What’s Anorgasmia in Women?

Have you ever felt super aroused yet never quite reached that peak of pleasure? If so, you’re not alone. Difficulty or inability to orgasm is something many women go through, though few feel comfortable talking about it. In fact, it’s a common sexual health concern that often goes unaddressed due to the fear of embarrassment or myths. The good news: there are solutions to enjoy a more satisfying sex life. In this blog, we’ll find out about anorgasmia in women – what it is, why it happens, how common it is, and research-backed ways to overcome it. 

What is Anorgasmia in Women?

Anorgasmia is the medical term for having problems reaching orgasm. In women, it means an orgasm happens late, very infrequently, or sometimes it doesn’t even happen despite getting adequate sexual stimulation and arousal. [1] In other words, you might be enjoying sex now and feeling more pleasure, but the climax just doesn’t happen or if happens, it’s much weaker than expected. Doctors call this condition female orgasmic disorder. It’s diagnosed only when a woman rarely or never gets an orgasm. Even if they get one, the intensity is very low. And it’s been happening for at least 6 months. [2] It’s also helpful to know anorgasmia can be classified by timing in your life:

• Primary anorgasmia: When you have never been able to reach an orgasm under any circumstances. This could be you if, for example, you’ve masturbated or had sex and not once got an orgasm since you have been sexually active. [3]
• Secondary anorgasmia: When you used to get orgasm in the past, but now you can’t. This might even happen after a long few years or after any life change (such as childbirth or starting a new medication).

Anorgasmia can be situational or generalized also. 

• Situational means you can climax in some situations but not in others (for instance, you can get an orgasm while you masturbate but not when you’re with a partner, or only with oral sex but not while penetrative sex). 
• Generalized means you still have the same problem, with any partner or even alone.

I always tell my patients with anorgasmia: be curious, be patient, and don’t be scared to experiment with what pleases you. Knowing your own body is the first treatment. – A Sex Expert, Allo Health Clinic

— Sanchita Mishra

Note: If you regularly have problems with orgasm or never had a climax at all, despite being sexually aroused, you may have anorgasmia. And importantly, it can only be considered a medical issue if it bothers you or else not. All women’s bodies are different – some get orgasm easily, others get rarely, and a few never ever had an orgasm. If you’re content with your sex life, then there’s no problem to fix. 

How Common Is Anorgasmia Among Women?

If you have anorgasmia, you might be very lonely. Nothing could be further from the truth. Orgasm difficulties are very common among women. Let’s look at what research has to say about the prevalence of anorgasmia and orgasm problems:

• Approximately 10% to 15% of women have never ever experienced an orgasm in their whole lifetime. [4] That’s right – about 1 in 10 women worldwide have never had an orgasm. 
• Even among women who have orgasmed before, many still report having such difficulties sometimes. A 2021 review noted that up to 28% of women in the U.S. and 46% of women in some Asian countries have reported having orgasm problems. [5] These numbers show us that this is a widespread issue.
• It’s also common for women to have some situational orgasm troubles. About half of all women (50%) say they have orgasm problems occasionally. [6] Many a time, women find it harder to climax after vaginal intercourse alone. In fact, roughly 3 out of 4 women can’t orgasm from penetration alone – they will need a clitoral touch to finish. [7] Clitoral stimulation is totally normal biology (as the clitoris has the highest number of nerve endings for pleasure). So if intercourse by itself doesn’t get you there, it doesn’t mean something’s wrong. It’s just how your body works. No issue. 

What Are the Signs and Symptoms?

Anorgasmia’s symptoms are as it’s defined. It is a constant orgasm problem, even if they get one it’s weak. It feels unsatisfying, despite getting the right amount of sexual stimulation. Other signs are:

• If you have a delay in climax to the point that you just give up.
• If you are always bothered due to the orgasm problem.
• You start avoiding all kinds of intimacy because you thought it might end up in disappointment.
• When your pattern is situational (for instance, you get orgasm solo but never with a partner).
• A sense that you’re almost there yet can’t fully let go.

If these challenges still go on for at least six months and cause you any distress, it’s likely anorgasmia. If trouble isn’t constant, then you’re safe.

How Do Some Psychological Factors Contribute Here?

Our mind is a very powerful sexual organ. So some psychological factors can cause anorgasmia. Here are some common factors that might be affecting you:

• Performance Anxiety: It’s very hard to get an orgasm when you’re anxious. To get an orgasm, you need to let go and focus on the pleasure only. Performance anxiety (when you keep on worrying about not orgasming while you’re trying to get an orgasm) is quite common in this case. 
• Stress and Mood Issues: Anxiety or depression can sometimes lower your libido and blunt physical response. You can’t get excited when you’re sad or have low energy. Add to it, side effects of some antidepressant medications (especially SSRIs) cause some delay in orgasm or inability to orgasm. [8] So it’s a double hit – the condition and the treatment both affect orgasm. 
• Past Trauma or Abuse: A painful past can trigger your subconscious fear which might affect your arousal and orgasm. Studies have shown that women who have experienced sexual abuse at least once are more likely to have orgasmic disorder or other sexual dysfunctions. [9]
• Body Image Concerns: Always feeling self-conscious can distract you from your pleasure. 
• Guilt or Shame: If you were raised to believe that good girls don’t enjoy sex or you have some internalized shame about sexuality, you might show some intimacy problems. This is a kind of psychological brake on your arousal.
• Lack of Knowledge or Misconceptions: Sometimes simply when you don’t know how a female arouses or gets an orgasm, it might seem like a disorder. 

If your mind is somewhere else or you are emotionally taxed, you might get orgasm problems. Start to address these internal blocks through therapy or counselling. 

What Physical or Medical Issues Might Lead to Anorgasmia?

Just as your mind affects your ability to get an orgasm, so does your body. There are some physical and medical factors that can have a hand in it:

• Medical Conditions: Health issues that have an effect on your nerves, blood flow, or energy levels can impact your orgasm. Diabetes, multiple sclerosis, and other nerve-related conditions can reduce your sensations with time.
• Hormonal Changes: Menopause starts lowering estrogen with time and causes vaginal dryness and low sensitivity. Thyroid disorders or low testosterone in women can also have similar effects on your sexual function.
• Medications: Many antidepressants (SSRIs), blood pressure drugs, and some antihistamines can impede orgasm.
• Pelvic Floor Disorders: When you have chronic pain or hypertonic (excessively tight) muscles, it can make orgasm difficult.
• Recent Surgeries or Childbirth: Hysterectomy, pelvic surgeries, or childbirth-related trauma sometimes disrupt nerve pathways and cause problems getting orgasms.
• Sexual Pain Disorders: If you feel pain during sex, in the case of dyspareunia (painful intercourse) or vaginismus (involuntary tightening of vaginal muscles), getting an orgasm can be troublesome. 

Note: If you suspect you might have a medical cause, consult a sexual health professional for better evaluation. You can see some better results, just by adjusting your medication or treating the condition.

How Is Anorgasmia Diagnosed?

The diagnosis of anorgasmia is usually done while the patient tells about the problems, and it may include a physical check-up. Here’s what happens:

• Your doctor might ask about when you first noticed the problem, any past orgasms you had, and what you’ve tried so far.
• Some existing health conditions, medications, hormonal factors, and any surgeries might be relevant. So tell your conditions to your doctor. 
• Your doctor might check for signs of pain, nerve issues, or other physical contributors.
• Your doctor might want to know the state of your current relationship (if you have one) and how satisfied you are with it.
• Lab tests are prescribed (if needed) to know about hormone levels, thyroid function, or blood sugar.

Be honest while answering. Doctors will use this information as clues to find the cause of your problem. If no single cause stands out, it’s called female orgasmic disorder. Try to consult a professional to get checked if your concerns are valid.

What Treatment Options Are Available?

Can anorgasmia be treated? Yes– in most cases, women might start getting orgasms. There are some treatment options available, but a mix of all works best. 

First Treat The Physical Causes

• If your antidepressant is causing the problem, talk to your doctor about alternatives or dosage changes.
• If you start managing your diabetes, thyroid disorders, or pelvic floor issues, you can restore your normal sensation.
• For women whose anorgasmia is due to menopause or hormonal deficiencies, hormone therapy might help. Estrogen therapy– systemic via pills/patches, OR localized via vaginal creams or rings. [10]

Consider Sex Therapy and Counseling

• Studies have shown that Directed Masturbation Training is very effective. [11] Your sex therapist will guide you through the process. Try to learn how to orgasm solo first.
• Slow low- pressure touch exercises can encourage experimentation.
• Try out cognitive-behavioural therapy (CBT) to treat your anxiety, past trauma, or negative beliefs surrounding sex.
• Psychotherapy (talk therapy) that is targeted at sexual issues has been shown to help women gain or regain the ability to have orgasms. [12]

Couples Therapy

• Here you get to learn how to express your desires and boundaries.
• You can resolve your relationship conflicts or trust issues and someone will be here to give you unbiased suggestions.

Sexual Aids

• Some like to use erotic materials (in PDF or audio form) to help arousal, and some use a vibrator to get consistent and strong stimulation to trigger that first orgasm.
• Clitoral suction devices are used to get better blood flow and sensitivity.

You can get better results when you combine medical and therapeutic strategies. It might take some trial and error to find out what works for you, but many options exist.

What Lifestyle Changes Can Help?

• Do meditation, yoga, deep breathing, or journaling to reduce stress which can interfere with sexual response. [13]
• Exercise regularly to fix your blood flow problems. Try to do pelvic floor exercises (Kegels) to enhance orgasmic contractions.
• Get enough sleep to take care of your libido.
• Cut down on alcohol and smoking as both can hamper blood flow and numb sexual sensation.
• Try to use a good quality lubricant to lower pain so that you can focus on pleasure.
• Balanced nutrition will support hormonal stability and give more energy.
• Masturbation remains one of the best ways to know your own body’s pleasure responses.
• Expert tip: Take your time. Devote more time to foreplay and stimulation that you enjoy. 

Work on these habits to remove all those hidden brakes that make orgasm difficult.

What Questions to Ask Your Doctor?

If you decide to see a doctor or therapist, these are some questions you can ask:

• What’s the exact cause of my orgasm problems?
• What tests do I need?
• Do you recommend sex therapy, couples counselling, or both?
• Can I involve my partner in appointments or sessions?
• How long might it take to see some results while on treatment?
• What are the possible side effects or downsides of the treatment options you’re suggesting?
• What should I do if this treatment doesn’t work for me?

Don’t be shy- ask as many questions as you want to ask. These are just some ideas. Sex experts are there to help only.