Coital anorgasmia is a common complaint among women consulting for sexual problems. Recently, a genetic predisposition was proposed. This presentation discusses the role of physical learning. Case report A 53 year old woman consulted with secondary anorgasmia of two years. She had been orgasmic through clitoral stimulation prior to an extensive vulvectomy including clitoridectomy for Bowen’s disease. Sexocorporal therapeutic interventions included instructions for digital vaginal stimulation and mobilisation of the pelvis through iliopsoas and pelvic floor muscle contractions with abdominal breathing.
After three months’ training, the patient achieved satisfying orgasms through vaginal stimulation and pelvic movement.
Concluding from research among women with genital mutilation (FGM), the clitoris is not inevitable for orgasm. The rate of orgasm through penile-vaginal stimulation is higher among FGM women than among women with intact clitoris. We propose that orgasmic response and the favored location of stimulation depends not just on genetics, but on the physical learning history. Clitoral response, comparatively easily accessible, may keep a woman from exploring and developing her vaginal sensitivity. The more remote vagina and surrounding pelvic floor muscles require repetitive pressure to develop responsiveness, which is enhanced through pelvic movement. Through corresponding physical training, as applied in sexocorporal therapy, vaginal sexual response can be accessible to women even after destructive surgery.
Women consulting for coital anorgasmia can be encouraged to develop vaginal sexual response through repetitive vaginal stimulation and play with pelvic muscles. It is important to give this information to women with extensive vulval surgery.
Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Recorded at 19th WAS World Congress for Sexual Health - Sexual Health & Rights: A Global Challenge Göteborg (Sweden) - June 21 – 25, 2009
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