Anorgasmia
Anorgasmia is a sexual dysfunction in which a person cannot achieve orgasm despite sufficient stimulation. Although anorgasmia can affect people of any gender, it is most commonly identified in women.
Symptoms of anorgasmia
While more generally, anorgasmia refers to the absence of orgasms, definitions of the condition vary, and are expanded to include delayed, infrequent, or significantly less-intense orgasms.
Anorgasmia may be considered a lifelong issue if you're experienced but have never had an orgasm before; an acquired issue if you have new problems with reaching orgasm; a situational issue if your difficulty climaxing is limited to particular situations, circumstances, or partners; or a generalized issue if you have problems with orgasm in any and all situations.
Causes of anorgasmia
As anorgasmia is not a specific physical condition, it can be caused by countless physical and/or psychological issues, including:
- Hormonal changes/imbalances
- Conditions linked to painful sex, like vulvodynia and vaginismus
- Chronic vaginal infections, including yeast infections and bacterial vaginosis
- Medication side effects (especially SSRIs)
- Surgery side effects
- Chronic pain or illness
- Anxiety
- Depression
- Stress
- Trauma
- Performance anxiety
- Insecurity, and an associated tendency to fake orgasms
Essentially, almost anything can affect your ability to reach orgasm. The roots of your anorgasmia are unique to you personally.
Can it be normal to never climax?
It is not considered “normal” for women to never reach orgasm during sexual stimulation. While it's common for women to struggle with orgasm, this is not because it's “naturally” more difficult for women to experience sexual satisfaction.
The fact that anorgasmia is much more common in women may be attributable to the orgasm gap, a term coined to refer to the highly gendered disparity in sexual pleasure and satisfaction. Studies have found that heterosexual women are the demographic having the least orgasms during sex, a phenomenon likely related to a lack of understanding of the female anatomy in general and the vulva in particular, and the reality that the vast majority of women can’t reach orgasm from penis-in-vagina intercourse alone, as clitoral stimulation is the main source of women's pleasure.
A 2016 review of over 400 studies on female sexual dysfunction concluded that about 26% of premenopausal women experience female orgasmic disorder (AKA anorgasmia). Other studies have put the number as high as 41%. Comparatively, between 1 and 5% of sexually active men experience delayed ejaculation.
Anorgasmia diagnosis
Getting an anorgasmia “diagnosis” is less important than getting to the root cause of your difficulties reaching orgasm.
In the problematic/outdated Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), anorgasmia is referred to as "female orgasmic disorder” for people with vulvas and “delayed ejaculation” for people with penises. In both cases, the criteria for diagnosis includes a “marked delay in, marked infrequency of, or absence of orgasm” during at least 75% of your sexual activity for at least six months. Additionally, this must be causing you “significant distress.”
While anorgasmia may be diagnosed by a doctor via a physical exam and/or a review of your medical history, any problems achieving orgasm—be they short or longterm—can be termed anorgasmia without the need for a professional opinion.
Things to consider:
- If you climax easily in certain situations—such as during masturbation, or when you receive prolonged oral sex, or during sex with certain partners, or when getting into a specific position—your orgasm difficulties are likely circumstantial rather than health-related. It's normal that some people need very specific types of stimulation to reach orgasm. If you’re relatively inexperienced sexually, it may just be a matter of discovering what works best for you.
- If you've noticed a significant change in your experience of pleasure and your ability to reach orgasm, it may be worth consulting a professional to rule out any physical health or medication-related causes.
- If you’re concerned you have a psychological or emotional issue that's inhibiting your ability to climax, consider consulting a qualified sex therapist.
How to treat anorgasmia
If you’ve established that you can’t reach orgasm and are ready to try different treatment options, consider the following:
- Rule out medical issues. If there's a physical problem contributing to your inability to orgasm, your doctor might adjust your medication(s), suggest hormone therapy, or treat/diagnose underlying conditions like depression or anxiety.
- Improve your relationship with sex. Now may be the time to delve deeper into aspects of yourself that you feel may be contributing to your anorgasmia. This might include reflecting on childhood trauma and/or sexual abuse in particular; a sex-negative or ultra religious upbringing; or a general stress response associated with sex. You might consider seeing a therapist, and/or easing into a mindful masturbation practice.
- Learn to love your body. Many people (women in particular) find themselves unattractive, which is, sadly, unsurprising considering the ongoing realities of mainstream messaging around body image. There is a link between body image and sexual pleasure, so if this feels like an area to work on for you, you might explore ways of feeling happier and healthier in your body. These may include: improving your relationship to food and exercise, buying some new lingerie, or taking some sensual photos of yourself.
- Acknowledge relationship problems. If you’re uncomfortable sexually with your current partner, and/or you have ongoing issues, arguments, or general disagreements which tend to flavor your relationship as a whole, or leave you feeling disrespected or anxious, adverse effects on your sex life are normal. Whether your issues with your partner are directly related to sex or not, work on resolving them. If you can’t, it may be time to seek couples therapy, or reevaluate your relationship. If you do succeed in finding a resolution, you may be surprised at your newfound ability to reach orgasm.
- Get creative. Sex should be an inherently creative form of play. Consider introducing new sex toys, games, erotica, and/or porn into your relationship (be it with yourself or a partner). Try new ways of masturbating or having sex. Consider trying roleplay or BDSM with a partner. There is no rule that says you need to orgasm with your own two hands, or via penetrative sex. Explore your body, and enjoy the process of learning what turns you on.
Ultimately, anorgasmia is an often complex issue which must be addressed from multiple angles at once. A willingness to reflect, experiment, and seek the counsel of a qualified sex therapist can all go a long way toward resolving the issue, making it easier to reach orgasm in the future.
