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If Women Don’t Climax, Do They Have Psychological Problems?

A new study shows the more likely issue is intercourse position.

Key points

  • Freud called women who don't climax during intercourse "frigid," which wounded many women's self-esteem.
  • Generally, the issue is not women's mental health, but quite often the sexual position(s) they choose.
  • A recent study shows which positions best facilitate women's orgasms.
Roberto Hund / Pexels
Source: Roberto Hund / Pexels

During sex with partners they love, many women have difficulty climaxing—or cannot have orgasms at all. Freud called such women “frigid.” His prescription: Years of psychoanalysis, several times a week. But his label—frigidity—wounded many women’s self-esteem, and his treatment was costly, time-consuming, and, quite often, ineffective.

For much of the 20th century, Freudian psychoanalysis was a prominent form of psychological treatment. But its popularity has waned. Today, the American Psychological Association has 146,000 members, and the American Psychoanalytic Association only 3,000.

Unfortunately, Freud’s notion of frigidity is still with us. Some men hurl that the epithet at women who don’t respond to themlike porn stars. And many women who have difficulty climaxing during partner sex feel haunted by the label, wondering about their mental health, the viability of their relationships, and even their ability to love.

Recently, Czech researchers asked a large sample of Czech adults about how they make love and if the women have orgasms. They found that women’s mental health and the quality of their relationships had little to do with their ability to climax. What mattered most was the sexual positions they chose.

The Study

The researchers from the Czech National Institute of Mental Health used Facebook to recruit 21,038 Czech adults (11,225 women and 9,813 men) who completed a survey on their sexuality and lovemaking. It included 13 black-and-white silhouettes that illustrated various intercourse positions. The researchers asked how often the participants had experienced each one, if they enjoyed sex that way, and if the women had orgasms in that position.

One-third of the women said they never had orgasms during intercourse, no matter which position(s) they tried. But among the two-thirds who could climax with partners, their orgasms mostly happened in just four of the 13 positions.

Which Positions? Why?

The positions most closely associated with women’s orgasms are man-on-top, woman-on-top, standing face-to-face, and sitting face-to-face.


  • These positions allow eye contact, which robust research has shown increases mutual attraction and boosts emotional closeness.
  • The four positions also encourage kissing, which many people consider a crucial element of sexual satisfaction.
  • Finally, face-to-face positions allow lovers to see their partners becoming aroused, for many, a major turn-on.

But of the four, woman-on-top was the one position most likely to help women climax. It offers unique erotic benefits the others can’t match:

  • When women are on top, they’re best able to control the speed and depth of insertion—very important for many women’s comfort.
  • This position allows women to move as they wish and establish the sensual rhythm(s) they enjoy.
  • Women’s hip movements allow them to rub their pelvises against men’s pubic bones, which stimulates the clitoris, their orgasm trigger. The clitoris sits outside the vagina above the opening beneath the top junction of the vaginal lips.
  • Woman-on-top leaves both lovers’ hands free for mutual massage over much of each other’s bodies. Whole-body massage boosts sexual arousal and contributes to sexual satisfaction.
  • Finally, this position allows women—or their partners—to use their hands or sex toys to caress the clitoris.

Other Studies Agree

The Czech study shows that one-third of women never climax during intercourse, no matter which position(s) they try. Many other studies agree. In her review of more than 50 years of research, Elizabeth Lloyd, author of The Case of the Female Orgasm, contended that only around one-quarter of women are consistently orgasmic solely from intercourse in any position. Several more recent studies have concluded that even fewer women are consistently orgasmic from intercourse alone.

The Czech study also showed that as far as orgasms are concerned, women’s mental health is much less important than how they make love. Many other studies agree:

  • Indiana University researchers surveyed 1,055 women aged 14 to 94. Fewer than one in five (18 percent) reported orgasms solely from intercourse. Most said the key to their orgasms was direct clitoral stimulation.
  • Scientists from several universities surveyed 407 lesbians and 370 heterosexual women. The two groups were demographically comparable, but the lesbians reported significantly more orgasms. Why? They received more gentle clitoral caresses, especially oral sex.
  • Researchers at Chapman University in Southern California analyzed orgasms among 52,588 American adults. Lesbian women reported climaxing during 86 percent of their partner lovemaking, and heterosexual women only 65 percent. The lesbians kissed more, shared more mutual whole-body massage, and received more clitoral hand massage and cunnilingus.

Attention: Men

Many men believe that women “should” have orgasms during intercourse. This is not surprising. In countless movies and TV shows, both men and women routinely appear to climax simultaneously during intercourse. Actually, orgasms during intercourse are rare for women, with simultaneous orgasms even less likely.

Meanwhile, most men get much of their sex education from pornography. During porn intercourse, the women thrash and moan and appear to have orgasms. Actually, they don’t. I’ve interviewed several women porn actors; none ever had orgasms on camera. But all were orgasmic at home with their partners—thanks to emotionally intimate relationships and gentle, extended clitoral caresses, especially oral sex.

  • Read more on the role of the clitoris in women’s sexuality.
  • If you’re interested in increasing women’s likelihood of orgasm in the man-on-top position, a simple variation on that position increases clitoral stimulation.
  • If you’re a woman who has trouble climaxing solo or with partners, I suggest the classic book Becoming Orgasmic: A Sexual and Personal Growth Program for Women.


Coleman, E.M. et al. “Arousability and Sexual Satisfaction in Lesbian and Heterosexual Women,” Journal of Sex Research (1983) 19:58.

Frederick, al. “Differences In Orgasm Frequency Among Gay, Lesbian, Bisexual, and Heterosexual Men and Women in a U.S. National Sample,” Archives of Sexual Behavior (2018) 47:273, doi: 10.1007/s10508-017-0939-z.

Fugl-Meyer, KS et al. “On Orgasm, Sexual Techniques, and Erotic Perceptions in 18-to-74-Year-Old Swedish Women,” Journal of Sexual Medicine (2006) 3:56.

Herbenick, D. et al. “Women’s Experiences with Genital Touching, Sexual Pleasure, and Orgasm: Results from a U.S. Probability Sample of Women Ages 18 to 94,” Journal of Sex and Marital Therapy (2018) 44:201.

Krejcova, L et al. “Kamasutra in Practice: The Use of Sexual Positions in the Czech Population and Their Association with Female Orgasm Potential,” Sexual Medicine (2022) 8:767.

Lloyd, Elisabeth. The Case of the Female Orgasm. Harvard University Press, 2005.

Swieczkowski, JB and CED Walker. “Sexual Behavior Correlates of Female Orgasm and Marital Happiness,” Journal of Nervous and Mental Diseases (1978) 166:3345.

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