La disfunción orgásmica o anorgasmia es la imposibilidad recurrente del orgasmo femenino, después de la correcta estimulación no se llega al orgasmo como normalmente debería suceder.
Entre las mujeres no es un tema común de hablar, generando tabú. Esta disfunción afecta entre el 5% al 40% de las mujeres en alguna etapa de sus vidas. La disfunción orgásmica puede presentarse en cualquier etapa de la vida de una mujer, ya sea solo en ciertas situaciones sexuales o en todas las situaciones sexuales en la mujer.
La respuesta sexual implica muchos factores, como la interacción compleja fisiológica, emociones, experiencias previas, creencias, estilo de vida y relaciones. La ruptura de cualquiera de estos factores puede afectar el deseo sexual, la excitación o la satisfacción sexual y su tratamiento puede involucrar más de un enfoque.
Los síntomas a considerar para identificar una disfunción orgásmica o anorgasmia:
- Tardar más tiempo del deseado para llegar a alcanzar el orgasmo.
- Tener orgasmos insatisfactorios.
- La imposibilidad de llegar a alcanzar un orgasmo.
- Poco o ningún deseo sexual.
- Trastorno de dolor sexual.
Causas de una disfunción orgásmica:
La respuesta sexual involucra al cuerpo y la mente en conjunto de manera compleja. Se necesita que ambos trabajen en conjunto correctamente para que se presente un orgasmo satisfactorio.
Los problemas sexuales pueden desarrollarse cuando las hormonas están en flujo, como durante la menopausia o posterior al tener un bebé. Las enfermedades graves también juegan un papel importante en esta problemática, como el cáncer, la diabetes y enfermedades cardiovasculares (corazón y vasos sanguíneos), contribuyendo a la disfunción orgásmica.
En un 5% de los casos se debe a un problema fisiológico como:
- Sequedad vaginal.
- Consumo de algunos fármacos, como los usados en terapia psiquiátrica para la depresión. Estos incluyen fluoxetina (Prozac), paroxetina (Paxil), y sertralina (Zoloft).
- Espasmo de los músculos que rodean la vagina, que ocurren involuntariamente.
- Dolor pélvico crónico.
- Desequilibrios hormonales.
- Ciertas enfermedades crónicas, como la esclerosis múltiple o lepra tuberculoide, en la que se ven afectados los nervios y por ende la sensibilidad.
El resto de las causas son psicológicas, pueden ir por falta de conocimiento de la sexualidad o bien puede ser por producto de una violación. Por lo que cualquier mujer podría verse afectada por la disfunción orgásmica.
El estrés, fatiga, depresión, timidez, actividades negativas, aburrimiento con la actividad sexual son algunos de los factores que pueden dificultar la llegada del orgasmo.
No se puede considerar anorgasmia o disfunción orgásmica, si se tienen orgasmos con completa normalidad y en algún momento no se alcanzó a llegar al clímax.
Se pueden diferenciar cuatro tipos de anorgasmia:
- Anorgasmia primaria: Personas que no han tenido un orgasmo.
- Anorgasmia secundaria: Personas que anteriormente han llegado a alcanzar el orgasmo pero dejaron de tenerlos.
- Anorgasmia situacional: Personas que pueden alcanzar el orgasmo solo en determinadas situaciones. Como por ejemplo, solo puede alcanzarlo con sus parejas, pero se le dificulta tenerlos solos o viceversa.
- Anorgasmia generalizada: Personas que no pueden alcanzar el orgasmo con ninguna pareja en ninguna situación, ni tenerlo solo.
Factores hormonales que influyen en la anorgasmia.
Los niveles reducidos de estrógeno como los que se producen después de la menopausia genera cambios en la respuesta sexual y cambios en los tejidos de los genitales. La disminución de estrógeno genera una reducción del flujo sanguíneo hacia la región pélvica, lo que pueden conducir a la disminución de sensibilidad de los genitales y también generar la necesidad de más tiempo para excitarse y posteriormente alcanzar el orgasmo.
Si la persona no es sexualmente activa, el revestimiento de la vagina suele adelgazarse y pierde elasticidad, conduciendo a un coito doloroso mejor conocido como dispareunia.
¿Cómo tratar la anorgasmia?
Para la anorgasmia femenina no hay fármacos que a diferencia de los casos de impotencia masculina si existen fármacos efectivos. Si existen algunos fármacos que ayudan estimulando la excitación de la mujer, pero no son muy efectivos, por el cual no son la mejor solución.
Por lo general se emplea tratamiento sexológico. Existen múltiples modelos terapéuticos, muy parecidos entre sí, aunque no se conoce a ciencia exacta cual es el más beneficioso para lograr una buena efectividad.
El tratamiento sexológico que recoge los aspectos de varias opciones terapéuticas para una mayor efectividad consta de cuatro pasos:
- Potenciación de la erotofilia: Trata de intentar eliminar los pensamientos negativos sobre la sexualidad y que el paciente disminuya su miedo incluso hasta perderlo en su totalidad por lo erótico. Este paso es más informativo, involucra charlas y se recomienda a los pacientes realizar lecturas.
- Autoestimulación: por primera instancia se le enseña al paciente a relajarse y a concentrarse en todas las partes de su cuerpo. Seguidamente, si se trata de mujeres con anorgasmia primaria, se comienza por la visualización de sus genitales por medio de un espejo, ya que esta anorgasmia mayormente se da por desconocimiento del cuerpo, órganos sexuales y al pudor por el sexo. Posteriormente, se pasa a la estimulación genital poniendo énfasis en el clítoris y por último, si la persona posee una pareja, se potencia la comunicación entre ellos.
- Erotización sensual y orgásmica: Luego de la autoestimulación se recomienda la estimulación por parte de la pareja.
- Capacitación orgásmica: En esta fase se procede de la estimulación manual a la penetración.
Las mujeres que reciben tratamiento de un especialista en terapia sexual por lo general pueden superar este problema.
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