Introduction:
Evidence suggests that masturbation, genital stimulation, body awareness and movement, pelvic floor exercises, depression, anxiety, positive and negative feelings, personality type, emotional and overall well-being, emotional intelligence have been studied in association with female orgasm through the years. However, sexual health providers as well as most women lack information regarding sexual satisfaction and reaching orgasm. However, the available reviews that include studies investigating several factors are rare.

Aim:
This systematic review presents the effect of social, behavioral and psychological aspects on female orgasm.

Material and Methods:
Three databases (PubMed, CINAHL, Scopus) were searched, a manual search in Google Scholar was performed using keywords and the reference lists of included studies were also screened to identify further articles. The eligibility criteria for inclusion were studies that sampled adult healthy women, used quantitative methodology and explored the factors influencing sexual satisfaction. The 10-item Critical Appraisal Skills Program (CASP) checklist was used to assess the methodological quality of the studies.

Results:
Out of 531 studies, forty-five were further screened. A total of twenty-one studies were included, with the largest portion of them conducted in USA, Portugal and United Kindom, followed by Swicherland, Iran, Brazil, Sweeden, Canada, Hungary and Netherlands. Four major themes influencing sexual satisfaction among females emerged from synthesis: psychological disorders (depression and anxiety), psychological background (emotional intelligence, emotional and overall well-being, personality type, positive emotions), genital stimulation (masturbation, self-stimulation of genitalia, partnered stimulation of sexual organs, different types of sexual activity), body awareness and movement (pelvic floor exercises, pelvic movement during sexual activity, cognizance of sexual arousal).

Conclusions:
While many factors affected positively the female orgasm, there were many factors that affected it negatively as well.