(022) Anorgasmia After Menopause

Abstract Introduction Postmenopausal anorgasmia is characterized by muted orgasm, delayed, orgasm, or inability to achieve orgasm. Typically it is distressing for women as they previously achieved satisfying orgasms. Etiology of postmenopausal orgasms is likely mulitifactorial and not yet clearly delineated as it could be a combination of blood flow, hormonal changes, and structural changes to the genitals. Objective To follow women seen in the female sexual medicine division for secondary muted orgasm or anorgasmia after menopause to understand etiology and treatment. Methods Charts were reviewed for any patient at University Hospitals Cleveland Medical Center for secondary anorgasmia or muted orgasm after menopause. Patients with primary anorgasmia were excluded. Results 194 women were found to have either muted orgasm or anorgasmia after menopause. Etiologies were unclear but likely multifactorial. Approximately 70% (n = 134) of them were started on vaginal estrogen, 20% (n = 39) were started on vaginal and estrogen compounded cream to be applied to the vestibule and/or clitoris, and 10% (n = 19) were started on vaginal prasterone. Approximately 30% (n = 58) were referred to behavioral health. 31% (n = 60) started on systemic testosterone. The average number of visits was three. 30% (n = 59) were able to achieve orgasm by this visit. Treatments most highly associated with successful orgasm/improvement of orgasm assessed by the patient’s report were prasterone and vibration. Conclusions More research is needed to understand the mechanism if action of anorgasmia after menopause to prevent it and treat it more quickly. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Astellas, Johnson & Johnson Global Public Health.