Lisa Thomas LMFT

Save Your Sex Life

Help! I Can't Have an Orgasm

Anorgasmia or the inabiliy to achieve orgasm is a fairly common problem.

Posted Nov 19, 2011

Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm alone or with a partner. It can often cause sexual frustration and anxiety in relationships.

In men, the condition can be referred to as delayed ejaculation. Anorgasmia is far more common in women than men, and it tends to be rare in younger men.

Anorgasmia is often caused by anxiety and an inability to relax during sexual relations. It can also be caused by medical problems such as diabetes, Parkinson's, multiple sclerosis, chemotherapy, pelvic trauma, hormonal imbalances hysterectomy, spinal cord injury, childbirth trauma, vulvodynia, and cardiovascular disease.

A common cause of situational anorgasmia, in both men and women, is the use of anti-depressant medications such as Prozac, Paxil, and Lexapro, to name a few. Though reporting of anorgasmia as a side effect of SSRIs is not exact, it is estimated that 15-50% of users are affected. Another cause of anorgasmia is the use of drugs or alcohol during sexual activity.

About 15% of women report difficulties achieving orgasm, and as many as 10% of women in the United States have never had an orgasm. Even for women who reach orgasm frequently, the frequency is still only about 50-70% of the time, meaning that even women who can achieve orgasm can often have failures.

Treatment for anorgasmia can help to solve the problem. Treatment begins with an orientation of your genitals using a mirror and touching exercises to begin familiarizing yourself with their feel, look, and responsiveness.

Once you are comfortable touching yourself without trying to achieve an orgasm, you can move to the stage of trying to touch yourself to achieve an orgasm. I often instruct women in my sex therapy practice to facilitate this step in the bath or shower as water can help to sensualize the elements for this step.

Begin to touch yourself slowly and then increase the pressure of your touch so it is firm. Usually to achieve your first orgasm, you are touching the outside of your genitals and stimulating your clitoris, not going inside your vagina yet. It may take up to 45 minutes to achieve enough relaxation to have an orgasm. Remember to try and fantasize about something relaxing or sexual. The two elements needed to achieve orgasm are arousal and relaxation.

If you are still struggling to achieve orgasm, consider buying a starter vibrator to help. Vibrators are great because they can provide more stimulation that you may be able to give yourself. Also, some women report discomfort touching their own genitals during masturbation so a vibrator can act as an aid between your hand and your genitals for comfort.

A good starter vibrator to purchase is often flat on the top to provide a square area to use on the outside of your genitals.

Trying to achieve orgasm alone often works better than trying to with a partner. Being alone eliminates any anxiety about being watched or how much time it may be taking. Once you have figured out how to climax alone, then showing your partner what you have learned about yourself is the step to bring your orgasm into your sexual relationship. If you find that using a vibrator works, discuss incorporating it into your sexual script with your partner during foreplay or intercourse.

Taking charge of your sexuality to find your orgasm may make you feel nervous—but mastering this important sexual skill will help you look forward to sexual pleasure throughout your life both alone and when you are with a partner.

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