Anne is distressed by a persistent delay in or complete absence of orgasm during sexual intercourse. her difficulty is most clearly an indication of

This can either be a hormonal or psychological issue such as anxiety or stress. Although health classes don't generally go into the emotional aspects so I would say Annie is suffering a hormonal imbalance. Likely low estrogen levels.

Hopefully this is helpful! :)

hmmm

true, i think.

i checked and it seems the answer is, true.