Orgasm consistency and its relationship to women’s self-reported and genital sexual response

According to the Incentive Motivation Model (IMM) of sexual response, the rewarding and pleasurable aspects of a sexual act strengthen its incentive value and capacity to trigger sexual motivation. One such sexual reward is orgasm consistency, the percentage of time that orgasm is experienced during a sex act. Orgasm consistency may serve to influence the incentive value of a sexual behaviour. We tested this tenet of the IMM by examining whether orgasm consistency predicted women’s sexual responses to films depicting various sex acts. Data were collected from four separate studies examining women’s genital and subjective sexual response. Participants ( N = 144, age range = 18–65) were presented with neutral and erotic film stimuli while their genital arousal was assessed using vaginal photoplethysmography or thermography. Participants reported their sexual arousal level before, during, and after each stimulus presentation, and completed questionnaires assessing sexual history and experiences, sexual interests, and sexual functioning. Orgasm consistency during penile–vaginal intercourse (PVI) significantly predicted genital arousal to films depicting PVI, but similar relationships were not observed between genital or self-reported arousal and orgasm consistency during receptive oral sex and masturbation. Findings suggest that increasing orgasm consistency to a sex act may increase its incentive value, thereby triggering greater genital response to depictions of that act. Lack of consistent orgasm or generally pleasurable and rewarding sex may limit the capacity of sex acts to trigger sexual motivation in future sexual encounters, thus contributing to low sexual arousal and desire in women.

Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

BACKGROUND: A set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin. OBJECTIVE: To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD). METHODS: The original draft was designed using data from two published case series (Hogan et al., 2014 and Healy et al., 2018), which represent the largest public collections of data on these enduring conditions. It was further developed with the involvement of a multidisciplinary panel of experts. RESULTS: A set of criteria were agreed upon for each of the above conditions. Features of PSSD, PFS and PRSD commonly include decreased genital and orgasmic sensation, decreased sexual desire and erectile dysfunction. Ancillary non-sexual symptoms vary depending on the specific condition but can include emotional blunting and cognitive impairment. PGAD presents with an almost mirror image of unwanted sensations of genital arousal or irritability in the absence of sexual desire. A new term, post-SSRI asexuality, is introduced to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor. CONCLUSIONS: These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.