Published on 29th October 2021

Climax, cum, the big O. Whatever you want to call them, orgasms are central to sexual pleasure, but for some, frustratingly unattainable. Anorgasmia is the medical term for when someone struggles to have a full orgasm during an abundance of sexual stimulation. It’s something more women have experienced than men (why doesn’t that surprise us eh ladies?), and the symptoms vary slightly between the sexes. Read on to find out more.


Types of Anorgasmia


The technical definition of an orgasm is ‘a feeling of intense physical pleasure and release of tension, accompanied by involuntary, rhythmic contractions of your pelvic floor muscles’. Not all orgasms are created equal though, and the way they feel can vary from person to person, and even from orgasm to orgasm. As orgasms vary, so does anorgasmia, and these are the different types:


  • Lifelong anorgasmia - You've never had an orgasm.

  • Acquired anorgasmia - You used to have orgasms, but now have difficulty reaching climax.

  • Situational anorgasmia - You're able to have an orgasm only in certain circumstances, such as during oral sex or masturbation or only with a certain partner.

  • Generalized anorgasmia - You aren't able to have an orgasm in any situation or with any partner.


Anorgasmia in women


Like most things in life, anorgasmia is rarely one-dimensional, usually triggered by a variety of different things. This can make it hard to pinpoint a root cause, but here are some of the most common barriers to reaching a climax for women:


Physiological causes


  • If you suffer from a serious illness or disease such as multiple sclerosis or Parkinson's, their associated effects on psychological well-being can cause anorgasmia. 

  • Major gynecologic surgery like a hysterectomy or cancer surgery can affect orgasm. 

  • Some prescription and over-the-counter medications can hamper orgasms, including blood pressure medications, antipsychotic drugs, antihistamines, and antidepressants.

  • Alcohol and smoking might be fun at the time, but they can affect your orgasms, and smoking even limits blood flow to your sexual organs. 

  • Getting older brings about normal changes in your anatomy, hormones, neurological system, and circulatory system which can affect your sexual desires. 

  • As if menopause doesn’t cause enough problems as it is (hello hot flushes and even memory loss), waning estrogen can have an impact on your sexuality.


Psychological causes


  • Even if you’re not taking antidepressants that can reduce your sex drive, general feelings of depression and anxiety can cause anorgasmia.

  • Suffering from poor body confidence, because if you’re not feeling good, you might not be feeling it at all. 

  • Although orgasms can be a stress release, reaching that point is hard when you’re worried about something stressful at work or financial pressures. 

  • Cultural and religious beliefs.

  • Orgasms require you to let go of your inhibitions which won’t happen easily if you’re feeling embarrassed in a particular situation or find sexual intercourse embarrassing. 

  • Sadly, some women feel high levels of guilt about enjoying sex. 

  • For some, sex is a triggering experience that reminds them of past trauma. 


Relationship issues


  • Nothing usually makes women cum quicker than being with a partner they trust, connect with and laugh with. Annoyingly trite but true. So if you're not in a happy, trusting relationship, orgasms might remain out of reach. 

  • If you’re angry at your partner, a state of acquired anorgasmia wouldn’t be uncommon. 

  • If you've never communicated your sexual needs or desires, your partner won't know what makes you feel good – communication can be a lifeline. 


Treatment


For some, anorgasmia can be a lifelong struggle, but for others, it can be cured with some medical or lifestyle changes. 



Lifestyle



  • Grab that hand mirror and get to know your body intimately. Being comfortable with yourself and understanding your body (inside and out) can work wonders. 

  • If you haven’t already tried masturbating, then what are you waiting for? You’ll start to find out what feels good and can let your partner know in the future. 

  • It’s very common for women not to be able to climax through penetration alone. So in spite of what it might look like in porn, clitoral stimulation is usually an integral part of a women’s orgasm. 

  • We’re not suggesting you make your way through the Karma Sutra (although that might also help), but experimenting with some different sex positions can bring on an orgasm. 

  • Get yourself a vibrator. Enough said. 

  • On the more technical side of things, a device called a clitoral vacuum can improve blood flow and increase stimulation. This device is battery operated and hand-held, with a cup that fits over the clitoris.

  • Talk about your worries with a couples counselor. This will help if the barriers to orgasm are emotional. 

  • It might sound a bit new age for some, but sex therapy specializes in treating sexual concerns and will give you behavioral exercises that you and your partner can try at home.


Medical


  • If you suspect that a medical condition is hindering your ability to orgasm, speak to your doctor immediately. 

  • For postmenopausal women, estrogen therapy can help to improve your sexual responses.


Anorgasmia in men


While there are lots of similarities between anorgasmia in men and women, there are also some major differences: 


Physiological causes


  • You could be suffering from congenital absence of the bulbocavernosus reflex, which triggers the anal sphincter to contract during ejaculation.

  • Some conditions such as multiple sclerosis, neuropathy (nerve damage) caused by diabetes, and uncontrolled hypertension (high blood pressure) can affect a man’s ability to orgasm. 

  • Hormonal imbalances including hypogonadism (low testosterone levels) and endocrine disorders may be a cause. 

  • If you have undergone prostate surgery (prostatectomy) and come into problems, or endured radiation therapy to treat prostate cancer.

  • Cauda equina syndrome, a rare condition in which exposed nerve fibers at the bottom of the spinal cord become irritated. 

  • Substance abuse, especially heroin use can be detrimental to orgasms. 

  • Some prescription medications such as antipsychotics, opiates, and antidepressants can cause anorgasmia. 


Psychological causes


  • In the UK around 1 in 8 men suffer from mental health issues such as anxiety, stress, depression, relationship difficulties, and hostility which are common causes. 

  • Among men, the most common psychological cause of anorgasmia is sexual performance anxiety.

  • Negative attitudes about sex tied to a repressive religious upbringing or family/parental issues established in early childhood. 

  • Early sexual abuse and trauma.

  • Grief, especially grief bought on by the loss of a partner. 


Treatment


  • If you suspect that any medication you’re taking is causing anorgasmia, ask your doctor about changing the dosage or switching to a different prescription.

  • In the case of hormonal issues, testosterone replacement therapy or a dopamine-promoting drug such as Dostinex (cabergoline) can restore a man's ability to orgasm.

  • For any issues related to mental health, you should speak to a doctor or therapist. Medication or talking therapy can help. 

  • Psychotherapy also may be beneficial for overcoming sexual performance anxiety or addressing past sexual and non-sexual trauma that may play a role in anorgasmia. Or you could go to a therapist with your partner. 

  • You might have heard about the male G-spot, but did you know it could be the answer to treating anorgasmia? Digital prostate massage (inserting a finger into the rectum prior to or during sex) will manually stimulate the prostate gland. 


The climax


We want everyone to experience mind-blowing orgasms, so if it’s not happening for you, don’t just accept it. It’s so important to speak to a trained professional who will help you pinpoint the causes of the issue and tailor a plan for you to overcome it. 


The medical information in this article is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.