Despite what you see in the media, orgasm is no simple, sure thing. This pleasurable peak is actually a complex reaction to many physical, emotional and psychological factors. If you're experiencing trouble in any of these areas, it can affect your ability to orgasm.

Physical causes

A wide range of illnesses, physical changes and medications can interfere with orgasm:

  • Medical diseases. Any illness can affect this part of the human sexual response cycle, including diabetes and neurological diseases, such as multiple sclerosis.
  • Gynecologic issues. Orgasm may be affected by gynecologic surgeries, such as hysterectomy or cancer surgeries. In addition, lack of orgasm often goes hand in hand with other sexual concerns, such as uncomfortable or painful intercourse.
  • Medications. Many prescription and over-the-counter medications can interfere with orgasm, including blood pressure medications, antihistamines and antidepressants — particularly selective serotonin reuptake inhibitors (SSRIs).
  • Alcohol and smoking. Too much alcohol can cramp your ability to climax; the same is true of smoking, which can limit blood flow.
  • The aging process. As you age, normal changes in your anatomy, hormones, neurological system and circulatory system can affect your sexuality. A tapering of estrogen levels during the transition to menopause can decrease blood flow to the vagina and clitoris, which can delay or stop orgasm entirely.

Psychological causes

Many psychological factors play a role in your ability to orgasm, including:

  • Mental health problems, such as anxiety or depression
  • Poor body image
  • Stress and financial pressures
  • Cultural and religious beliefs
  • Fear of pregnancy or sexually transmitted infections
  • Embarrassment
  • Guilt about enjoying sexual experiences
  • Past sexual or emotional abuse

Relationship issues

Many couples who have problems outside of the bedroom also experience problems in the bedroom.Overarching issues may include:

  • Lack of connection with your partner
  • Unresolved conflicts or fights
  • Poor communication of sexual needs and preferences
  • Infidelity or breach of trust
  • Intimate partner violence
Feb. 14, 2015