4 Important Things About Anorgasmia Your Doctor Never Told You

Your partner is wonderful, and you have such a great connection. They make you laugh and support you through the tough times. They’re everything you’ve ever wanted. And after all this time, you still admire how their butt looks in their favorite jeans.

So why are things not so hot in the bedroom? If things are so great with your partner, why can’t you orgasm when you have sex with them?

Or maybe you even tried all the “tricks” and all the toys, but there was still nothing to get you over the edge and find release.

You may be struggling with anorgasmia. According to the Mayo Clinic, this term refers to people who consistently have difficulty reaching orgasm even after sufficient sexual stimulation. 1

Understandably, this condition impacts your relationship because it can feel frustrating for both you and your partner. Or it keeps you from dating because you don’t want to deal with such a disappointing experience.

What you should know about anorgasmia in women and vulva owners.

Each of us is unique, so it makes sense that our needs are different. Some bodies need different kinds of stimulation than others to climax because most don’t get that from penetration alone

Giving your clit a little extra love and attention can often get the job done. But what if you and your partner are doing all the “right” things, and you still can’t orgasm?

You’re not alone. According to the National Institute of Health, anywhere between 11%-41% of women and vulva owners experience anorgasmia.2

Some always experience issues reaching orgasm, and others occasionally have difficulty. It may depend on your situation. There are 4 main types of anorgasmia that can be diagnosed.

  • Lifelong or primary anorgasmia: you’ve never had an orgasm
  • Acquired or secondary anorgasmia: you used to be able to orgasm but now have difficulty
  • Situational anorgasmia: you’re only able to orgasm in specific situations, like masturbating, having oral sex, or with a certain partner. This is also the most common type of anorgasmia in vulva owners.
  • General anorgasmia: you’re not able to orgasm in any situation, even if you’re aroused and have sufficient stimulation

There are several possible reasons why you’re having issues. Anorgasmia may be caused by:

  • Medication
  • A history of pelvic pain
  • Needs that change with age
  • A medical condition 
  • A history of abuse (can be verbal, emotional, physical, or sexual)

The reasons listed above may seem obvious, but other common causes of anorgasmia in women may surprise you.3

  • Anxiety
  • Guilt about enjoying sex
  • Stress
  • Perfectionism
  • Trust issues
  • Self-esteem issues
  • Religious or cultural beliefs 
  • A need to feel in control

Human sexuality is very complex, especially for women and vulva owners. Usually, a combination of several of these factors makes it difficult for you to orgasm. Let’s check out one of the most common ones.

What medications can cause anorgasmia?

If you experience anorgasmia, the culprit could be hiding in your medicine cabinet. Although prescription medications are usually to blame, some over-the-counter pills can complicate arousal and libido too. So what meds can cause anorgasmia?

Antipsychotics, opioids, heart and blood pressure medications can affect your ability to orgasm. Many antidepressants also impact your sex drive, especially SSRIs (selective serotonin reuptake inhibitors).4 As many as 50% of people on SSRI antidepressants report sexual side effects.

That’s because these meds work to boost the serotonin levels in your body, which is why you feel better when you take them. But serotonin is a natural sex drive inhibitor. So SSRI antidepressants increase serotonin - which decreases libido - and makes it harder to orgasm. 

Talk to your doctor about what meds can cause anorgasmia. Adjusting your dose often allows for continued symptom relief without negatively impacting your sex life.

Is there an effective anorgasmia treatment?

Whether you’ve been struggling for a long time or only recently, there is hope. I understand how frustrating it is, but the great news is that there are many effective treatment options.

Which anorgasmia treatment is right for you?

First, complete a thorough medical history with your doctor to rule out any underlying issues. They’ll work with you to resolve any medical conditions or adjust any medications that prevent you from climaxing.

If your anorgasmia is related to menopause, your doctor may recommend estrogen therapy. And in some cases, doctors recommend testosterone therapy. The FDA hasn’t approved this yet, and experts don’t yet agree if the benefits outweigh the side effects.

But thankfully, for most women and vulva owners, anorgasmia treatment is much more straightforward than that. Sometimes the best thing to do is to get to know yourself better.

Learning where and how you like to be touched may not have been high on your priority list with our hectic lives. But it’s never too late to explore.

You might get squeamish at the thought of this, or maybe even overwhelmed (“I just don’t know what I like!”), and this is where professionals can help you feel more comfortable psychologically. I’ll talk more below on how Sex Therapists are trained to make these conversations and exercises easier to do on your own.

However, if you’re ready to give it a go now you can try with your hand or a vibrator. If you’re not comfortable exploring yourself, ask your partner to help. They’ll be happy to get in on the fun. After all, pleasure is sweetest when shared.

First try to calm your mind and just focus on what sensations are neutral. Then when you’re feeling more comfortable with that process, start to notice the sensations you’re enjoying.

Your body needs to warm up, so starting in places further from the “hot spots” and then working your way toward the higher “pleasure centers” can help build momentum. 

Your anorgasmia treatment may simply involve more stimulation. Especially if you’ve never experienced an orgasm, the reason could be that you’re not getting enough sexual stimulation.⁵5 

Switching up positions or using toys may give you the stimulation needed to enjoy the best sex ever.

If orgasm is difficult with penetration, make sure to give your clitoris a lot of love when you feel the pressure building. 

Improving the kind of stimulation might not be sexual either — it could be psychological, emotional, or mental. The Arousal Architecture Assessment™ can help you learn more about the kinds of stimulation that helps build sexual arousal for easier access to orgasm.

What you can do about anorgasmia

Now you understand the common causes and treatments of anorgasmia. But what if you’ve gone through the whole checklist and still don’t see any improvement? You’ve…

  • Talked to your doctor about medication
  • Checked for any underlying medical conditions
  • Done some self-exploration to see what you like
  • Increased stimulation on your own or with a partner based on your Arousal Architecture™ results.

But you still can’t orgasm. Does that mean you have to accept sex with no happy ending? Absolutely not.

If you’re in a relationship, Sex Therapy can help. This doesn’t mean anything is wrong with you or your relationship. Counseling with a specialized professional can give you the tools to understand and communicate your needs without judgment or guilt.

A therapist can bring to light past barriers getting in your way. Or if you’re in a relationship, they can help you identify any unresolved conflicts that have shown up in the bedroom.

Female anorgasmia (or vulvar anorgasmia) is often linked to issues that have nothing to do with sex. Addressing these issues goes a long way to relieving your anorgasmia.  

Working with an experienced Sex Therapist can pinpoint the causes of your anorgasmia. We’ve helped hundreds of women and vulva owners just like you unlock the secret to more satisfying and pleasurable sex.

We can teach you how to identify your needs and communicate them effectively. You’ll have exercises to do at home on your own or with a partner.

Don’t be discouraged if you’ve had trouble reaching climax. Even if you’ve never orgasmed before, a satisfying sex life is possible. You deserve all the pleasures in life. And I’m happy to show you how. Book a free call today to get your Sexual Solutions Road Map to more fulfilling sex and enjoyable orgasms.

  1. Anorgasmia in women – Symptoms and causes – Mayo Clinic ↩︎
  2. ​​Female orgasmic disorder ↩︎
  3. Orgasmic Dysfunction: Causes, Symptoms, and Treatments ↩︎
  4. Delayed Orgasm and Anorgasmia ↩︎
  5. Anorgasmia in women – Diagnosis and treatment – Mayo Clinic ↩︎
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Kayna Cassard, MA, LMFT, Sex Therapist, Painful Sex Specialist

I help folks overcome sexual pain + anxieties through unconventional + trauma-informed interventions using the NeuroSomatic Sex™ Method for Sex Therapy, Coaching, + Online Courses. Get free sexual wellness resources at: cassardcenter.com/freebies

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