Couple holding hands unable to orgasm anorgasmia

Anorgasmia is the medical term used for regular difficulty reaching orgasm after ample sexual stimulation, causing personal distress. Anorgasmia is a common occurrence, affecting many women worldwide.

What, technically, is an orgasm?

An orgasm is a feeling of intense physical pleasure and a release of tension, accompanied by involuntary, rhythmic contractions of the pelvic floor muscles. Some women actually feel pelvic contractions or a quivering of the uterus during orgasm, while some do not. Some women describe fireworks all over their body, while others describe the feeling as a tingle. 

Orgasms vary in intensity and frequency as well as the amount of stimulation necessary to trigger one. In fact, less than a third of women consistently have orgasms with sexual activity. Plus, orgasms often change with age, medical issues, or with the use of medications. 

If a woman is happy with the climax of her sexual activities, there's no need for concern. However, if one is bothered by lack of orgasm or with the intensity of orgasm, a conversation with one’s medical doctor should be initiated. Lifestyle changes and sex therapy may be beneficial.

Different Types of Anorgasmia

Primary anorgasmia

A woman has never orgasmed. 

Secondary anorgasmia

A woman used to have orgasms, but now experiences difficulty reaching climax. 

Situational anorgasmia

A woman is able to achieve orgasm only during certain circumstances such as during oral sex or masturbation. This is actually quite common. In fact, most women experience orgasm solely via stimulation of the clitoris. 

General anorgasmia

A woman has never orgasmed in any situation or with any partner.

What Causes Anorgasmia?

Despite what one sees in the movies, an orgasm is not a simple or sure thing. This pleasurable peak is actually a reaction to many physical, emotional and psychological factors. If one is experiencing trouble in any of these areas, it can affect one’s ability to achieve orgasm. 

A wide range of illnesses, physical changes, and medications can interfere with orgasm. 


Any illness can affect the human sexual response cycle, including diabetes and neurological diseases such as multiple sclerosis. 


Orgasm may be affected by gynecologic surgeries such as hysterectomy or cancer surgery. In addition, lack of orgasm often goes hand-in-hand with other sexual concerns, such as uncomfortable or painful intercourse (Dyspareunia) is commonly seen in menopause


Many prescription and over-the-counter medications can interfere with orgasm, including blood pressure medications, antihistamines and antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs). 

Alcohol or Drugs

Too much alcohol can hinder one’s ability to climax. The same holds true for recreational drugs. As people age, normal changes in their anatomy, hormones, nervous system, and circulatory system can affect their sexuality. A tapering off of estrogen levels during menopause can decrease sensation to the clitoris, nipples and skin. Blood flow to the vagina and clitoris may also be impeded, which can delay or prevent orgasm entirely. 

Psychological factors

Many psychological factors play a role in one’s ability to reach orgasm, including: 

  • Mental health issues such as anxiety or depression 
  • Performance anxiety 
  • Stress and financial pressures 
  • Cultural and religious beliefs 
  • Fear of pregnancy or sexually transmitted diseases 
  • Embarrassment 
  • Guilt about enjoying sexual experiences 

Relationship factors

Many couples experiencing problems outside of the bedroom will also experience problems in the bedroom. These overarching issues may include: 

  • Lack of connection with one’s partner 
  • Unresolved conflicts or fights 
  • Poor communication of sexual needs and preferences 
  • Infidelity or breach of trust 

What are Anorgasmia Treatments?

Due to its complexity, anorgasmia can be difficult to treat. The treatment plan will depend on the underlying cause of the symptoms, and the doctor may recommend a combination of lifestyle changes, talk therapy and medication, if necessary. 


It is advisable to speak with one’s doctor about the inability to reach orgasm. It is also advisable to communicate openly and honestly with one’s partner.

Allowing for more intimate time

While continuing to be active with intercourse, one is encouraged to explore other ways of being intimate. Shifting the focus from orgasm as a means to an end, to pleasure in and of itself, may be helpful in treating anorgasmia. Massage, touching, and masturbation with or without a partner are ways to experience intimacy and sexuality without intercourse.

Understanding turn-ons

Understanding one’s body, and how you like to be touched, can lead to enhanced sexual satisfaction. To gain a better understanding of one’s genital anatomy, it is advisable to take out a mirror and look. Take some time to explore. Masturbating, with or without the use of a vibrator, can help in discovering the type of touching that feels best—priceless information to share with one’s partner. Those uncomfortable with self-exploration can try exploring with the help of their partner. Several books on our website specifically deal with the issue of orgasms in women.

Sufficient stimulation

Many women who experience anorgasmia are simply not obtaining sufficient sexual stimulation. Most women need direct, or at least indirect, stimulation of the clitoris in order to achieve orgasm. Switching sexual positions can enhance clitoral stimulation during intercourse; some positions also allow for self-stimulation or for one’s partner to stimulate the clitoris. Using a vibrator that focuses on clitoral stimulation may also help facilitate an orgasm. 

Handling relationship issues

Conflicts and disagreements in a relationship can affect the ability to experience orgasm. A counselor can help work through disagreements and tensions to help a couple get their sex life back on track. 

Sex therapists are therapists who specialize in treating sexual concerns. While one may be embarrassed or nervous about seeing a sex therapist, it can be quite helpful in treating anorgasmia. Therapy often includes sex education, help with communication skills, and behavioral exercises that can be done with one’s partner in the privacy of one’s home. 

Treating underlying medical conditions

If a medical condition is hindering one’s ability to orgasm, treating the underlying cause may resolve the problem. Changing or modifying medications known to inhibit orgasm may also eliminate one’s symptoms. 

Hormone therapy

Systemic estrogen therapy by pill, patch or gel can have a positive effect on brain function and mood factors that affect sexual response. Local estrogen therapy, in the form of a vaginal cream or a slow-releasing suppository or ring that a woman places inside her vagina, can increase blood flow to the vagina and help improve desire. In some cases, a doctor may prescribe a combination of estrogen, progesterone and low-dose testosterone, if necessary. 

Testosterone can play an important role in female sexual function. A woman’s body naturally produces testosterone, although in much smaller amounts than found in men. A blood test can reveal if any, or all, of the sex hormones are deficient, as is commonly seen during the transition into menopause. While it is medically known that testosterone may help reverse anorgasmia in some cases, particularly if estrogen and progesterone aren't helping, it remains a controversial treatment option. The Food and Drug Administration does not approve its use for sexual dysfunction in women. Testosterone can cause negative side effects including acne, excess body hair, and mood or personality changes. Testosterone therapy seems most effective for women with low testosterone levels as a result of surgical removal of the ovaries. If a woman chooses to employ this therapy, her doctor will closely monitor her symptoms.

Natural Anorgasmia Treatment Options

Natural products are available that may help some women who have difficulty reaching orgasm. Oils and supplements like clitoral arousal gels and warming lubricants work by increasing sensation and blood flow to the clitoris and surrounding tissue. 

In reality, most couples aren't experiencing the earth shattering, fireworks type of sex portrayed on TV and in the movies. Perhaps it is advisable to reframe one’s expectations. Focusing on mutual pleasure and intimacy, rather than solely on achieving orgasm, may actually lead to sustained pleasure that is itself both fulfilling and satisfying.


Related Resources on Anorgasmia

Taking Control of Your Faltering Sex Life

The Equation for a Better New Year

  • 1 of 1