Women with female sexual orgasmic disorder (FSOD) – difficulty reaching orgasm – may have “a clitoral hyposensitivity,” according to the authors of a recent Journal of Sexual Medicine study.
Both psychological and physiological factors can contribute to FSOD. However, research has focused more on psychological aspects than physiological ones. In this study, the researchers used quantitative sensory testing (QST) to investigate whether women with FSOD had vibratory “sensory deficits” that might impair their orgasmic function.
QST is a diagnostic procedure that assesses genital sensation using thermal and vibratory probes.
Participants included 199 women with an average age of 38 years. The women all were patients at a sexual dysfunction clinic in Israel between 2014 and 2016.
Two groups were formed. The study group (89 women) had a primary complaint of FSOD. The remaining 110 women (the control group) had other sexual complaints, such as poor lubrication or low arousal, but not FSOD.
The women completed the Female Sexual Function Index (FSFI) questionnaire, which assesses the domains of desire, arousal, lubrication, orgasm, satisfaction, and pain.
They also underwent QST, with probes applied to both the vagina and the clitoris. For each application, the stimulus probe was gradually intensified until the woman reported a sensation. In this way, the researchers determined sensation thresholds.
Average FSFI total and orgasm domain scores were “significantly lower” in the study group compared to the control group, indicating poorer function. Lower total FSFI scores among study group participants might suggest that FSOD influences other domains of female sexual dysfunction, the authors said.
The study group also had higher vibratory sensory thresholds for the clitoris. In other words, they needed more intense stimulation to feel sensation.
“These findings support a role of the clitoris in obtaining sexual orgasm and a possible physiologic cause of FSOD, beyond the demonstrated psychological causes,” the authors wrote.
Vaginal vibratory sensory thresholds did not differ significantly between the groups. But that doesn’t mean vaginal response shouldn’t be evaluated when assessing sexual dysfunction, the researchers pointed out.
“Probably the best way to evaluate FSOD and its true magnitude is by taking into consideration both clitoral and vaginal sensory thresholds, together with FSFI-FSOD domain scores, combined with a good medical history,” they concluded.
The Journal of Sexual Medicine
Gruenwald, Ilan, MD, et al.
“Female Sexual Orgasmic Dysfunction and Genital Sensation Deficiency”
(Full-text. Published online: December 19, 2019)