In this section, we describe procedures that may help women learn to increase sexual arousal and reach orgasm by themselves or with a partner. We also include suggestions for dealing with vaginismus.

Becoming Orgasmic

Therapy programs for learning to experience orgasm are based on progressive self-awareness activities that a woman does at home between therapy sessions. At the beginning of treatment, body exploration, genital self-exam, and Kegel exercises (see Chapter 3) are emphasized; then therapy and home exercises move progressively to self-stimulation exercises similar to those described in Chapter 8 (see "Self-Pleasuring Techniques"). One advantage of self-stimulation is that a woman who does not have a partner can learn to become orgasmic.

A vibrator is sometimes used to help a woman experience orgasm for the first time so she knows that she can have this response. (A vibrator is often less tiring to use than the fingers and supplies more intense stimulation.) After she has experienced a few orgasms with the vibrator, it is helpful for her to return to manual stimulation. This step is important because it is easier for a partner to replicate a woman’s own touch than the stimulation of a vibrator. Another method, involving the EROS Clitoral Therapy Device (shown in I Figure 14.4), is designed to increase blood flow to, and thereby arousal of, the clitoris (Munarriz et al., 2003). The hormones and products discussed in the section on treating low sexual desire may also be useful for increasing arousal.