Sex 9-1-1: Why Can't I Orgasm?

Like pretty much everything important, sex involves biology, psychology, and society. It is only by examining orgasm through this lens that we can grasp the complex interaction of these factors in combining to facilitate or impair our ability to experience one of the most potently powerful pleasures on the planet: the orgasm.

Recent studies indicate that 16 to 25 percent of women in places including the U.S., Australia, Canada, and Sweden, report challenges with orgasming. In other countries, rates are significantly higher (a whopping 74 percent of women in Ghana report orgasmic dysfunction).

Anorgasmia is the technical term for problems experiencing orgasm. Primary anorgasmia is when the person has never experienced orgasm. Surprisingly, it's the more straightforward form of anorgasmia to treat.

Secondary or acquired anorgasmia is when one could previously orgasm but no longer can. This is trickier to deal with and is usually a result of issues with hormones, relationship distress, depression, or anxiety. A visit to the gynecologist followed up with a consult to a sex therapist can help sort out the various biopsychosocial issues implicated.

Orgasmic dysfunctions can range from mild to severe.

"Mild" orgasmic dysfunction has been reported to affect up to 60 percent of women. Some cases of anorgasmia can be situational. You may be able to orgasm during certain circumstances, for example, when masturbating alone, but not when your partner is present, or not during sexual intercourse.

Common reasons women have trouble orgasming

In my experience, the most common cause of primary anorgasmia stems simply from insufficient practice masturbating. Without repeated practice to lay down the "orgasm pathways," the sensory pathways from the genitals to the brain's pleasure machinery are not sufficiently connected and strengthened to make orgasms accessible.

A lack of information and understanding of female sexual anatomy doesn’t help. Once we can appreciate the magnificence of our erotic equipment, we can better operate it.

The mind gets in the way

Learning plays a big role in our sexual dysfunctions. Women might not be as exuberant about learning how to masturbate or even be hampered in their willingness to experiment with having sex in the context of a culture that bombards us with conflicting and creepy messages about our sexuality. You should have a perfect body. You should be a sex object. But, if you are too into sex, or have too many partners, you are a slut. Think shame, guilt, and fear here.

Traumas loom large

Beyond cultural programming, traumatic experiences around sexuality can shut down our ability to relax into sensations and feel comfortable with and entitled to have sexual pleasure. The trauma needn't be extreme to impair the ability to experience orgasmic delights. No matter how sophisticated or sex-positive your attitudes and beliefs at the top of your mind are, old sex-negative messages and experiences can trigger defenses and prevent us from letting go enough to orgasm.

Women are often not comfortable asking for what they need. This is largely related to fears about offending the partner or being seen as too assertive. Or it can result from being unsure about what works for them in the first place.

Substances can get in the way.

Antidepressants like the SSRIs (Paxil, Prozac, Lexapro, etc) that affect the serotonin system can impair the ability to orgasm. So can too much alcohol. And cigarette smoking doesn’t help because it impairs blood flow.

Tips to work enhance the ability to orgasm

Practice the radical act of self-loving. If anorgasmia is primary or persistent: masturbate. And while you are doing that, Kegel, Kegel, Kegel. A Kegel practice can be the single most effective tool in ramping up the orgasm machinery. Remember, you can't play in a band until you learn how to play your own instrument. Helpful hint: Use a vibrator and don't worry about getting addicted or diminishing your sensitivity. Laying down the pathways to connect your genitals and the sensory pathways that go up to the pleasure places in the brain will jump-start your orgasm factory.

Orgasm Essential Reads

How Women Can Increase Their Odds of Orgasm During Sex

It’s Time to Reveal Your Fake Orgasm

For your mind: Practice the radical art of self-acceptance

If you have been shamed about sex or have traumas big or small, talk to a sex therapist. Clients who come in for treatment of primary anorgasmia become more able to permit themselves to release into pleasure after recognizing how past shaming experiences kept them from exploring their pleasure bodies.

If you used to be able to orgasm but can't anymore, factors you need to consider

Biological

Are you having hormone issues or taking new medications that might be impacting your sexual systems? Speak to your doctor.

Psychological

Are you too stressed out to relax into orgasm? If so, addressing your stress levels may do wonders for your sex life. Make this a priority. Healthy hedonism heals.

Relational

What is the state of your intimate partnership? Conflict in relationships can be a big reason the orgasm becomes elusive. If you don't feel safe with your partner or harbor big resentments, orgasms can be the causality. Take the orgasm shut down as good information which can facilitate the difficult but freeing conversations that are a big part of creating ongoing sexual potential in partnerships.

Embrace the paradox

Letting go of seeking the orgasm can help it find you. Put mind and body together to radically accept what is so, while celebrating your body, your senses, your right to your sensations. And in the meantime, recognize that orgasms are not the end-all of sex. Some women report orgasming easily but not feeling particularly satisfied, while others report satisfying levels of pleasure with or without the orgasm. Say yes to the experiences you are having.