What Causes a Lack of Orgasm?

Physical and mental changes may be making it harder for you to orgasm

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While the inability to achieve orgasm (anorgasmia) is undoubtedly frustrating, anorgasmia is common and can be caused by a number of physical and psychological factors. Lack of adequate stimulation, acute stress, anxiety, as well as depression and relationship problems can all interfere with the ability to experience orgasm. Other health conditions, such as incontinence, can cause problems too.

Everyday stress and the many roles and responsibilities women deal with can result in distractions, making orgasms more difficult to achieve.

In addition, cultural and religious prohibitions may result in anorgasmia (possibly related to a heightened sense of guilt).

Medications can also interfere with the ability to experience orgasm. Many antidepressants, including Prozac, Zoloft and Paxil have a high propensity to cause such problems. In addition, antipsychotic drugs such as Haldol, Thorazine and Mellaril can cause inability to reach orgasm and Valium may delay orgasm. Fortunately there are other antidepressants (Wellbutrin SR) and antipsychotic drugs (Zyprexa and Seroquel), which don't seem to cause inability to experience orgasm. Antihypertensive drugs may also interfere with orgasm.

Any disease, such as multiple sclerosis, that interrupts the nerve supply to the genitals may cause lack of orgasm.

Treating Anorgasmia

If you struggle reaching orgasm, one of the first things you are going to want to do is determine the cause. If your problem is psychological, speaking to a therapist can help.

If you and your partner are having relationship troubles, the two of you can speak to a couples counselor. Sex therapists, a therapist who provides sexual education and behavioral exercises, can also help you break down the barriers preventing you from orgasming. There are also self-help books available to assist women in developing skills that will improve their ability to reach orgasm.

Building confidence, in yourself and in your body, can make you more comfortable during intimate moments. By becoming more comfortable with and understanding your body, you may be able to naturally increase your ability to orgasm. Most women need direct stimulation of the clitoris to orgasm. If you are only having penetrative sex, and not orgasming this may be why. Talk to your partner about what feels good for you or try self-stimulation or a vibrator. 

If medications or medical conditions are preventing you from orgasming, talk to your doctor. You may be able to switch medications or change your dosage. 

How Is Pain During Sex Treated?

In postmenopausal women who experience diminished vaginal lubrication, hormone replacement therapy is often recommended. Vaginal creams containing estrogen may also help.

Even women who are not postmenopausal experience problems with vaginal lubrication which can create friction during sex, and ultimately cause pain. In this case, use of over-the-counter vaginal lubricants before intercourse is a possible remedy.

If the woman experiencing pain is in a relationship, she should communicate with her partner. Together they can work to find a position that is more comfortable. Sometimes a change in the time of day when you are more rested may help.

If pain is persistent, see your doctor. The pain could be a symptom of another medical condition. In fact, most physicians view dyspareunia (pain with intercourse) as a pain disorder and treat accordingly (analgesics/creams, etc.).

There are many treatments available. Your doctor will work with you to find a solution to your problem.

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