Chasing orgasm and sexual pleasure: a review of conceptual models, assessment tools, and psycho-perceptual interventions

By and large, the scientific literature on orgasm and sexual pleasure is still dominated by the biomedical model, thus overshadowing the exploration of its psychoperceptual dimensions. Our clinical and theoretic understanding of orgasm remains limited as well our integration of sexual pleasure. Methods. A literature review was conducted on PubMed between 2013 and 2023 with three facets in mind : the identification of conceptual models of orgasm and pleasure ; the identification of clinical tools devoted to the assessment of orgasm and sexual pleasure ; and the identification of psycho-perceptual factors underlining the experience of orgasm and pleasure. Results. Recently published conceptual models on orgasm continue to highlight the difficulty in integrating the neuro-endocrine and physiological dimensions of orgasm with its psycho-affective and perceptual dimensions. Conversely, available models on sexual pleasure are multidimensional. Two self-report questionnaires are specifically devoted to the assessment of the biological and psychological characteristics of orgasm (Orgasm Rating Scale (ORS) and Bodily Sensations of Orgasm (BSO)), while several others are devoted to the assessment of its psychosociological aspects (i.e., orgasm faking, orgasm beliefs, etc.). Only a few assessment tools have been developed to capture the experience of sexual pleasure. Empirical studies devoted to the psycho-perceptual factors associated with orgasm and sexual pleasure revolve mainly around the following themes : 1) body and sexual image ; 2) emotional states ; 3) cognitive processes ; and 4) mindfulness state. Validated psychological interventions targeting orgasm difficulties and sexual pleasure remain the exception compared to biomedical ones. Discussion. Orgasm and sexual pleasure research would benefit from further work investigating its psycho-perceptual dimensions. The interplay of intrapersonal and interpersonal factors should also be considered.