Female orgasmic disorder (FOD) is defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, as a persistent or recurrent delay in, or absence of, orgasm following a 'normal' sexual excitement phase. FOD is a common problem affecting sexual function in a substantial proportion of women. Studies suggest that it is prevalent in 11-41% of women worldwide and can have a tremendous impact on the individual's quality of life, relational satisfaction and general well-being. The etiology of FOD tends to be multifactorial as it relates to genetics, medical conditions, medications, alcohol and drug use, other sexual dysfunctions, mental illness, life stressors, communication deficits and relationship issues. It is critical that sexual functioning in patients is assessed frequently through interview and/or validated questionnaires to aid in treatment strategy and/or referral. Currently, there are no approved medications to treat FOD. However, there are medications and psychological treatments that have shown promise in either treating FOD or thwarting the side effects of medications that can cause FOD. This chapter discusses the epidemiology and etiology of FOD and provides a comprehensive critical review of the literature on assessment and treatment of FOD.
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