Male Sexual Dysfunction
To be diagnosed as having primary orgasmic dysfunction, a woman must report a lack of orgasmic attainment during her entire lifespan. There is no definition of male sexual dysfunction that parallels this severity of exclusion.
A Male Is Judged Primarily Impotent:
The definition means simply that he has never been able to achieve intromission in either homosexual or heterosexual opportunity. However, he might, and usually does, masturbate with some regularity or enjoy occasions of partner manipulation to ejaculation.
For the primarily non-orgasmic woman, however, the definition demands a standard of total orgasmic responsivity.
The edict of lifetime non-orgasmic return in the Foundation’s definition of primary orgasmic dysfunction includes a history of consistent non-orgasmic response to all attempts at physical stimulation, such as masturbation, male or female manipulation, oral-genital contact, and vaginal or rectal intercourse.
Every possible physical approach to sexual stimulation initiated by self or received from any partner has been totally unsuccessful in developing an orgasmic experience for the particular woman diagnosed as primarily non-orgasmic.
If a woman is orgasmic in dreams or fantasy alone, she still would be considered primarily non-orgasmic.
Foundation personnel has encountered two women who provided a positive history of an occasional dream sequence with orgasmic return and a negative history of physically initiated orgasmic release.
However, no woman has been encountered to date that described the ability to fantasy to orgasm without providing a concomitant history of successful orgasmic return from a variety of physically stimulative measures.
There are salient truths about male and female sexual interaction that place the female in a relatively untenable position from equality of sexual response.
Of primary consideration is the fact of a woman’s physical necessity for an effectively functioning male sexual partner if she is to achieve a coitally experienced orgasmic return.
During coition, the non-orgasmic human female is immediately more disadvantaged than her sexually inadequate partner in that her performance fears are dual in character. Her primary fear is, of course, for her own inability to respond as a woman, but she frequently must contend with the secondary fear for the inadequacy of male sexual performance.
The outstanding example of such a situation is, of course, that of the woman married to a premature ejaculator. From mutual responsibility for sexual performance, the woman has only to make herself physically available to provide the male with ejaculatory satisfaction.
The premature ejaculator in turn makes himself available, there usually is little correlation between intromission, rapid ejaculation, and female orgasmic return during the episode.
Married Premature Ejaculator
The biophysically disadvantaged female usually is additionally disadvantaged from a psychosocial point of view. Not only is there the insufficient bio-physical opportunity to accomplish orgasmic return, but in short order, the wife develops the concept of being sexually used in the marriage.
She feels that her husband has no real interest in her personally nor any concept of responsibility to her as a sexual entity. Many times the wife might be at a peak of sexual excitation with intromission. Without fear for her husband’s sexual performance, she could be orgasmically responsive shortly after the coital connection, displaying a full bio-physical capacity for sexual response.
But as she sees and feels the male thrusting frantically for ejaculatory release, she immediately fears the loss of sexual opportunity, is distracted from the input of biophysical stimuli by that fear, and rapidly loses sexual interest.
With the negative psychosocial-system influence from the concept of being used more than counterbalancing the high level of biophysically oriented sexual tension she brought to the coital act, the orgasmic opportunity is lost.
A brief attempt should be made to highlight the direct association of male and female sexual dysfunction in marriage, for there were 223 couples referred to the Foundation for treatment with bilateral partner complaints of sexual inadequacy. By far the greatest instance of a combined diagnosis was that of a non-orgasmic woman married to a premature ejaculator.
Of the total 186 premature ejaculators treated in the 11-year program, 68 were married to women reported as primarily non-orgasmic and an additional 39 wives were diagnosed as situationally non-orgasmic. Thus, in 107 of the 223 marriages with bilateral partner complaints of sexual dysfunction, the specific male sexual inadequacy was premature ejaculation.
Since the in-depth descriptions of the premature ejaculator presented in the earlier topics include full descriptions of the problems of female sexual functioning in this situation, there is no need for a detailed history representative of the 68 women primarily non-orgasmic in marriages to prematurely ejaculating men.
Another salient feature in the human female’s disadvantaged role in coital connection is the centuries-old concept that it is a woman’s duty to satisfy her sexual partner. When the age-old demand for accommodation during coital connection dominates any woman’s responsivity, her own opportunities for orgasmic expression are lessened proportionately.
If a woman is to express her biophysical drive effectively, she must have the single-standard opportunity to think and feel sexually during coital connection that previous cultures have accorded the man.
must consider the marital bed as not only his privilege but also a shared responsibility if his wife is to respond fully with him in coital expression. The heedless male driving for orgasm can carry along the woman already lost in high levels of sexual demand, but his chances of elevating to orgasm the woman who is trying to accommodate to the rhythm, depth, and power of his demanding pelvic thrusting are indeed poor.
It is extremely difficult to categorize female sexual dysfunction on a relatively secure etiological basis. There is such a multiplicity of influences within the biophysical and psychosocial systems that to isolate and underscore a single, major etiological factor in any particular situation is to invite later confrontation with pitfalls in therapeutic progression.