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Movies make it seem like orgasming is as universal an experience as, say, post-bean farts.
But some vulva owners can’t get off.
It’s called anorgasmia, and it’s more common than Rom Coms or erotica might have you believe.
“Anorgasmia is defined as the inability to achieve orgasm, despite sufficient sexual stimulation and is associated with personal distress,” says Dr. Heather Jeffcoat, a doctor of physical therapy who specializes in sexual dysfunction, pain, and incontinence, and author of “Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve.”
Those last four words are important: associated with personal distress.
The inability to orgasm only qualifies as anorgasmia if it’s accompanied by feelings of:
- frustration
- self-doubt
- shame
- inadequacy
- anger
“There’s a diagnostic classification system based on whether it has been lifelong or acquired,” explains Jeffcoat. There’s also something called situational anorgasmia.
Primary anorgasmia
Also known as lifelong anorgasmia, primary anorgasmia is used to describe the experience of a vulva owner never having an orgasm, even after “sufficient” stimulation.
Primary anorgasmia is most common in people who:
- are younger
- are less sexually experienced
- grew up in sexually repressive environments
Secondary anorgasmia
Secondary anorgasmia occurs when a vulva owner used to climax, but over time their orgasmic response has disappeared.
Dr. Uchenna Ossai, an ASSECT-certified sex educator, pelvic floor therapist, and founder of YouSeeLogic, adds that sometimes this term is used for folks who have an incredibly difficult time reaching orgasm.
Secondary anorgasmia is most common in folks who:
- recently gave birth or went through menopause
- have had genital surgery
- were assaulted later in life
- recently started a new medication
- have experienced a change in weight
- have recently been injured
Situational anorgasmia
Situational anorgasmia occurs when you aren’t able to orgasm during certain sexual activities. For instance, P-in-V or oral sex.
But truthfully, this term is more harmful than useful.
Why? Because this “diagnosis” makes it seem like not being able to climax during certain activities is uncommon. But that’s not the case!
On the contrary, it’s VERY common to not climax during sexual activities that don’t provide the type of stimulation you need to orgasm.
Case in point: Some research shows that less than 19 percent of vulva owners can climax via penetration alone.
So, should we be diagnosing the 81 percent of vulva owners who can’t as situationally anorgasmic? No!
Instead, we should stop perpetuating the idea that all vulva owners need the exact same thing to come.
A 2011 study suggests that at least
This study in particular suggests that this figure may be higher in certain populations.
For example, the researchers found that 26.3 percent of the 1,200 vulva owners surveyed in Hesarak, Karaj experienced anorgasmia.
Environmental, emotional, mental, spiritual, and physiological factors all work together to mediate a vulva owners sexual response.
In other words, there are so many reasons someone’s orgasm may be MIA. These include:
Shame
“Shame is a huge factor in sexual dysfunction — including anorgasmia,” says Nefertari Sloan, a radical sex educator and LGBTQ+ activist.
“If you aren’t proud of your sexuality and have been conditioned to fear sex and feel confused about who you are, your body will listen,” says Sloan.
Trauma
“For someone who experienced orgasm during sexual trauma, orgasm can become a trauma trigger,” explains Ossai. “So if someone begins to feel an orgasm coming, the body can begin to shut down.”
But it’s not just sexual trauma.
Sloan adds: “Technology and white supremacy has left many of us with a number of traumas that are now directly affecting how we even view ourselves.”
Pelvic floor over or under activity
“Poor pelvic floor muscle awareness, and pelvic floor muscle overactivity and underactivity, can all cause anorgasmia,” says Jeffcoat.
Dyspareunia
Dyspareunia = pain during sex.
There are several causes of painful sex, including:
As Jeffcoat puts it, “It’s going to be difficult for people to achieve orgasm if they’re experiencing pain.” Makes sense, right?
Certain chronic health conditions
There are many many many medical conditions that can cause anorgasmia. Ossai says these are the most common ones she sees:
- diabetes
- hypertension
- Crohn’s disease
- meningitis
- vascular disease
- chronic pain
- autoimmune diseases
- IBS and chronic constipation
Certain medications
“Antidepressant and anti-anxiety medications are well-known as being damaging to orgasmic response,” says Ossai.
Same goes for antipsychotics, blood control meds, and hormonal supplements.
Read on for a step-by-step action plan.
Step 1: See an MD or OB-GYN
If an underlying medical condition is interfering with your O, addressing the underlying condition can help you reach climax.
Step 2: Go to a pelvic floor therapist
“A pelvic floor therapist can evaluate muscle function and determine whether orgasm is inhibited due to pelvic floor dysfunction or pelvic floor pain,” says Jeffcoat. “If it is, they can help you treat both.”
Step 3: Seek out a sex therapist
Ideally a trauma-informed sex therapist.
They’ll be able to help you find and address the root of your sexual hang-ups.
It’s common for anorgasmia to lead to resentment, feelings of self-consciousness, and insufficiency within a relationship. In these instances, a couples’ sex therapist can help.
“Yes,” says Ossai. “It’s definitely treatable.”
However, “It may be harder for folks with primary anorgasmia,” explains Ossai. “It’s a tall hill to climb. It’s definitely climbable, but it may take time.”
She says that for folks with secondary anorgasmia, “part of treatment is learning to manage your expectations of your orgasm.”
Let’s say, for instance, you had an amazing orgasm when you were 20 with this one partner — it may not be possible to experience that exact same orgasm again, so reframing your desired end result may be helpful.
Odds are there’s an underlying physical, emotional, or mental cause that needs addressing. So a practitioner’s office really is your first stop.
They’ll likely prescribe some combination of lifestyle changes, mediation (or medication change), and therapy or pelvic floor therapy, as well as some or all of the below.
Learn about your anatomy
Jeffcoat recommends all vulva owners, anorgasmic or not, get familiar with their own anatomy by:
- Looking at their bits in the mirror.
- Learning about their anatomy via OMGYES.
- Reading Emily Nagoski’s “Come As You Are: The Surprising New Science That Will Transform Your Sex Life,” which you can buy online.
Masturbate, masturbate, masturbate
Masturbation can help you learn what kinds of touch bring you pleasure, regardless of whether your solo sex sessions result in orgasm, says Jeffcoat.
Buy a rumbly vibrator
Jeffcoat recommends that folks with anorgasmia opt for a rumbly vibrator, as these will stimulate the entire clitoral structure — even the parts you can’t see. That’s right, the clit is more than meets the eye!
Popular rumbly vibrators that you can buy online include the:
Prioritize non-penetrative play
“One of the biggest lies taught to us is that sex means a penis inside of a vagina,” says Sloan. “But the reality is there are so many other ways to experience pleasure.”
Their recommendation? “Try to view every inch of your skin as a canvas to be explored, and every sensation as a sensation that’s worthy of appreciation.”
That means viewing all sex acts, including the following, as sex:
- back massage
- armpit licking
- anal fingering
- foot worship
- nipple stimulation
Do a ~personal inventory~
For folks with secondary anorgasmia, Ossai recommends asking yourself the following Qs:
- What’s going on with my solo sex life?
- Are my usual stress management techniques working?
- How am I feeling about the people I’m currently having sex with?
- What happened in-between when I could orgasm and now?
- Why am I engaging in sexual activity?
Stop focusing on the orgasm
“For people with anorgasmia, the best advice is to stop focusing on orgasm altogether,” says Ossai. Instead, she says, the point should be pleasure. Pressure is, after all, an orgasm-block.
Expand your understanding of sex
“Our definitions of sex are so boxed in that folks are having sex and thinking that it’s not over unless you come,” says Sloan.
But there are so many reasons sex might end, such as:
- physical exhaustion
- a sense of release
- your kids, parents, or other housemates came home
- you lost interest
- time restraints
Also: An orgasm doesn’t necessarily mean sex is over.
Turn on your other senses
“Getting stuck in your head and stressed about not orgasming is a one-way ticket to not orgasming,” says Sloan. That’s why they recommend leaning into all your senses while getting it on.
“Put together a nice playlist to set your own mood, try out different flavors, light a candle, and allow yourself to feel,” they suggest.
You’ve probably been groomed to believe that orgasm = the goal, end, and point of sex. So being intimate with someone is going to take some reframing on your part.
Trust them
If your partner says that they can and do enjoy getting down, even though they don’t come, believe them!
It’s entirely possible to experience heart-pounding, earth-shattering pleasure without climax.
Quit the idea that you’re going to make them orgasm
This framing keeps “orgasm,” not “pleasure,” as the goal of sex, while also:
- putting more unnecessary pressure on your partner to orgasm
- making their pleasure about you, not them
Don’t short-change their pleasure
Your partner may not orgasm, but that doesn’t mean they don’t deserve pleasure. They do!
When interviewed for a Refinery29 article, Stefani*, a 23-year-old writer from New York City, shared that when people find out that she has anorgasmia, “they will kind of just give up early fingering or eating [her] out.”
“I feel like they’re thinking, ‘I’m tired; she’s not gonna come; what’s the point?” she says.
*Name was changed at the request of the interviewee.
Orgasms aren’t the point of sex, but they can be enjoyable.
So, if you haven’t had or currently aren’t having one, take comfort in knowing that anorgasmia can be treatable with the right care.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.