Overview

Anorgasmia is the medical term for regular difficulty reaching orgasm after ample sexual stimulation, causing you personal distress. Anorgasmia is a common occurrence, affecting a significant number of women.

Orgasms vary in intensity, and women vary in the frequency of their orgasms and the amount of stimulation necessary to trigger an orgasm. In fact, most women don't consistently have orgasms with vaginal penetration alone. Plus, orgasms often change with age, medical issues or medications you're taking.

If you're happy with the climax of your sexual activities, there's no need for concern. However, if you're bothered by lack of orgasm or the intensity of your orgasms, talk to your doctor about anorgasmia. Lifestyle changes and sex therapy may help.

Symptoms

An orgasm is a feeling of intense physical pleasure and release of tension, accompanied by involuntary, rhythmic contractions of your pelvic floor muscles. But it doesn't always look — or sound — like it does in the movies. The way an orgasm feels varies from woman to woman, and in an individual woman, it may even differ from orgasm to orgasm.

By definition, the major symptoms of anorgasmia are inability to experience orgasm or long delays in reaching orgasm. But there are different types of anorgasmia:

  • Lifelong anorgasmia. This means you've never experienced an orgasm.
  • Acquired anorgasmia. This means you used to have orgasms, but now experience difficulty reaching climax.
  • Situational anorgasmia. This means you are able to orgasm only during certain circumstances, such as during oral sex or with a certain partner. Most women can't reach orgasm through vaginal penetration alone.
  • Generalized anorgasmia. This means you aren't able to orgasm in any situation or with any partner.

When to see a doctor

Talk to your doctor if you have questions about orgasm or concerns about your ability to reach orgasm. You may find that your sexual experiences are normal. Or your doctor may recommend strategies to reduce your anxiety and increase your satisfaction.

Causes

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
References
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