Anorgasmia in Women: Reclaim Your Pleasure & Sexual Health
It's a confusing time when you want to practice self-care, take control of your sex life, connect with your partner, and have mind-blowing orgasms - but you can't.
Sexual desire and sexual satisfaction are related but not always working together! It's frustrating and embarrassing to recognize that you have a sexual dysfunction, and even more so when we discuss this with our loved ones and healthcare providers.
Sexual health is a topic surrounded by stigma, false narratives, and societal judgments. When we come across a stumbling block, like an orgasmic dysfunction, it's time to reframe the situation into one filled with amazing opportunities to explore, learn, and heal.
Table of Contents
Defining Anorgasmia
The Prevalence of Anorgasmia
The Female Sexual Response Cycle
The Male Sexual Response Cycle
Causes of Anorgasmia
Symptoms and Patterns
When to Seek Professional Help
Areas You Can Focus On
The Role of Sex Therapy
The Importance of Communication
Defining Anorgasmia in the Modern Context
Anorgasmia in women is the inability to orgasm. Even with exciting arousal, desire, and sexual stimulation, the climax is unobtainable. This condition is also called female orgasmic disorder (FOD).
In today's modern context, where self-care is a priority, anorgasmia can be a significant challenge for many women striving for pleasure and fulfillment in their intimate lives. Sometimes, the concept of self-care excludes sexual fulfillment because of the taboos surrounding sex.
It's common to have sexual problems, and thankfully, resources that embrace sexual healing without misconceptions and judgments can help.
Primary and secondary anorgasmia
There are two classifications of anorgasmia in women - primary and secondary. It's important to realize that neither of these is better than the other - they are simply different sexual experiences.
If you have never experienced an orgasm, that's primary anorgasmia.
If reaching orgasm falters along the way, that's secondary anorgasmia. This may include decreased intensity or frequency of orgasm. Or, you can orgasm, but only in specific situations, with or without a partner. Secondary anorgasmia also includes the disappearance of the climax.
Your well-being suffers when you can't orgasm
While the highly clinical definition of anorgasmia describes the physical manifestations, we can't overlook the resulting relationship issues, frustrations, stressors, and subsequent mental health side effects because of the lack of orgasm.
You may experience significant distress that flows into other aspects of your life. It's not uncommon to avoid sex as an attempt to skirt around the problem, or you may have resigned altogether.
You may experience a subsequent drop in interest in initiating or receiving physical intimacy. The diminished interest can create or widen the gap between partners' libidos.
Feelings of guilt, embarrassment, and anxiety may amplify over time.
Therapy can help create a well-rounded treatment plan to help break these painful cycles. It is essential to recognize that addressing anorgasmia is not just about fixing a problem but embracing a journey of self-discovery, communication with partners, and seeking support to reclaim one's sexual well-being.
The Prevalence of Anorgasmia Among Women
You are not alone. Many women find the orgasm to be elusive.
Approximately 18% of women will always orgasm during sex. Another 29% will climax most of the time. All other women rarely, never, or are unsure about orgasming.
This research study summary has more statistics.
What types of sex lead to orgasms for women
When determining what sexual activity leads to intercourse for women, there are a few primary categories. Vaginal intercourse leads to climax in 62% of women. External stimulation helps 46.2%, internal manual stimulation is 27.1%, and anal intercourse is 7.1% of women. Responses overlapped as some women can climax from more than one activity.
While these numbers are interesting, it's important to remember that you don't have to fit into a category, and your experiences don't need classification.
There are many types of orgasms for women, including clitoral, vaginal, cervical, anal, and mental orgasms. There is no right or wrong type of orgasm to have or how to reach it. When we strictly relate orgasm to intercourse, other pleasurable means are often overlooked. Oral sex, manual stimulation, anal play, and all manner of non-intercourse intimate acts can influence the orgasm and significantly increase overall pleasure and connection.
Read about a study that explored the many ways women can climax.
The Female Sexual Response Cycle
Women are wonderful and complicated, and our sexual response flow differs from that of men.
A clever researcher by the name of Rosemary Basson outlined a sexual cycle that addresses a primary difference between men and women - the spontaneous sex drive and how it differs for women.
You can read the complete publication here.
The basics of the nonlinear sexual cycle for women
Perhaps the most critical aspect of Basson's sexual response model is that the orgasm is not the only source of pleasure, nor is it the goal.
Many women begin in a neutral frame of mind, and the spontaneity of the sex drive can happen at many points in the model.
It's also clear that this nonlinear path stresses intimacy as a vital boost to sexual response.
Today's research tells us that approximately 75% of women have responsive sexual desire versus spontaneous sexual desire.
You can read more about this cycle here.
How this cycle can prevent or support the orgasm
When we view anorgasmia through Basson's model, we can see a few things.
The orgasm is often desired during sex, but pleasure and satisfaction don't rely on it.
Women sometimes mix up the order of things. We can find desire before or after sexual arousal or activity.
Women's relationship dynamics and intimacy influence our sexual response.
As we learn this model and layer our experiences over it, we can better understand the underlying causes of anorgasmia and uncover ways to bring pleasure back.
The "ladder of arousal" as a numerical scale
For women, we can also think about the arousal process on a sliding scale. Imagine a scale set from 0 to 10, with 10 being an orgasm. So, we can imagine 0 as the spot where women can begin physically and mentally.
We know, however, that this isn't the case. Women often start in the negatives and must find a way to zero before the fun trip towards 10 begins.
Anxiety, depression, distraction, the endless to-do list, kids, chores, bills, work stress, and frustration about a sub-par sex life puts women in the negatives. The first part of our trip to 10 is climbing out of the negatives - which can be daunting!
When you envision this scale, you can mindfully start climbing. You don't have to be alone in this process or floundering to find "tricks" to make it up another rung. There is help.
The male sexual cycle
In contrast, men follow a linear path based on spontaneous sexual desire. The male model is based on research by Masters and Johnson. For men, it begins with desire, then excitement, moves into the plateau, then orgasm, then resolution.
Men, too, can have anorgasmia, which falls under the category of erectile dysfunction and is also helped with meaningful sex therapy.
The Masters and Johnson research also included women, but further research tells us that women rarely follow this same path as men.
You can learn more about erectile dysfunction here: https://www.cindymichel.com/blog/compassionate-sex-therapy-for-erectile-dysfunction
Causes of Anorgasmia – Hormones and Other Physical Reasons
Never to be outdone by the length of our to-do lists, the list of reasons why women develop female orgasmic disorder is long and has three components: physical, psychological, and relational influences.
Physical influences – hormones, menopause, medications, and more
As women age, our hormones are ever-changing. Women have differing desires based on where they are in their menstruation cycle. Even outside of menstruation, hormones fluctuate during pregnancy, perimenopause, and other medical conditions influencing hormones. Declining estrogen levels around menopause can also interfere with sexual happiness.
Other components of our medical histories impede orgasm. Notably, high blood pressure, insomnia, anxiety, and chronic illness correlate to sexual dysfunction. Many medications, such as selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, decrease libido.
Vulvodynia and vestibulodynia create painful intercourse, even with adequate sexual stimulation.
Your gynecologist, urologist, or primary care physician can help you navigate treatment options for the physical aspects of female orgasmic disorder. Then, you can begin to overcome any other influences. Many sex therapists work confidentially with healthcare practitioners to form a holistic approach to overcoming anorgasmia.
You can learn more about painful sex here: https://www.cindymichel.com/blog/vaginismus-help-los-angeles
Psychological Factors Contributing to Anorgasmia
Trying to unravel any type of sexual dysfunction may feel like solving the "chicken or egg" dilemma. Your body and mind are intrinsically connected, and your body has a memory, too. Many psychological issues contribute to anorgasmia, and there are just as many paths to overcome them.
Emotional and Mental Influences
Mental health challenges can go beyond anxiety and depression. There is a myriad of other mental health issues that impact how our bodies and brains interact. Drug, alcohol, and other addictions also factor into mental health.
A sexual history with manipulation, abuse, or trauma influences daily experiences and sexuality, even years later. You may cling to shame and guilt about these past traumas. Such traumatic events weave their way into our psyche and body, influencing mental and emotional health on many levels.
Relational Experiences and Influences
Not all relationships with ourselves and others are healthy. Emotional disconnection, power dynamics, or conflicts seep into your sex life.
Differing libidos is a common challenge among partners and can lead to communication blocks and resentments as you initiate or reject sexual advances.
Some people have an incomplete sexual education or are missing a sexual relationship with themselves. A sexual education stemming from cultural or religious influences that support chastity and purity can place shame and consequences on healthy, intimate acts.
Different Manners of Thinking and Organizing Information
Neurodivergent individuals or partners have specific and unique communication needs. Neurodivergent people are masters at straightforward communication but often misinterpret neurotypical behaviors and speech. Increased anxiety, sensory overload, and focusing challenges in the neurodivergent mind also influence the enjoyment of sex.
Social Pressures
Societal influences often cloud sexual acceptance and prohibit healthy sexual expression and gender identity. And our visual experiences in the world bombard us with beauty, wealth, and moral standards that create poor body image, insecurity, and disgrace.
The psychological burdens you carry don't have to be so heavy. Sex-positive, enlightened therapy unravels the layers holding you back from a satisfying, intimate life.
Identifying Symptoms and Recognizing Patterns
When thinking about your sexual history in terms of enjoyment and reaching orgasm, do you see patterns? Exceptions? Or a new normal?
Baseline vs blip
It's helpful to discern between baseline sexual satisfaction and a blip in the system. Remember your last relationship with a partner or yourself, where you had that spark and butterflies. This giddy stage is the new relationship energy (NRE) stage, and it's exhilarating!
Humans have a baseline of sexual desire that clicks along happily, and then gets boosted with NRE. Over time, as the relationship grows and changes, that desire returns to the baseline. You can consider that heightened desire and NRE a blip, as it's unsustainable.
Has overall pleasure decreased, too?
With anorgasmia, focus on the baseline, not the blip. Does that baseline drop lower now? Perhaps it's the lowest it's ever been.
How is the baseline different now, and what makes it different? Do you have more, less, or equal pleasure? What about intimacy? What about fun?
You may think, "Anorgasmia is the most complicated thing ever to exist, and there's no way out of it." Consider sex therapy as your custom map to connecting or re-connecting with pleasure.
How is anorgasmia affecting other parts of life?
There may be parts of your routine and life that suffer as a result of female orgasmic disorder. It becomes so easy for the cycle to take hold. There's dissatisfaction and frustration with sex, then stress and unpleasant emotions. These negatively influence sex and so on. The loop becomes endless.
It's natural to focus on these consequences and side effects. But you don't have to.
You now have the opportunity to reframe your sex life. Release the orgasm as the goal, and find new ways to engage, connect, and find contentment and pleasure. You may want to take this time to explore fantasies, play with kinks, and focus on healthy, entertaining sex.
When to Seek Professional Help
Seeking sex therapy is an investment in your present and future. You will find therapy is appropriate when your anorgasmia amplifies your emotional distress or causes relationship damage.
Find professional help anytime; you don't have to wait for a specific signal. Therapy is fantastic when you want to find options for increasing pleasure or want more education about sex and pleasure. You may also be curious about exploring play, kink, or new ways of sexual and gender expression.
Seeking therapy and guidance can help you to uncover the primary reasons that are inhibiting you and get a plan to work through them.
Sex therapy is effective for anorgasmia and restoring enjoyable sexual function.
You will have confidential, safe, and sex-positive guidance to help you unravel your roadblocks. When you can discover the underlying influences, many things can happen.
You can move past trauma, learn to manage anxiety, develop effective self-care habits, and evolve communication skills with your partner.
Read this first-hand account of a woman's journey through anorgasmia and sex therapy.
Looking at the healthcare big picture
From the bird's eye view, address any painful sex first. When you enjoy sex without pain, you are already on the path to treating anorgasmia. Your healthcare practitioners can address any other physical issues impeding climax.
Concurrently, dive into your past and present hurts, learn to jump through sexual roadblocks, and work on your mind-body relationship.
Areas You Can Focus On
As you develop a sexual healing plan with your healthcare providers and sex therapist, many techniques and therapies may pique your interest. There's a lot of scientific wisdom available, and many of these techniques help women move up from a negative number on the arousal ladder.
Mental aspects
Science tells us that women sometimes live in the "fight, flight, or freeze" portion of the nervous system. To climb the arousal ladder and break free of this system , you can:
Address anxiety and catastrophizing - transition to the parasympathetic nervous system for calmness and relaxation.
Focus on sex-positive thoughts - the power of the mind is astonishing! Women are known to orgasm from thoughts, memories, and fantasies. This isn't attainable for everyone, but it speaks to the power we have within our minds.
Recognize that what you think about is more important than turning your brain off.
Course-correct your sexual response cycle. Therapy helps you understand how you travel through a sexual arousal cycle and areas that need attention.
Find an environment that relaxes you. Your setting can include lighting, pillows, comfort items, sex toys, and anything else that supports your mind's ease.
Physical aspects don't need to involve climax
Many techniques and practices can help you relax. Bringing mindful and purposeful relaxation to your life will often help the body relax. Somatic therapies emphasizing this relationship, such as breathing and whole-body exercises, also contribute to developing intentional relaxation.
You can permit yourself to stimulate and explore different areas of your body. If you find reduced sensations in one area, you may discover increased sensations in another. Explore the "go-to" spots like clitoris, nipples, and G-spot and venture into new territory. Perhaps the feet, nape of your neck, or bottom.
Bring movement back into your body. Blood flow to erogenous zones increases when your muscles work.
Strengthen your mind-body relationship
Give yourself permission to understand your body, find new pleasures, adjust previous pleasures, and let go of negative associations. Find the movements, sensations, and stimuli that you enjoy.
Notice the situations that allow you to feel good. Are certain rooms, lighting, or temperatures a factor? What could change for you to become more at ease and aroused?
Take agency of your body. Love your body. Forgive your body. Work toward loving all of your personhood - mind, emotions, relationships, attractions, and physical self.
It might seem that you will be asking yourself endless questions, which could lead you down a nonhelpful rabbit hole. That's the advantage of working with a certified sex therapist who gives you a map to follow.
Technology and books for sexual health
Today's modern conveniences, like technology, make finding sex toys and erotica fast and easy. Apps and websites deliver erotica to your ears, and others provide fun guides for trying different masturbation techniques.
Websites and apps
Dipsea is a subscription platform that delivers sensual and spicy audiobooks. Many are approximately 15 chapters to help you find mental stimulation.
Quinn is an app, also a subscription, that delivers shorter, erotic scenes into your ears. Their endless list of categories is an excellent opportunity to explore new topics and situations.
omgyes.com - is a wonderful, affordable resource filled with pleasure-creating tips for masturbation.
Sexualityresources.com is a helpful website for toys and education.
Dodsonandross.com – This website hosts ample education from one of the leaders in the field of the female orgasm, Betty Dodson. You will also find her famous rock-n-roll orgasm technique here, too.
Books to further understanding
Many excellent books have great information and fantastic ideas. Of note are the following:
Come As You Are, written by Emily Nagoski, PhD.
Come Together, also by Emily Nagoski, PhD.
She Comes First, by Ian Kerner
Becoming Cliterate: Why Orgasm Equality Matters – and How to Get It by Dr. Laurie Mintz
Adult toys
There is no shortage of sex toys available these days. Gone are the days of choosing a traditional vibrator, as new designs and functionalities have expanded your choices.
Some toys work well as masturbatory aids, and some specifically for play with a partner. They may stimulate more than one location, including the g-spot, cervix, clitoris, anus, or nipples.
Some adult toys work with pulses, vibrations of all magnitudes, or suction. The clitoral stimulators with suction are popular, with good reason.
Many online sex toy shops also provide tasteful instructions to help you have a heightened experience.
Sex Therapy's Role in Addressing Anorgasmia in Women
A certified sex therapist will help you peel back the layers to help you find and understand the source of your anorgasmia. This can include working with your healthcare team to support the emotional journey through physical challenges when needed.
It's not uncommon to hesitate or ignore talking with your medical team about anorgasmia. While not required to begin sex therapy, it's helpful for your healthcare practitioner and therapist to work with you if this is within your comfort zone.
The influence of trauma
A sex therapist is also uniquely qualified to understand past traumas and their effect on your experiences and how they can color your thoughts about the future. It's not always the case that sexual difficulties directly relate to past sexual trauma. There may be subtle and seemingly unrelated pain that therapy can uncover and then address.
Therapy can help you understand any past negative experiences. The goal is not to forget, ignore, or change those traumas. Instead, understanding can lead to self-love, clear intentions, and an identity not defined by trauma. It's freedom to move forward and enjoy sex!
Managing mental health
Therapists are experts at teaching you how to manage anxieties, depression, and many other mental obstacles to enjoying sex. This process might not focus directly on sex and orgasm, but instead provide holistic guidance that blankets many aspects of life.
Evolving your outlook on sex and orgasm
Sex therapists will also help you:
Understand, respect, and love your body
Enhance communications with loved ones
Change your outlook and focus during intimacy and sex
Gain knowledge about sex
Develop agency and advocate for your sexual health
The Importance of Communication in Relationships
For partnered women struggling with female orgasmic disorder or men with ED, relationships may suffer. It's difficult and vulnerable to discuss sexual dysfunction with a partner, and you may feel broken, judged, or afraid.
Or, you are partners with someone with anorgasmia. How do you understand and support this? Often, anorgasmia can amplify differing libidos, creating stress for you, too.
Couples therapy
Therapy for partners, whether simultaneously or individually, teaches you to hear and understand your partner. You can also learn how to help your partner understand you.
It's important to learn how to effectively communicate your needs, desires, and dislikes just as much as your love, support, and hopes.
Lines of communication can be open, honest, and without fear. Then, couples can explore fun and new things, enhance emotional and physical intimacy, and boost pleasure.
A sex therapist provides guidance via talk therapy sessions to individuals or couples. Guided exercises help establish trust in your relationship, and there's often fun homework between sessions to further this trust.
Is individual or couple's therapy best for you?
The decision to pursue sex therapy may create uncertainty about privacy and sharing with a partner.
Individual sex therapy is beneficial for both partnered and single people. There are many instances where a partnered individual needs to sift through deeply personal experiences before learning how to share them with a loved one.
Couple's therapy works well for safely exploring relationship issues that influence intimacy and sex. It's also a fantastic place to learn about communication, sex techniques, toys, kinks, and intimate exercises that foster play and exploration.
You also have the option to engage in both individual and couple's sessions to benefit from both.
Bringing sex education into the sessions
A sex therapist can explain the emotional and physical biomechanics of sex. As we age and our relationships evolve, once reliable sex needs to evolve, too. It's time to learn more about other ways to find connection and sexual gratification and how partners can help overcome anorgasmia.
Other homework might include exercises to enhance touch, reintroduce your bodies to each other, or boost excitement about sex without the orgasm as a goal.
Key Highlights
Anorgasmia is a common and often misunderstood challenge many women face. It's best approached with empathy, viewing it as an opportunity for self-discovery and healing rather than a problem to be fixed. Sexual health is an essential aspect of overall well-being, and you can find support without shame.
The causes of anorgasmia are multifaceted, encompassing physical, psychological, and relational factors. However, there is hope through various treatment options and therapeutic approaches and recognizing that pleasure and satisfaction in intimate relationships don't need to rely on reaching climax.
By embracing a holistic view of sexual health and fostering open communication between partners, women can reclaim their sexual well-being and find fulfillment in their intimate lives.
Contact Me
Join me for a complimentary consultation to explore if sex therapy is the right fit for you. I look forward to meeting you!
Learn More About Me and My Services to begin aligning with your life and goals today. I offer in-person sessions to individuals and couples in my Los Angeles, CA office. If you prefer tele-health therapy, I offer services to those residing in California, Florida, and New Mexico.
References:
O. Shaeer, K. Shaeer, E. Serefoglu, M. Fode, A. Giraldi, 235 The Global Online Sexuality Survey: Female Orgasm from A Bilateral Perspective, The Journal of Sexual Medicine, Volume 14, Issue Supplement_1, January 2017, Page S68, https://doi.org/10.1016/j.jsxm.2016.11.150
Weitkamp, K., & Wehrli, F. S. V. (2023). Women's Experiences of Different Types of Orgasms-A Call for Pleasure Literacy?. International journal of sexual health : official journal of the World Association for Sexual Health, 35(2), 193–208.
https://doi.org/10.1080/19317611.2023.2182861
Rosemary Basson (2000) The Female Sexual Response: A Different Model, Journal of Sex &Marital Therapy, 26:1, 51-65, DOI: 10.1080/009262300278641