It may be associated with performance pressure and an unwillingness to pursue pleasure, as separate from the other persons satisfaction; often, women worry so much about the pleasure of their partner that they become anxious, which manifests as impatience with the delay of orgasm for them. This delay can lead to frustration of not reaching orgasmic sexual satisfaction. Psychoanalyst Wilhelm Reich, in his 1927 book Die Funktion des Orgasmus (published in English in 1980 as Genitality in the Theory and Therapy of Neurosis) was the first to make orgasm central to the concept of mental health, and defined neurosis in terms of blocks to having orgastic potency. Although orgasm dysfunction can have psychological components, physiological factors often play a role. For instance, delayed orgasm or the inability to achieve orgasm is a common side effect of many medications. Menopause may involve loss of hormones supporting sexuality and genital functionality. Vaginal and clitoral atrophy and dryness affects up to 50%–60% of postmenopausal women. Testosterone levels in men fall as they age. Sexual dysfunction overall becomes more likely with poor physical and emotional health. "Negative experiences in sexual relationships and overall well-being" are associated with sexual dysfunction. Theoretical biological and evolutionary functions of female orgasm
Shifts in research
The function or functions of the human female orgasm have been debated among researchers. Researchers have several hypotheses about the role, if any, of the female orgasm in the reproductive and therefore evolutionary process.
He "concluded that satisfaction from penile penetration [is] mainly psychological or perhaps the result of referred sensation".Masters and Johnsons research into the female sexual response cycle, as well as Shere Hites, generally supported Kinseys findings about female orgasm. Masters and Johnsons research on the topic came at the time of the second-wave feminist movement, and inspired feminists such as Anne Koedt, author of The Myth of the Vaginal Orgasm, to speak about the "false distinction" made between clitoral and vaginal orgasms and womens biology not being properly analyzed. Clitoral and vaginal relationships
Accounts that the vagina is capable of producing orgasms continue to be subject to debate because, in addition to the vaginas low concentration of nerve endings, reports of the G-spots location are inconsistent—it appears to be nonexistent in some women and may be an extension of another structure, such as the Skenes gland or the clitoris, which is a part of the Skenes gland. In a January 2012 The Journal of Sexual Medicine review examining years of research into the existence of the G-spot, scholars stated that "[r]eports in the public media would lead one to believe the G-spot is a well-characterized entity capable of providing extreme sexual stimulation, yet this is far from the truth".Possible explanations for the G-spot were examined by Masters and Johnson, who were the first researchers to determine that the clitoral structures surround and extend along and within the labia.