Anorgasmia in women

Overview

Anorgasmia is delayed, infrequent or absent orgasms — or significantly less-intense orgasms — after sexual arousal and adequate sexual stimulation. Women who have problems with orgasms and who feel significant distress about those problems may be diagnosed with anorgasmia.

Among all women, the frequency and intensity of orgasms vary. Also, for any individual, orgasms can be different from one time to the next. The type and amount of stimulation needed to have an orgasm also varies.

Multiple factors may lead to anorgasmia. These include relationship or intimacy issues, cultural factors, physical or medical conditions, and medicines. Treatments can include education about sexual stimulation, sexual enhancement devices, individual or couple therapy, and medicines.

Female orgasmic disorder is another term for the spectrum of problems with orgasms. The word "anorgasmia" specifically refers to not being able to have an orgasm, but it's also used as shorthand for female orgasmic disorders.

Symptoms

An orgasm is a peak feeling of intense pleasure in response to stimulating sexual activity.

Vaginal penetration during sex indirectly stimulates the clitoris. But this may not be enough stimulation for orgasm. Many women may also need direct manual or oral stimulation of the clitoris to reach orgasm.

Anorgasmia, or female orgasmic disorder, is defined as experiencing any of these in a significant way:

• Delayed orgasm.
• Absence of orgasm.
• Fewer orgasms.
• Less-intense orgasms.

Anorgasmia can also be:

• Lifelong, if you've never had an orgasm.
• Acquired, if you have new problems with having orgasms.
• Situational, if you have problems with orgasm only in certain situations, with certain kinds of stimulation or with certain partners.
• Generalized, if you have problems with orgasm in any situation.

Women who don't always reach orgasm during sexual encounters may not find it distressing. In that case, the lack of an orgasm is not considered a disorder.

When to see a doctor

Talk to your healthcare professional if you have concerns about your sex life, especially if you're concerned about your ability to have an orgasm.

Causes

Sexual arousal and orgasms are complex reactions to various physical, emotional, sensory and psychological factors. Difficulties in any of these areas can affect your ability to have an orgasm.

Personal and psychological factors

Past experiences, behaviors, background or mental well-being may contribute to problems with orgasms. These include:

• Past sexual or emotional abuse.
• Lack of knowledge about sexual stimulation or interactions.
• Poor body image.
• Guilt or embarrassment about sex.
• Cultural or religious beliefs about sex.
• Stressors, such as financial problems or loss of a loved one.
• Mental health conditions, such as anxiety or depression.

Relationship factors

Problems with your sex partner may be contributing factors to problems with orgasms. These may include:

• Lack of emotional intimacy.
• Unresolved conflicts.
• Poor communication of sexual needs and preferences.
• Infidelity or breach of trust.
• Intimate partner violence.
• Partner's sexual dysfunction, such a male partner with erectile dysfunction.

Physical causes

A wide range of illnesses, physical changes and medications can interfere with orgasms:

• Health conditions. Long-term conditions — such as diabetes, overactive bladder or multiple sclerosis — may be contributing or complicating factors in orgasm disorders.
• Gynecological treatments. Tissue damage from gynecologic surgeries, such as hysterectomy or cancer surgery, may affect the ability to have an orgasm.
• Medicines. Many prescription and nonprescription medications can inhibit orgasm, including blood pressure medicines, antipsychotic medicines, antihistamines and antidepressants — particularly selective serotonin reuptake inhibitors (SSRIs).
• Alcohol and smoking. Alcohol suppresses the nervous system and may hamper the ability to have an orgasm. Smoking can limit blood flow to your sexual organs, affecting your ability to have an orgasm.
• Age-related changes to the body. Changes to the body after menopause or later in life may contribute to various types of sexual dysfunction.

Related sexual disorders

Women experiencing anorgasmia may have one or more related sexual problems. These may contribute to or complicate the problem with having orgasms. These conditions include:

• Problems with sexual arousal.
• Little or no desire for sex.
• Pain from sexual intercourse or other sexual stimulation.
• Dryness of the vagina or vulva.
• Involuntary tightening of the vagina, called vaginismus.

Risk factors

Risk factors linked to having trouble with orgasm include:

• Low education level.
• Low income.
• Poor health.
• Depression and other mental health conditions.
• History of trauma, such as sexual abuse.