Correlation of question 15 of the FSDS-DAO with clinician evaluation of female orgasmic disorder.

INTRODUCTION: Female orgasmic disorder (FOD) is the second most frequently reported sexual dysfunction in women. According to the Diagnostic and Statistical Manual of Mental Disorders, the term "marked distress" is central to the diagnosis of FOD. AIM: Objectives of this study were to explore terminology used by women diagnosed with FOD to describe their associated feelings and establish a correlation between patient ratings of question 15, "How often do you feel frustrated by problems with orgasm" on the Female Sexual Distress Score/Desire Arousal Orgasm (FSDS-DAO) with clinician evaluations of FOD. METHODS: Research was performed at one sexual medicine facility. Recruited participants were patients diagnosed with FOD. Fifteen women meeting inclusion/exclusion criteria were enrolled, completed the FSDS-DAO and a structured interview to assess terminology associated with orgasm difficulties. MAIN OUTCOME MEASURE: Patient reported terminology for characterization of FOD, validity of question 15 of FSDS-DAO. RESULTS: When asked to describe their orgasm difficulties, 60% of participants said "frustrated." Other terms included disappointed, pariah, subhuman, desperate, and concerned. Fifty-three percent (53%) claimed their inability to orgasm affected day-to-day life. In participants where FOD did not affect day-to-day life, 57% actively suppressed thoughts about inability to orgasm. Responses to question 15 of the FSDS-DAO ranged from 2-4 (mean 3.6) indicating participants were very frustrated. CONCLUSIONS: To diagnose FOD, clinicians assess the level of associated distress through individualized patient interviews with no standardized tool. The term "distressed" is a medical construct and did not resonate with participants when describing their experience. participants used "frustrated" as an emotional descriptor to their sexual experience and scored high on question 15 of the FSDS-DAO. This study demonstrates the FSDS-DAO, specifically question 15, correlates well with the clinician diagnosis of marked distress and may be an appropriate tool for evaluating treatment benefit in the FOD population.

Characterization of orgasmic difficulties by women: focus group evaluation.

INTRODUCTION: Female orgasmic disorder (FOD) is the second most prevalent sexual disorder in women. According to the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV-TR), the term "marked distress" is central to the diagnosis of FOD. In practice, the term "distress" for use as a criterion for a clinical diagnosis is a medical construct and may not correlate with the language used by women with FOD to describe what they are experiencing. AIM: The objective of this study was to explore the terminology used by women to describe their feeling associated with difficulties in achieving orgasm. METHODS: Women experiencing difficulties in achieving orgasm were invited to participate in a focus group. The focus groups included a characterization, picture sort and language exploration exercise and completing the Female Sexual Distress Scale-Desire, Arousal, Orgasm (FSDS-DAO) to determine the impact and emotional associations of decreased/lack of orgasms. MAIN OUTCOME MEASURES: Patient reported terminology for characterization of their FOD, and validity of question 15 of FSDS-DAO. RESULTS: Sixty-seven percent (44/66) of the women used the word "frustrated" when asked, "What one word would you use to describe your orgasm difficulties?" In the language exploration exercise, the most common term used to describe emotions associated with decreased orgasm was "frustration." Responses (0 = never to 4 = always) to question 15 (frustrated by problems with orgasm) of the FSDS-DAO, ranged from 1 to 4 (mean 3.0) indicating that women were very frustrated. CONCLUSIONS: The term "frustrated" was the most relevant and common emotion women feel when they have difficulties in achieving orgasm. Additionally, the women consistently supported the content validity of question 15 of the FSDS-DAO. Despite the use of the term "distress" in the DSM-IV-TR criteria for FOD, the term reflects the medical construct required to become a sexual dysfunction and does not appear to be an accurate representation of most women's feelings of orgasm difficulties.