Standard Operating Procedures for Female Orgasmic Disorder: Consensus of the International Society for Sexual Medicine

Abstract

Introduction As the field of sexual medicine evolves, it is important to continually improve patient care by developing contemporary “standard operating procedures” (SOPs), reflecting the consensus view of experts in sexual medicine. Few, if any, consensus SOPs have been developed for the diagnosis and treatment of Female Orgasmic Disorder (FOD). Aim The objective is to provide standard operating procedures for FOD. Methods The SOP Committee was composed of a chair, selected by the International Society for the Study of Sexual Medicine, and two additional experts. To inform its key recommendations, the Committee used systematic reviews of available evidence and discussions during a group meeting, conference calls and e-mail communications. The Committee received no corporate funding or remuneration. Results A total of 12 recommendations for the assessment and treatment of FOD were generated, including suggestions for further research. Conclusions Evidence-based, practice recommendations for the treatment of FOD are provided that will hopefully inform clinical decision making for those treating this common condition.

“Standard Operating Procedures for Female Orgasmic Disorder” is not Based on Best Evidence

“…A few of the omissions and misrepresentations are detailed here, along with references providing evidence to the contrary of the assertions of Laan et al [1].…”

“…Given the authoritative-sounding title, the recent JSM article "Standard Operating Procedures for Female Orgasmic Disorder: Consensus of the International Society for Sexual Medicine" [1] might be assumed by many readers to reflect the available evidence on that topic. Many readers might also assume that there is no need to read far beyond the literature presented, and might assume that to practice otherwise risks not using standard operating procedure for female orgasmic disorder (FOD).…”

“…In section 2 of the Laan et al article [1], it was asserted that "In general, women seem relatively unaware of their own genital changes, particularly at the early stages of sexual response, and therefore may lack the proprioceptive feedback that could further increase their arousal" [1] (p. 75). Of note, studies conducted in Laan's laboratory [7,8] indicated that women who had greater intercourse orgasm consistency (but not greater orgasm consistency from other sexual behaviors) had excellent concordance of subjective and vaginal responses.…”

“…These findings, together with those showing that self-reported lack of attention to vaginal sensations can reduce the capacity to attain intercourse orgasm [4], suggest that the putative lack of proprioceptive feedback of vaginal sensations might be a sign of distraction from sexual sensations in women with difficulties in attaining intercourse orgasm. Quite properly, Laan et al [1] acknowledged that lack of focusing attention on sexual cues is a risk factor for orgasmic dysfunction, but they seemed to dismiss the cues from the vagina itself.…”

“…Laan et al [1] rightly noted that lack of adequate stimulation by partners with erectile dysfunction and premature ejaculation may lead to women's complaints of orgasmic failure. However, they failed to note that such male difficulties are particularly relevant for women's intercourse orgasm [4,6,9].…”