An orgasm is an intense feeling of pleasure and release of tension, with or without involuntary, rhythmic contractions of the pelvic floor muscles. It is the feeling of being “spent.”
If you are unable to reach orgasm after a reasonable amount of stimulation, and this bothers you or interferes with your relationship, you may have anorgasmia.
But don’t make the mistake of using someone else’s definition of orgasm to define your own sexual climax. Most of us do not have the kind of sexual experience depicted in movies and television. Orgasms vary in intensity, frequency, and the amount of stimulation needed to trigger them.
Most women need direct or indirect clitoral stimulation to climax. Orgasms often change with age, medical issues or medications.
Concerned? Talk to your doctor.
If you’re concerned about the lack of orgasm or the intensity of your orgasms, it’s time to see your doctor.
Anorgasmia ranges from never having an orgasm ever with any partner, to the ability to have orgasms, but only in certain circumstances.
Causes of anorgasmia
The condition can have physical or psychological causes. Relationships issues can also play a role.
Physical causes include serious illnesses, such as multiple sclerosis and Parkinson’s disease; gynecologic surgeries, such as hysterectomy or cancer surgeries; pain during intercourse; medications, including blood pressure medications, antipsychotic drugs, antihistamines and antidepressants.
Alcohol can impair your ability to climax, and smoking can limit blood flow to your sexual organs.
Changes in your anatomy, hormones, neurological system and circulatory system can affect your sexuality as you age. Waning estrogen levels during menopause and after can impact sexuality as well.
Psychological factors also play a role in your ability to orgasm. Anxiety or depression, poor body image, stress, financial pressures, cultural/religious taboos against female sexual pleasure, and past sexual abuse can all inhibit the ability to orgasm.
If there are non-sexual problems in your relationship, such as lack of connection with your partner, unresolved conflicts, poor communication, infidelity or partner violence, these can also impact orgasm.
Diagnosis and treatment
In order to diagnose anorgasmia, your doctor will take a full medical history, and conduct a physical exam. Treatment will depend on the cause of your symptoms.
If the problem is physical, it may be resolved by changing your medications, estrogen therapy, testosterone therapy or a natural product.
Understanding your body and trying different kinds of stimulation can be helpful. Ask your doctor for a diagram of female anatomy, or explore your body with a mirror. Try self-stimulation with your hand or a vibrator to learn what type of touch feels best. Then share this information with your partner.
You might need more stimulation or more direct stimulation of the clitoris to orgasm. Try different sexual positions, or use a vibrator during sex. A hand-held, battery-operated device called a clitoral vacuum can also improve blood flow to increase stimulation.
If the problem is psychological, couples counseling can help you work through feelings that may be affecting your ability to orgasm. Sex therapists specialize in this kind of problem, and can provide sex education, communication guidance and behavioral exercises to try at home. Relaxation is a necessary component! Find a way to relax.
Take the focus off orgasm and put it on pleasure.
Concentrating on climax can make the problem worse. Focus on intimacy and mutual pleasure instead. Often, a sustained feeling of pleasure is as satisfying as orgasm.