Information about the effects of hysterectomy on orgasmic functioning in women is largely anecdotal; there are as yet no well-controlled, large-scale studies on this topic. One way to express this expertise is to take a sexual history from any patient who: Couples determined to achieve female orgasm during intercourse should start paying more attention to the clitoris, Lloyd and Whelihan said. This demonstrates that emotions have more of an effect on orgasm during intercourse than they do on masturbation. Frederick Hollick was a firm believer that a main cause of hysteria was licentiousness present in women. This latter element addresses Hurlbert's belief that women whose male partners delay orgasm until after she climaxes will be more interested in having sex. Orgasms do not only occur during sexual stimulation.
When the patient presents with an orgasmic dysfunction or when the sexual history reveals a concern, the physician should follow up with questions about the particular difficulty.
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Depending on the chronicity of the problem and the distress it has caused, the obstetrician or gynecologist may elect to provide treatment in the office. Object Relations Couple Therapy, pp 21 — Another difficulty related to sexual abuse is some women's tendency to defend themselves against the helplessness they felt in the abusive situation by controlling their adult sexual encounters. Areas of inquiry in a general sexual history should include the following:. For most women, however, the major physical contributor to orgasmic difficulty is anatomy: