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.
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:
Talk to your doctor if you have questions about orgasm or concerns about your ability to reach orgasm.
Orgasm is a complex reaction to various physical, emotional and psychological factors. Difficulties in any of these areas can affect your ability to orgasm.
A wide range of illnesses, physical changes and medications can interfere with orgasm:
Many psychological factors play a role in your ability to orgasm, including:
Couples' problems outside of the bedroom can affect their sexual relationship. Issues might include:
A medical evaluation for anorgasmia usually consists of:
Treatment for anorgasmia will depend on the cause of your symptoms. It might include lifestyle changes, therapy and medication.
For most women, a key part of treatment includes addressing relationship issues and everyday stressors. Understanding your body and trying different types of sexual stimulation also can help.
Understand your body better. Understanding your anatomy and how and where you like to be touched can lead to better sexual satisfaction. If you need a refresher course on your genital anatomy, ask your doctor for a diagram or explore your body in a mirror.
Self-stimulation with your hand or a vibrator can help you discover what type of touch feels best to you and can provide information you can share with your partner. If you're uncomfortable with self-exploration, try exploring your body with your partner.
Increase sexual stimulation. Women who've never had an orgasm might not be getting enough sexual stimulation. Most women need direct or indirect stimulation of the clitoris to orgasm.
Switching sexual positions can produce more clitoral stimulation during vaginal penetration. Using a vibrator or fantasizing during sex also can help trigger an orgasm.
For some women, a device called a clitoral vacuum can improve blood flow and increase stimulation. This device is battery operated and hand-held, with a cup that fits over the clitoris.
Estrogen therapy for postmenopausal women. If anorgasmia is associated with menopausal symptoms, such as night sweats and hot flashes, systemic estrogen therapy — by pill, patch or gel — might relieve those symptoms and improve sexual response.
Local estrogen therapy — in the form of a vaginal cream or a slow-releasing suppository or ring that you place in your vagina — can increase blood flow to the vagina and help improve sexual arousal.
Testosterone therapy. Testosterone plays a role in female sexual function, but how big a role is uncertain. Replacing testosterone in women is controversial, and it's not approved by the Food and Drug Administration (FDA) for sexual dysfunction in women.
Additionally, it can cause side effects, including acne, excess body hair (hirsutism) and male-pattern baldness. Testosterone seems most effective for women with low testosterone levels as a result of surgical removal of the ovaries (oophorectomy).
If you choose to use this therapy, your doctor should monitor its effects on you.
Natural products, such as those made with L-arginine, are marketed for improving women's sex lives. But these supplements haven't been well-studied for this use, and they're not regulated by the FDA.
Talk with your doctor before trying natural therapies, which can cause side effects and interact with other medications.
Your difficulty reaching orgasm can be frustrating for you and your partner. Plus, concentrating on climax can make the problem worse.
Most couples aren't having the headboard-banging, earth-shaking sex that appears on TV and in the movies. So try to reframe your expectations. Focus on mutual pleasure and intimacy instead of orgasm. You might find that a sustained pleasure plateau is just as satisfying as orgasm.
If your lack of orgasm from sexual activity distresses you, make an appointment with your family doctor or your gynecologist.
Here's some information to help you prepare for your appointment.
Make a list of:
For anorgasmia, basic questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor might ask you questions, including:
Be open with your partner. Continue sexual activity, and also explore other ways of being intimate. Shifting the focus from orgasm to pleasure might help.
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