Female orgasm is not necessary for coitus and reproduction from an evolutionary point of view. Furthermore, many women have difficulties in achieving an orgasm. In the present review, the authors discuss the possible benefits of female orgasm, the ability to have an orgasm in different times of the woman's life cycle and in various states of health. We further explore the effect of hormones on orgasm and evaluate different types of treatments for the improvement of female orgasm. Based on the current literature, so far there is no well-established information regarding the precise physiologic causes of female orgasm, hence the bulk of research on this theme comes from psychology or sociology sources. This, of course, does not promote the physiologic, as well as the hormonal knowledge of female orgasm. Therefore, to date, female orgasm still remains a riddle to medicine.