An orgasm is a release of tension and a feeling of intense physical pleasure. Orgasmic dysfunction or anorgasmia is a condition where a woman finds it difficult to reach an orgasm despite sufficient sexual stimulation and when she is sexually aroused.

While it may not seem so, anorgasmia is a prevalent disorder affecting about 11% to 41% of women globally. Multiple causes, including physical, physiological, and relationship issues, are responsible for this condition.

Fortunately, anorgasmia is a treatable condition in the majority of cases. So, if you feel you may be having this problem, consult your doctor and they will help you manage the condition.

What Is Anorgasmia?

An orgasm is a release of tension and a feeling of intense physical pleasure along with rhythmic, involuntary contractions of your pelvic floor muscles. 

Orgasms are different for every woman; some feel fireworks throughout the body while others do not feel anything. The amount of stimulation needed to get an orgasm and its frequency is also different for everyone.

However, the majority of women need some kind of indirect or direct clitoral stimulation and cannot climax from penetration alone. While orgasm may look simple, it is not so. It results from your body’s complex reactions to emotional, physical, and psychological factors. Problems in any of these areas can affect your ability to orgasm.

Besides, orgasms change with age or medical conditions.

Anorgasmia is a condition where you regularly have difficulty reaching an orgasm despite ample sexual stimulation. This lack of orgasm distresses you and affects your relationship. If you are happy with your sexual activities, there is no need to worry. But, if the lack of orgasm bothers you, talk to your doctor about it.

Symptoms

As discussed before, orgasm is a feeling of intense pleasure and release of tension. The absence of orgasm can distress you or affect your relationship.

Some common symptoms of anorgasmia are:

  • Delayed orgasms
  • Lower abdominal pain during sexual intercourse
  • Inability to orgasm
  • Unsatisfying orgasms

Women with anorgasmia have difficulty in reaching climax during masturbation or sexual intercourse.

There are four types of anorgasmia:

  • Primary anorgasmia: A condition where you have never had an orgasm.
  • Secondary anorgasmia: Here, you have difficulty reaching orgasm, but you have had one before.
  • Situational anorgasmia: It is the most common type of anorgasmia. Here, you can only orgasm during specific situations, such as during masturbation or oral sex.
  • General anorgasmia: A condition where you cannot achieve orgasm under any circumstances, even when sexual stimulation is adequate, and you are highly aroused.

Causes

Orgasm is a result of your body’s complex reactions to emotional, physical, and psychological factors. Problems in any of these areas can affect your ability to orgasm.

Physical Causes

Many physical changes, diseases, and medications can alter your orgasms.

  • Aging: As you age, changes in your hormones, body, nervous system, and blood system may affect your sexuality. Declining estrogen levels during the transition to menopause and menopausal symptoms such as mood changes and night sweats may impact your sexuality.
  • Diseases: Conditions such as Parkinson’s disease and multiple sclerosis and their psychological complications can hamper orgasm.
  • Gynecological problems: Surgeries such as hysterectomy or cancer surgeries may also influence orgasm. Besides, anorgasmia is also associated with other sexual concerns such as painful or uncomfortable intercourse.
  • Alcohol and smoking: Smoking inhibits the blood flow to your sexual organs, and excess alcohol consumption hampers your ability to climax.
  • Medications: Certain over-the-counter and prescription medicines, such as antipsychotic drugs, antihypertensives, and antidepressants, especially selective serotonin reuptake inhibitors, may result in anorgasmia.

Psychological Causes

Psychological factors that may alter your ability to orgasm include:

  • Mental health disorders such as depression or anxiety
  • Financial pressure and stress
  • Poor body image
  • Religious and cultural beliefs
  • Guilt about enjoying sex
  • Embarrassment
  • Past emotional or sexual abuse

Relationship Issues

Problems between couples may also affect the sexual relationship. Some problems include:

  • Unresolved conflicts
  • Breach of trust or infidelity
  • Lack of communication and connection with your partner
  • Intimate partner violence
  • Lack of communication of sexual preferences and needs

Treatment

Managing anorgasmia depends on the cause of your problems. Some treatment options include therapy, medicines, and lifestyle changes.

Therapy

In most women, treatment of anorgasmia includes addressing everyday stressors and relationship issues. Trying different types of sexual stimulation and understanding your body can also help.

  • Understand your body better: Understanding where and how you like to be touched aids in better sexual satisfaction. You can also take your doctor’s help to understand your genital anatomy. You can understand it through a diagram or explore your body in a mirror. Stimulating yourself with a vibrator or your hands can help you understand what type of touch feels good, and you can share this information with your partner. If you find it odd to self-explore, try doing this with your partner.
  • Improve sexual stimulation: The majority of women need stimulation to the clitoris to orgasm. For women who never have had an orgasm they might not be getting enough sexual stimulation. Trying sexual positions may also offer clitoral stimulation during vaginal penetration. Fantasizing during sex or using a vibrator can also help you to orgasm. For many women, a clitoral vacuum may increase stimulation and improve blood flow. The device is hand-held and battery-operated with a cup that stays over the clitoris.
  • Couple counseling: A couples counselor may help you manage conflicts in your relationship, which can affect your ability to orgasm. A sex therapist may also help treat sexual concerns. Therapy includes help with communication skills, sex education, and behavioral exercises for you to try at home. 

Medical Treatments

Some treatment options include:

  • Estrogen therapy: If anorgasmia is due to menopausal symptoms such as hot flushes and night sweats, systemic estrogen therapy may help. Estrogen is available in the form of patches, pills, or gel. Estrogen therapy may help relieve the symptoms and improve your sexual response.
  • Local estrogen therapy: It is available in the form of a slow-releasing ring or suppository or vaginal cream to place in your vagina. This helps boost blood flow to the vagina, which enhances sexual arousal.
  • Treating underlying conditions: If a disease affects your ability to orgasm, managing it may resolve your problem. Modifying or changing medicines with adverse effects on sexual health may also improve your problem.
  • Testosterone therapy: While this hormone is primarily found in men, it does play a role in female sexual function. But replacing testosterone may not help everyone, and it is not approved by the Food and Drug Administration for anorgasmia. Besides, testosterone therapy may have side-effects such as excess body hair, acne, and male pattern baldness. However, testosterone may be useful in women with low testosterone levels due to oophorectomy, surgical removal of the ovaries. In case the doctor advises testosterone therapy, they will monitor its effect on you.

All in all, treatment of anorgasmia include:

  • Switch antidepressant medications
  • Increase clitoral stimulation during sexual intercourse and masturbation 
  • Treat any underlying medical conditions
  • Cognitive behavioral therapy (CBT) or sex therapy

Some nutritional supplements and over-the-counter (OTC) products may also help manage anorgasmia. Moreover, arousal oils such as Zestra increase stimulation and warm the clitoris. These oils can be used during masturbation or sexual intercourse.

However, these OTC medicines or products are not safe for everyone, and thus it is recommended to talk to your doctor before using them. They may interfere with your current medication or cause an allergic reaction.

Living With

Anorgasmia may be frustrating and may have an impact on your relationship. But the good news is that you may be able to reach orgasm with appropriate treatment. It is also essential to know that you are not alone, and many women deal with anorgasmia at some point in time.

If you have this problem, therapy can help you. Couples or individual therapy focuses on your views about sexual intercourse. Consulting your therapist can help you and your partner learn about each other’s sexual desires and needs.

They can also help address everyday stressors or relationship issues that may be affecting your ability to orgasm. Also, resolving the underlying problem can help you orgasm in the future.

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