Background About 50% of women who report orgasmic difficulty (OD) during partnered sex are distressed by their condition, yet why some women are distressed and others are not is unclear. Aim To determine whether sexual distress is related to women's perceived causes of their OD during partnered sex. Methods We established homogenous subgroups of women based on their attributions for OD during partnered sex, and these groups were validated by comparing them on variables relevant to sexual response. We then predicted OD-related distress from subgroup memberships as well as from a number of sociodemographic, control, and empirically supported sexual response variables. Results 3 distinct OD subgroups emerged: type 1—high psychological–high somatic reasons; type 2—partner-related reasons; and type 3—moderate psychological–low somatic reasons. These groups also differed on independent parameters related to sexual frequency and arousal. Subgroup membership, along with age, sexual relationship satisfaction, and frequency of partnered sex predicted sexual distress related to OD. Clinical Implication Particular perceptions regarding the causes for OD help predict women's sexual distress, and such factors might be considered in identifying sexual issues and managing them within the context of a sexual relationship. Strengths & Limitations A large sample size drawn from a multinational population powered the study, while the cross-sectional nature of the sample could not rule out bidirectional associations between predictor covariates (including OD subgroup) and the outcome measure (sexual distress). Conclusion Type 1 membership (high levels of psychological and somatic attributions) predicted greater levels of OD-related distress than type 2 (partner-related attributions) or type 3 (moderate psychological and low somatic attributions) membership, with type 1 women having a greater likelihood of internalizing (accepting responsibility/blame for) OD attributions.

Introduction: Although faking orgasm among women appears quite common, the roles of orgasmic problems and relationship type in partnered sex and masturbation have not been fully explored. Aim: We assessed the relationship between orgasmic problems (separately in partnered sex and masturbation) and faking orgasm across various types of relationships while also considering the role of demographic and sexual function related covariates. Methods: In this study of 1,168 Hungarian women, we assessed orgasmic problems, sexual functioning, and the prevalence and frequency of faking orgasm in 3 relationship types: romantic relationships, one-night stands, and continuing sexual relationships of more than one night. Main Outcome Measure: Differences in faking orgasm across 3 types of relationships; the association between faking orgasm in 1 type of relationship with faking orgasm in other types of relationships; and the relationship of "orgasmic problems" in partnered sex and masturbation to the presence and frequency of faking orgasm in various relationship types. Results: A subset of women who faked orgasm in 1 relationship type were more likely to fake orgasm in other relationship types. Orgasmic problems predicted the occurrence and frequency of faking orgasm in all 3 relationship types, though to different degrees. Other factors, including orgasmic difficulty during masturbation, the frequencies of masturbation and partnered sex, and the self-rated importance of sex were also related to the frequency of faking orgasm. Conclusion: Our findings suggest that faking orgasm has both dispositional and situational elements. "Orgasmic problems" in partnered sex was a consistent and robust predictor of the occurrence and frequency of faking orgasm in different relationship types. Hevesi K, Horvath Z, Sal D, et al. Faking Orgasm: Relationship to Orgasmic Problems and Relationship Type in Heterosexual Women. Sex Med 2021;XX:XXXXXX.

Introduction Faking orgasm by women reportedly occurs quite frequently, with both relationship characteristics and orgasmic difficulty being significant predictors. Aim We explored women's motives that might mediate the associations between orgasmic difficulty and relationship satisfaction on the one hand, with the frequency of faking orgasm on the other. Methods In a study of 360 Hungarian women who reported “ever” faking orgasm during partnered sex, we assessed the direct and indirect (mediated) associations between orgasmic difficulty, relationship satisfaction, and the frequency of faking orgasm. Outcomes Determination of motives that mediate the association between orgasmic difficulty and the frequency of faking orgasm, and the association between relationship satisfaction and the frequency of faking orgasm. Results Increased orgasmic difficulty was directly related to increased frequency of faking orgasm (β = 0.37; P < .001), and each variable itself was related to a number of motives for faking orgasm. However, the only motive assessed in our study that mediated the relationship between orgasmic difficulty and the frequency of faking orgasm was insecurity about being perceived as abnormal or dysfunctional (indirect effect: β = 0.13; P < .001). A similar pattern emerged with relationship satisfaction and frequency of faking orgasm. These two variables were directly related in that lower relationship satisfaction predicted higher frequency of faking orgasm (β = -0.15; P = .008). Furthermore, while each variable itself was related to a number of motives for faking orgasm, the only motive assessed in our study that mediated the relationship between the 2 variables was insecurity about being perceived as abnormal or dysfunctional (indirect effect: β = -0.06; P = .008). Clinical Translation Insecurity related to being perceived as abnormal or deficient, along with sexual communication, should be addressed in women with a history of faking orgasm but who want to cease doing so. Strengths and Limitations The sample was relatively large and the online survey adhered to best practices. Nevertheless, bias may result in sample characteristics when recruitment is achieved primarily through social media. In addition, the cross-sectional sample prevented causal determination and represented Western-based values. Conclusions The associations between orgasmic difficulty and faking orgasm, and between relationship satisfaction and faking orgasm, are both direct and indirect (mediated). The primary motive for mediating the indirect association between the predictor variables and the frequency of faking orgasm was the insecurity about being perceived as deficient or abnormal.