Can T Orgasm
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Can T Orgasm
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Treatable problem to discuss with your doctor
July 29, 2020 / Diabetes & Endocrinology
July 29, 2020 / Diabetes & Endocrinology
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We don’t often think about what needs to happen to go from arousal to a satisfying orgasm. Your mind needs to stay clear and focused, your nerves sensitive and blood needs to flow to all the right places. There’s a mental, emotional and physical aspect to sex, and unfortunately a variety of problems can interfere.
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Many
women find they cannot climax during penile-vaginal sex. If a woman has never
climaxed in her adult life, we call it primary orgasmic dysfunction. If she had
been able to climax in the past, but now finds it difficult or impossible, we
call it secondary orgasmic dysfunction.
Only 10% of women easily climax. Most women are in the remaining 80 to 90%. I see many women in my practice who feel relief just to know they are “normal” when they have trouble climaxing with just vaginal sex but can climax with direct clitoral stimulation. It’s unfortunate that many women think they are not normal if they cannot climax solely through vaginal intercourse. Most women can not! It is important to relax and know that you are normal.
To
help with being able to climax, it is important for a woman to know where her
erogenous zones are. She should also communicate about them with her partner.
Various parts of a woman’s body respond to touch and stimulation, such as the
face, lips and neck.
A
woman’s most sensitive erogenous zones include:
Women
who have been able to climax without difficulty in the past but now are having
trouble need an evaluation. I take their history and then I do a physical and a
hormonal and medication evaluation.
Often, one or more of the following is a culprit:
• Medicines , including antidepressants/selective serotonin reuptake inhibitors (SSRI) • Hormonal deficiency (This is very common, especially after menopause) • Partner issues • Medical problems, such as diabetes and hypertension • Lack of exercise • Smoking • Drinking • Sleep disorders
To
treat orgasmic dysfunction, off-label oral prescription bupropion can help.
Viagra may also work. In particular, it can work as an off-label treatment to
help women who are on SSRI antidepressants.
Some doctors will also prescribe off-label “Scream Cream” made by a compounding pharmacy. This cream includes a variety of topical medications. When a woman applies it to the clitoris, it increases blood flow and helps promote an orgasm.
Women can use this cream alone or they can use it along with a stimulating device, such as the Intensity™ device, which is an FDA-approved pelvic electrical stimulating device. It stimulates the pelvic muscles that contract with climax and also provides direct clitoral stimulation. There is another device that is FDA-approved to treat orgasmic dysfunction, called the Eros device, which is only available through a doctor’s prescription.
It’s
important to note that there are other problems, besides orgasmic dysfunction,
that can affect women sexually and cause female sexual dysfunction. They
include low libido, painful sex, difficulty being aroused and even sexual aversion.
All of these issues are real. They can cause women a lot of distress and affect their relationships. But the good news is that treatments are available, which many women don’t realize.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Having difficulty achieving an orgasm is normal for many woman, but with the proper help it can be attained.
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There are more factors affecting your ability to climax than you probably realize.
For plenty of people, climaxing is anything but easy. And while these issue face people of all genders, according to the Cleveland Clinic only 10 percent of women can easily achieve orgasm . The other 90 percent have to deal with a lot of outside factors that can impede their ability to climax, including what sex position they're in to what they face when they're at work. If you're struggling to climax, there are some surprising reasons why you're not reaching orgasm , and addressing these issues may just help you achieve (and enjoy!) a more satisfying sex life.
Like Area 51 and the Bermuda Triangle, the female orgasm is considered to be something of a mystery. (This isn't a coincidence, of course, but the result of scientific researchers systematically ignoring women and their ailments.) Some experts even think that the G-spot (which has long been believed to be the key to achieving vaginal orgasm ) is a myth. Rather than getting off through vaginal penetration, it's possible a person needs clitoral stimulation to reach the big O. Every woman is built differently, of course, and figuring out just what does and doesn’t work for you — or what factors from your daily life could be affecting you in the bedroom — can be a complicated business. But just because something’s difficult doesn’t mean you should give up hope.
If you're one of the many women struggling to reach climax, here are just 15 problems that may be affecting your ability to orgasm and what you can do to solve them.
Anxiety can cause intrusive thoughts that may make it difficult to orgasm. In fact, a 2018 survey from Valparaiso University in Indiana indicated that more than half of the women surveyed cited anxiety as a reason for why they struggled to achieve orgasm. "Often people find themselves 'getting in their head' during sex or masturbation," Danica Mitchell , sex therapist and social worker, tells Woman's Day. "There are a lot of societal narratives that get in the way of enjoying sex and masturbation, and guilt and shame are common mental barriers." According to Mitchell, confronting those narratives that induce shame and guilt may help in feeling less anxious and more connected to your body during pleasure. "Seeing a couples or sex therapist can help in addressing any of this," she says.
Oxytocin — also known as the "feel good" or "love" hormone — goes hand-in-hand with orgasms, Kat Van Kirk , Ph.D., marriage and sex therapist, tells Woman's Day. If your body isn't producing enough of it, climaxing can be more difficult. Stress can be a major reason for low oxytocin production, but spending more time with your partner, looking into their eyes, holding hands, and kissing have all been proven to boost production of the hormone. Have a furry friend? Cuddling with a pet may also cause the release of oxytocin.
Drinking water throughout the day can prevent everyday health problems like fatigue and constipation, and can also help you climax in the bedroom, Eden Fromberg , D.O., founder of Holistic Gynecology New York, tells Woman's Day. The arousal tissue that extends into the connective tissue system needs to slide and glide in order to work its O-inducing magic, and it can't do that without fluid, she explains. To make sure you're adequately hydrated, down an extra glass or two of water before you plan a romp in the sack, especially if you've had cocktails, since alcohol can cause dehydration.
Being vocal during sex has been proven to work wonders for women, as it can allow you to orgasm longer, harder, and more often, Laurel House , relationship expert and author of Scre wing the Rules, tells Woman's Day. So when something really turns you on, say it — whether it's through a moan, quietly saying, "Right there," or screaming, "Yes!" If that feels uncomfortable after a few tries, House suggests heightening your sensory experience. "Take in the feeling of skin-to-skin contact; enjoy the pressure of your partner's body pressing down on yours,"she says. Embracing these sensations will help you tune out the world and focus on maximizing your experience.
If you don't feel good about yourself, chances are you're going to have a more difficult time feeling good during sex. "One common reason that women may fail to orgasm is because they are overthinking. They are in their heads," Moushumi Ghose , owner and founder of Los Angeles Sex Therapy, tells Woman's Day. "This might be because of body image insecurities. They are concerned that their partner is going to notice their belly rolls or their cottage-cheese thighs, which is taking them out of the moment."
Overcoming your insecurities takes time and work, and it won't happen overnight. "Developing a mindfulness practice, or a breathing practice to help you stay centered, is one of the easiest ways to start breaking the pattern of overthinking today," Ghose explains. "Journaling and writing to get thoughts out of your head is awesome, too, and having daily practices around these things can be quite helpful and liberating."
When you're taught to be in control of every aspect of your life, it can be tough to do the exact opposite in bed. But refusing to let go could be the reason you're unable to orgasm because, well, orgasms tend to take over as they move throughout your body. But if just the thought of that gives you heart palpitations, don't freak out — as Jenny Block , author of O Wow: Discovering Your Ultimate Orgasm , tells Woman's Day, you don't lose complete control over your body. At most, your body may shake and your vaginal wall muscles contract, she says. So when you're in the moment, and sensations start to build, keep breathing and try to let your body go with it. If you feel like you still need help letting go, talking with a sex therapist may help.
According to Mitchell, if a woman is experiencing pain or discomfort during sex, it will be incredibly difficult for her to orgasm. "Vulvodynia and Vaginismus are disorders in women that cause pain and often go undiagnosed for long periods of time," she explains. "If there is a physiological reason why sex or masturbation is uncomfortable, it's important to start treatment there."
If you suspect you could be suffering from Vulvodynia or Vaginismus, pay a visit to your doctor to get yourself checked out.
How often you pleasure yourself can directly affect your chances of reaching orgasm when you're with a partner(s). According to Van Kirk, a woman's ability to fantasize and use her imagination during masturbation can help her unleash her creative inhibitions in bed, and it helps her learn exactly how and where she likes to be touched. According to a 2017 study in The Journal of Sex and Marital Therapy , nearly 40 percent of women need clitoral stimulation to orgasm, and that's something you may only discover you need during masturbation. To increase your chances of achieving orgasm with a partner, Block recommends masturbating a few times a week. And while some women may not feel comfortable using sex toys, they can greatly enhance your sexual experiences and may help you achieve orgasm if you're having trouble. Start with something small, like a bullet vibrator , then check out this guide if you feel like exploring.
The 2018 Valparaiso University survey also indicated that insufficient lubrication affected nearly a quarter of women who had difficulty reaching orgasm. "Lack of lubrication may make sex less enjoyable and make orgasm difficult," Mitchell explains. "Always have your favorite lube on hand as it can easily make partnered or solo sex more pleasurable."
Lubes are available at drugstores and online, and you can consult this handy guide for expert tips on the best lube for every occasion.
You're not a mind reader, and neither is your partner(s). So staying silent about what really turns you on isn't going to help you climax. Plus, every woman is different, so movements and angles that feel amazing for one person may not do it for another. "It's important to feel comfortable and safe with a partner and be able to communication the types of sexual acts or touch you like," Mitchell says. "While selfishness often has a negative connotation in context, it's OK to be 'sexually selfish,' meaning you are responsible for your pleasure and orgasm. Seek behaviors that feel good, listen to your body, ask for what you want, and guide your partner in pleasing you." The lesson here: speak up. "Sometimes a groan or a touch of the hand can make all of the difference," Van Kirk says. If they still don't get it, tell them directly, or move their hand exactly where you want it.
Everyone knows to pee right after sex to help prevent a urinary tract infection , but it's smart to go beforehand, too. "It can be incredibly hard to reach orgasm when your bladder is full," Block says. The reason is simple: instead of being in the moment, you're constantly feeling the pressure to pee, and praying you don't do it in bed. If there's no way you're going to make it to the end, Van Kirk suggests slipping out of bed to dim the lights, lighting a candle, and encouraging your partner to masturbate while you take a quick pee break.
Medications that cause a spike in prolactin levels — a protein that reduces libido — could be the culprit behind your inability to climax, Van Kirk says. "Typically, blood pressure medications, birth control pills, and antidepressants are the main culprits," she adds. Antihistamines may also work against you because they can reduce your ability to self-lubricate and make sex comfortable. If that's the case, make sure you have plenty of lubricant and talk to your doctor about a possible medication switch if problems persist.
Chaining yourself to your desk may make your boss happy, but it's bad news for your pelvic muscles. Sitting all day shortens them, and that can lead to pelvic pain that could make it more difficult to orgasm , says Van Kirk. To prevent problems, she suggests setting an alarm as a reminder to move every half-hour to hour during the work day. (Some activity trackers and smart watches will buzz your wrist to encourage 250 steps every hour.) Able to slip into a private office or conference room? Stretch your hip flexors with back bends , squats , and butterfly stretches .
Not only are high heels often painful to walk in, wearing them can also have deforming effects on your psoas muscles, which connect with muscles and nerves that lead to your pelvic floor, genitalia, and related organs, Fromberg explains. "When your psoas muscles are sticky and tense due to prolonged high heel wear, they can't transmit the arousal message necessary for orgasm," she adds. Avoid wearing them as much as possible, opting for more comfortable, supportive footwear instead.
Too much emphasis on achieving orgasm can make sex feel like a goal-oriented task, turning intimacy into more work than pleasure. "When we try too hard to orgasm or we focus too much on the outcome, not only orgasm, but pleasure, arousal, sensuality and connectivity slips away and eludes us," Ghose says. "People often say, 'I'll focus harder,' when the antidote to that is actually to focus less and try to enjoy and be more present. If a woman tries too hard to achieve orgasm, then chances are she's missing out on the pleasure and the joy of her own body."
According to Ghose, you should avoid the temptation to focus on results rather than enjoy the moment. "Developing some practices around sensuality can be helpful, like reading erotica, buying some nice lingerie or sex toys to experiment with," she says. "The key is getting out of your head and out of your own way, and there are many fun and exciting ways to do it. You just have to have an open mind, and of course, be relaxed and enjoy the journey!"
Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Ⓒ 2022 Dotdash Media, Inc. — All rights reserved
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more .
Medically reviewed by
Lindsay Cook, PharmD
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Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Ⓒ 2022 Dotdash Media, Inc. — All rights reserved
Verywell Health is part of the Dotdash Meredith publishing family.
Jerry Kennard, PhD, is a psychologist and associate fellow of the British Psychological Society.
Lindsay Cook, PharmD is a board-certified consultant pharmacist.
Male anorgasmia is the persistent inability of a man to have an orgasm , even after sexual stimulation. Anorgasmia, or Coughlan's syndrome, affects both men and women, but it's more common in women.
Male anorgasmia can be distressing to those who experience it, especially since it often occurs with delayed ejaculation . This is when an orgasm is possible, but it's difficult and takes longer to achieve.
It's estimated that about 8% of men have delayed or absent orgasm. 1 It's less common among younger men and increases with age. 2
The condition should not be confused with erectile dysf
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