If you struggle to reach orgasm some (or all) of the time it can be frustrating and upsetting, but rest assured you are not alone. Difficulty achieving orgasm is normal and common in men, women and people of all genders. But it’s more common for women and people with vulvas, thanks to a number of physical and psychological factors.
The orgasm gap - the frequency at which men have orgasms during sex compared to women - is a major contributor to a lack of climaxing and sexual satisfaction for women. If you’re a woman or person with a vulva, it’s sadly not uncommon to not enjoy sex. But why is this the case and most importantly, how can you close the gap and learn to climax?
Most women and people with vulvas will be able to have an orgasm, but many will have difficulty reaching climax at some point throughout their lives explains Dr Shazia Malik, consultant gynaecologist and obstetrician at The Portland Hospital. ‘As long as you’re happy with your sexual experiences, there’s no need to seek medical advice,' she says. 'Many women have satisfying sexual experiences that don’t include an orgasm, whereas other women may feel they aren’t satisfied without one – and that can change over time.’
Malik says it’s only necessary to seek advice if being unable to orgasm is affecting your quality of life, sexual satisfaction or intimate relationships. If this is the case, ‘there’s no need to feel embarrassed or ashamed to do so,’ she adds.
Why some women struggle to reach orgasm
As Malik explains, struggling to orgasm can have different causes for different women. Female orgasm is complex and still not fully understood, but what we do know is that a large part of female arousal is psychological. ‘This is why stress, tiredness or issues in the relationship can all affect sexual arousal and ability to reach orgasm,’ she says.
But there are also a number of physical factors that can affect someone’s ability to climax.
Anorgasmia and sexual dysfunction
‘Sexual desire interacts with and partially overlaps with mental arousal, and when these two separate systems converge it leads to genital arousal and receptiveness,’ says Dr. Maria Fernanda Peraza Godoy, a urologist, sexual medicine expert and co founder of Healthy Pleasure Collective. ‘
When genital arousal translates as positive feedback, the person’s sexual desire increases, as does their mental arousal. ‘Genital blood flow and genital arousal are fundamental in facilitating an orgasm,’ Godoy says. But if there is a problem in any phase of the sexual response, ‘negative feedback can result and as a consequence, orgasm could be absent.’
When this happens regularly, it is known as anorgasmia or sexual dysfunction. Studies have found this can affect between 11 per cent and 41 per cent of women and people with vulvas. This can be a lifelong condition for some, and be situational for others - with their ability to orgasm reliant on their partner, a specific sexual act, or the context of the sexual experience. There are many reasons why this might happen.
Anorgasmia physical reasons
There are a number of physical reasons why you might have difficulty reaching orgasm and struggle to climax:
• Lack of clitoral stimulation
The lack of adequate sex education in the UK means many women and people with vulvas start having sex before they masturbate, or get to know their own bodies. Female pleasure isn’t taught in schools, and is only just starting to be discussed openly in public spheres. This lack of education results in many heterosexual women and men believing penetrative penis-in-vagina sex should result in female orgasm. In reality, most women and people with vulvas need clitoral stimulation in order to climax.
😲 A study by OMGYes found only 18 per cent of women climaxed through penetration alone.
If you’ve been having the kind of sex that prioritises your partner’s pleasure and revolves around penetration, dedicate time to stimulating your clitoris instead. Using a good quality water-based lubricant, start by lightly tracing circles around your clitoris. Remember to begin at the outside and work your way in, towards the clitoris. Everyone masturbates and likes to be touched in different ways - some people prefer a gently tapping motion on the clitoris, others find they can only stimulate around the area due to sensitivity. Find what works best for you.
• Hormonal imbalance
Godoy says an imbalance in your oestrogen and androgens could lead to changes in your arousal phase, and could cause anorgasmia. Hormonal changes also can affect your sexual desire.
• Dyspareunia: Pain during sex
Pain during intercourse is the main factor which explains orgasmic disorders, says Godoy. She also says vaginal atrophy - the inflammation of the vaginal walls - can occur during the menopause and can be caused by a hormonal imbalance. This can result in vaginal dryness and pain during sex.
Some prescribed medications are associated with a woman’s inability to orgasm. These include antidepressants like selective serotonin re-uptake inhibitors (SSRIs). Other medications known to affect sexual desire include anti-anxiety drugs such as alprazolam and diazepam, blood pressure drugs such as atenolol, metoprolol, clonidine, methyldopa, and some diuretics.
Godoy says diabetes could also affect your orgasms, secondary to micro neuropathy or microvascular injury as a consequence of the disease. This decreases the blood flow and sensitivity in the genital area, and can also cause sex to be painful.
• Gynaecological surgeries such as hysterectomy
Undergoing a hysterectomy can impact your sexual response. ‘Pelvic surgeries and surgeries for digestive or gynaecological cancer could, performed without nerve-sparing techniques, affect the sensitivity of the female genitalia,’ says Godoy.
• Painful orgasms
Some women and people with vulvas may find they can orgasm, but that it is painful when they do. Painful orgasms are known as dysorgasmia. This is a condition where the woman experiences quite severe, cramping pain in the lower part of the abdomen or the rectum, immediately after reaching orgasm. It occurs most commonly at around the time of the menopause and tends to get better as time goes by.
Anorgasmia psychological reasons
There are a number of psychological reasons why you might have difficulty reaching orgasm and struggle to climax:
✔️ Mental health conditions
Common mental health conditions like anxiety and depression affect one in six of us, according to mental health charity Mind. Anxiety, depression and stress all contribute to a lack of sexual desire and can impact our ability to orgasm during sex and masturbation.
✔️ Sexual abuse
Women with a history of sexual abuse or survivors of sexual trauma such as female genital mutilation (FGM) may struggle to climax.
✔️ Poor body image and confidence
Enjoyable sex requires all parties to be relaxed and comfortable. If you experience a lack of confidence or have issues surrounding your body image it can be difficult to get into the right mindset when having sex.
✔️ Shame and guilt
Whether for religious or cultural reasons, many women and people with vulvas feel shame and guilt around their sexual desire. Women are socialised to believe men want sex more, and that their pleasure isn’t a priority.
✔️ Unresolved relationship issues
There are many issues within a relationship that can affect your ability or orgasm during sex. Infidelity, arguments, a lack of trust, poor communication of your sexual preferences and desires can lead to an inability to climax.
If you want to seek help for anorgasmia and sexual dysfunction, visit your GP and explain what you have been experiencing. Remember, you are not alone and should not feel embarrassed. Speaking to a medical professional about the potential causes and undergoing a physical examination will help you determine what the contributing factors are to your inability to orgasm.
If these are deemed psychological, you may be referred to a sex therapist or to a cognitive behavioural therapist.
If a physical cause is identified, this will be treated appropriately - for instance with hormone therapy, or by switching medications. ‘It’s important to treat the base disease or condition to restore a normal sexual function,’ Godoy adds.
Further help and support
For further advice about anorgasmia or any sexual concerns you might have, try one of the following resources:
- NHS.UK: to check for any medical issues or be referred to a therapist.
- Relate or Relationships Scotland: for relationship support.
- COSRT: find therapists that are able to work with any relationship or sexual issues.
- Sexual Advice Association: help to improve sexual health and wellbeing.
- IPM: education, training and research in psychosexual medicine.
Last updated: 06-03-2020