to address comorbid erectile dysfunction according to established guidelines.
Importance of Specialist Care
Given the complexity and potential impact of these conditions on sexual satisfaction and relationships, consulting with a healthcare provider who specializes in sexual health is recommended for proper diagnosis and treatment. This specialist can help determine the underlying causes of the condition and develop an individualized treatment plan to address the specific needs of the patient.
From the Research
Definition and Diagnosis
- Sexual anhedonia is not explicitly defined in the provided studies, however, anorgasmia is defined as the absence of orgasm 2, 3, 4.
- Anorgasmia is characterized as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress 3.
- Delayed orgasm is defined as increased latency of orgasm despite adequate sexual stimulation and desire 2.
Comparison of Sexual Anhedonia and Anorgasmia
- There is limited information available on sexual anhedonia in the provided studies, however, anorgasmia is a well-defined condition with various etiologies, including medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia 2, 3, 4.
- Anorgasmia can be further classified into different subtypes, including female orgasmic disorder, which is defined as the absence, delay, infrequency, or marked diminishment in intensity of orgasm in at least 75% of sexual experiences, persisting for at least 6 months and causing distress 5.
Treatment Options
- Treatment for anorgasmia can be challenging due to the lack of standardized FDA-approved pharmacotherapies, and common treatment plans are often multidisciplinary and may include adjustment of offending medications and sex therapy 2, 3.
- Psychological treatment, including directed masturbation, sensate focus, and psychotherapy, has been shown to be effective in helping women with female orgasmic disorder to gain or regain the ability to have orgasms 5.