Overview

Anorgasmia is the medical term for regular difficulty reaching orgasm after ample sexual stimulation. The lack of orgasms distresses you or interferes with your relationship with your partner.

Orgasms vary in intensity, and women vary in the frequency of their orgasms and the amount of stimulation needed to trigger an orgasm. Most women require some degree of direct or indirect clitoral stimulation and don't climax from 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 the lack of orgasm or the intensity of your orgasms, talk to your doctor about anorgasmia.

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 among women, and in an individual, it can differ from orgasm to orgasm.

By definition, the major symptoms of anorgasmia are the inability to have an orgasm or long delays in reaching orgasm that's distressing to you. But there are different types of anorgasmia:

  • Lifelong anorgasmia. You've never had an orgasm.
  • Acquired anorgasmia. You used to have orgasms, but now have difficulty reaching climax.
  • Situational anorgasmia. You're able to have an orgasm only in certain circumstances, such as during oral sex or masturbation or only with a certain partner.
  • Generalized anorgasmia. You aren't able to have an 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.

Causes

Orgasm is a complex reaction to various physical, emotional and psychological factors. Difficulties in any of these areas can affect your ability to orgasm.

Physical causes

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

  • Diseases. Serious illnesses, such as multiple sclerosis and Parkinson's disease, and their associated affects on psychological well-being can hamper orgasm.
  • Gynecological issues. Gynecologic surgeries, such as hysterectomy or cancer surgeries, can affect orgasm. Also, lack of orgasm often goes with other sexual concerns, such as uncomfortable or painful intercourse.
  • Medications. Many prescription and over-the-counter medications can inhibit orgasm, including blood pressure medications, antipsychotic drugs, antihistamines and antidepressants — particularly selective serotonin reuptake inhibitors (SSRIs).
  • Alcohol and smoking. Too much alcohol can hamper your ability to climax. Smoking can limit blood flow to your sexual organs.
  • Aging. As you age, normal changes in your anatomy, hormones, neurological system and circulatory system can affect your sexuality. Waning estrogen levels as you transition to menopause and menopausal symptoms, such as night sweats and mood changes, can have an impact on sexuality.

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
  • Embarrassment
  • Guilt about enjoying sex
  • Past sexual or emotional abuse

Relationship issues

Couples' problems outside of the bedroom can affect their sexual relationship. Issues might include:

  • Lack of connection with your partner
  • Unresolved conflicts
  • Poor communication of sexual needs and preferences
  • Infidelity or breach of trust
  • Intimate partner violence

April 19, 2018
References
  1. Bradford A. Female orgasmic disorder: Epidemiology, pathogenesis, clinical manifestation, course, assessment, and diagnosis. https://www.uptodate.com/contents/search. Accessed Nov. 28, 2017.
  2. Frequently asked questions. Women's health FAQ072. Your sexual health. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Your-Sexual-Health. Accessed Nov. 28, 2017.
  3. Shifren JL. Sexual dysfunction in women: Epidemiology, risk factors, and evaluation. https://www.uptodate.com/contents/search. Accessed Nov. 28, 2017.
  4. Alexander M, et al. Randomized trial of clitoral vacuum suction versus vibratory stimulation in neurogenic female orgasmic dysfunction. Archives of Physical Medicine and Rehabilitation. In press. Accessed Nov. 30, 2017.
  5. Thomas HN, et al. Changes in sexual function among midlife women: "I'm older … and I'm wiser." Menopause: The Journal of the North American Menopause Society. 2017;25:1.
  6. Bradford A. Treatment of female orgasmic disorder. https://www.uptodate.com/contents/search. Accessed Nov. 28, 2017.
  7. Shifren JL. Sexual dysfunction in women: Management. https://www.uptodate.com/contents/search. Accessed Nov. 30, 2017.
  8. L-Arginine. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Nov. 30, 2017.

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