ABSTRACT
Pre- and post-menopausal women complain that the quality of orgasm had diminished over time or that they need to work harder to achieve orgasm. Relational factors play the largest role in orgasm difficulties and assess for the women's level of current relationship satisfaction and history of previous intimate relationships. While anorgasmia have an organic basis, it is most commonly an issue of lack of experience with masturbatory orgasms and other psychological factors that inhibits the woman with female orgasmic disorder (FOD). The treatment program for FOD addresses all domains of the intersystem but focuses predominately on cognitive-behavioral interventions. Directed masturbation has been shown to be an effective evidence-based form of cognitive-behavioral therapy for treating FOD. Sexual fantasies are an essential element of sexual desire and arousal. It is important to appreciate the role of fantasy in continuing the arousal process as the woman approaches orgasm.
