Sexual experiences don’t need to culminate in an orgasm in order to be enjoyable, but for some women, crossing that so-called finish line is important — and yet frustratingly elusive.
According to the Mayo Clinic, orgasmic disorder, or anorgasmia, refers to “delayed, infrequent or absent orgasms — or significantly less-intense orgasms — after sexual arousal and adequate sexual stimulation.”
But getting a diagnosis means acknowledging that your struggles with orgasm are a problem, which is not easy for many women to admit, either to themselves or to their partners or doctors. Further, given that between 10% and 15% of women have never had an orgasm, it’s possible that many believe it’s not possible.
Sex and relationship therapist Deb Laino, author of The Missing Link: A Fusion of Sexuality, Psychology, Lifespan Development and You, says that an orgasmic disorder diagnosis typically comes only after a person experiences significant stress from their inability to reach climax. She tells Yahoo Life: “If someone’s in a relationship and they have really low desire, and it doesn’t cause any problems in the relationship, we wouldn’t make a diagnosis with that. A problem is only a problem if it causes marked distress.”
There are many reasons why women may struggle with orgasms, and the first step is to understand exactly what the issue is for the individual.
According to Dr. Laura Purdy, the Chief Medical Officer at Wisp, a sexual and reproductive telehealth company, female orgasmic disorder is classified into different types: primary, which refers to those who have never experienced an orgasm; secondary, which refers to people who have previously experienced an orgasm but are now struggling; and situational, which refers to those who can orgasm only in certain situations, like when they are masturbating.
Figuring out one’s relationship to orgasm can help narrow down what might be behind the disorder, and whether there are physical or psychological issues at play.
Laino says it’s important to first evaluate whether there may be physical issues affecting one’s ability to orgasm. This can include pain disorders, such as dyspareunia, or painful intercourse, or vaginismus, a disorder in which the muscles around the vagina tighten, making penetration painful. If sex is painful — or if sexual activity becomes associated with pain — it can be very hard for a person to relax enough to climax.
There are other factors that can make orgasm challenging. Medications, such as serotonin reuptake inhibitors (SSRIs), which are used to treat depression, can make it hard to reach orgasm, as well as impact your overall ability to become aroused.
Menopause can also make orgasm more difficult to achieve, as blood fills the genitals more slowly. When one does achieve orgasm, it also may feel less intense. More direct stimulation of the clitoris may be needed in order to combat this issue.
Often, psychological issues stop people from orgasming — and these can even include cultural attitudes about sex.
For people who’ve experienced sexual trauma, it can be challenging to allow oneself to see sex as something pleasurable — which is why it’s important to see a sex therapist who can help navigate these emotions. However, experience with sexual trauma is not necessary when being impacted by shame-inducing attitudes about sex.
Laurie Mintz, sexual psychologist and author of the book Becoming Cliterate: Why Orgasm Equality Matters — and How to Get It, notes that in purity culture, in which premarital sex is seen as something that should be avoided, sex is often considered “dirty.” A sex therapist can help a client “get rid of any sexual shame,” which may affect one’s ability to fully enjoy sex and reach orgasm.
For people dealing with psychological issues blocking their ability to reach orgasm, Mintz says it’s vital to get people connected to their bodies, as well as educate them on their genital anatomy — specifically, “the vulva, where our touch-sensitive nerve endings are most likely to result in orgasm.”
Mintz says that a sex therapist will assign patients some “homework” — aka “sending the woman home with instructions to pleasure herself and masturbate.”
Most of the time, Mintz says, people will eventually orgasm through self-pleasure and that it often entails use of a vibrator. “There are physicians who say we could even call vibrators medical devices,” she says, noting that “our genitals have special corpuscles that respond to vibration.”
One reason why some women might not reach orgasm with a partner is also the misguided notion that penetrative sex should lead to an orgasm — which, for most women, it doesn’t on its own. Clitoral stimulation is necessary for most women to achieve orgasm, which is why many say they can reach orgasm during masturbation but not with a partner.
“The most essential step to orgasm with a partner is getting the same type of stimulation as you get alone,” Mintz says. “Women who bridge that gap are more orgasmic with a partner. I often tell my clients that there is no masturbation technique that can’t be transferred to partner sex with creativity and communication.”