The Role of Psychopathological and Personality Covariates in Orgasmic Difficulties: A Prospective Longitudinal Evaluation in a Cohort of Women from Age 30 to 50

There are little published data on the prevalence of orgasmic difficulties in representative samples and no longitudinal data on the subject. In addition, our knowledge of the factors, which increase or protect against the risk of orgasmic difficulties, is still rudimentary. The aim of this study was to evaluate the cumulative incidence rate and longitudinal course of orgasmic difficulties from age 30 to age 50, and the role of psychopathological and personality covariates in a representative population cohort of women. Semi‐structured interviews with single‐item questions on sexual problems in general as well as on orgasmic difficulties were conducted. Psychopathological covariates were from the Symptom Checklist 90 Revised and personality characteristics from the Freiburg Personality Inventory. Coping resources were measured by the scales of mastery and self‐esteem. One‐year prevalences of orgasmic difficulties, associations with psychopathological and personality covariates as well as coping resources were the main outcome measures. Orgasmic difficulties were reported annually by 7.4% to 13.5% of the women with a mean of 10.0% and a cumulative risk of 27.3% from age 30 to 50. No relation between age and the prevalence of orgasmic difficulties could be demonstrated. Psychopathological covariates such as depression, psychoticism, interpersonal sensitivity, obsessive‐compulsive symptoms, and somatization were moderately associated with orgasmic difficulties. Also, personality traits, i.e., nervousness, aggressiveness, depressiveness, irritability, sociability, and openness, were related to orgasmic difficulties. With a cumulative risk of 27.3%, orgasmic difficulties represent a frequent sexual problem. Annual prevalence rates are particularly high in women with psychopathological characteristics and modestly related to various personality traits. Our findings support the relevance of psychosocial factors in the regulation of female orgasm. More basic research is needed to better understand underlying pathophysiological mechanisms and to improve diagnostic as well as therapeutic tools for women suffering from orgasmic difficulties. Leeners B, Hengartner MP, Rössler W, Ajdacic‐Gross V, and Angst J. The role of psychopathological and personality covariates in orgasmic difficulties: A prospective longitudinal evaluation in a cohort of women from age 30 to 50. J Sex Med 2014;11:2928–2937.