Home » Misc » No orgasim with intercourse

No orgasim with intercourse


Anorgasmia in women - Symptoms and causes

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 medications. Treatments can include education about sexual stimulation, sexual enhancement devices, individual or couple therapy, and medications.

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.

Products & Services

  • Assortment Women's Health Products from Mayo Clinic Store
  • Book: Mayo Clinic The Menopause Solution
  • Book: Your Sexual Health

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 health care provider if you have concerns about your sex life, especially if you're concerned about your ability to have an orgasm.

Request an Appointment at Mayo Clinic

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.
  • Medications. Many prescription and nonprescription medications can inhibit orgasm, including blood pressure medications, antipsychotic drugs, 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 (vaginismus)

By Mayo Clinic Staff

Related

Products & Services

Can't Orgasm From Intercourse? Here's What to Do

There are a lot of reasons why you may have trouble reaching orgasm.

So start with some homework.

Orgasming isn’t as simple as we’re led to believe. In pop culture, climaxing is often portrayed as something that happens easily — and hella fast. But for many people, it takes more effort — and even a little homework.

“Sometimes, throughout someone’s entire life, they haven’t been able to have an orgasm for a variety of different reasons,” says Kat Kova, a Toronto-based sex therapist. “Other times, it happens out of the blue.” 

Why orgasming can be difficult 

Anyone can have issues achieving an orgasm, but research shows there’s an “orgasm gap” between men and women. Only about 18 per cent of women say they can reach climax through intercourse alone, and 36 per cent say they need clitoral stimulation during intercourse in order to come, a recent report found.  

These findings make sense given the clitoris, not the vagina, is the female sex organ. It’s where the majority of nerve endings that lead to orgasm are found. When you touch yourself, you know how hard or soft, and how slow or fast, to do it to climax. 

For people with penises, erectile dysfunction is a condition that can prevent orgasms. Erectile dysfunction can be caused by physical or psychological factors, but can be addressed by speaking to a doctor.   

Other underlying conditions can be the reason why orgasms can be hard to come by. Mental health issues, like anxiety and depression, as well as stress and exhaustion can affect the sex drive. Something as innocuous as busy month at work, for example, may be why you’re suddenly having troubles orgasming. It’s hard to be physically present when the mind is elsewhere. 

(Related: What Exactly Is Tantric Sex, and Should I Try It with My Partner?)

How can I increase my chance of orgasm?

Everyone has their own turn-ons and sexual preferences. If you are not communicating your needs and desires to your partner, you may not achieve the sexual satisfaction you’re looking for, Kova says.  

“Some people think, ‘I’m in a long-term relationship so I can’t be kinky anymore.’ They think that they have no way of sharing that [sexual preference] with their partner without feeling an incredible sense of guilt and shame,” she explains.

This can lead to an avoidance around sex because it may feel easier to skirt around possibly uncomfortable conversations than tell your partner what you really need to get off. “That will definitely stand in the way of an orgasm,” Kova says.

(Related: Are There Different Types of Orgasms? What Sex Experts Say)

How can I talk to my partner about this?

It’s important everyone learns their body and sexuality in order to figure out what works for them. It helps to discover what brings you to orgasm on your own so make time for exploration, both alone and with a partner. If you don’t know your pleasure points on your own, how can you expect others to? 

When you figure out what you like and what makes you orgasm, communicate that with your partner in a healthy and consensual way. Kova says many people don’t openly talk about what feels good and what’s acceptable for them, which is key to a satisfying sex life. 

If you know you need clitoral stimulation to orgasm, for example, discuss manual stimulation, toys and tongue with your partner. You can also play with positions. 

“Explore on your own and then kind of script it out: ‘This is what I like; this is what feels good,’” Kova says. “Share that with your partner. You can actually show them how you touch yourself and let them know what feels good and what doesn’t feel so good.”

(Related: Here’s What a G-Spot Is and How to Find It)

What if I don’t orgasm every time?

Lastly, don’t beat yourself up if you don’t achieve an orgasm every time you have sex. It’s very common for people to have difficulty from time to time, regardless of whether they’re on their own or with another person. 

“These expectations that we get socially can impact our lived experience of our sexuality,” Kova says. “A lot of people put [too much] pressure on themselves.”

Next: The Honest, Expert-Backed Truth About Having Sex While on Your Period

Popular Videos

ⓘ

Lack of orgasm (anorgasmia) - causes, symptoms, diagnosis, treatment and prevention

Anorgasmia (lack of orgasm) is a fairly common sexual disorder that is most common in women. This condition can be caused both by physiological causes and be the result of psychological trauma or a woman's lack of readiness for sexual intimacy. Naturally, the possibility of reaching the highest point of sexual satisfaction depends on the behavior of both sexual partners in the process of intimacy.

Causes

Social norms of behavior and stereotypes sometimes leave a serious imprint on the perception of sexual relations by women. The shyness and complexes that affect sexual relations are often rooted in childhood and family upbringing, the first negative sexual experience. That is why in the process of intimacy, many women practically do not make adjustments to the sexual behavior of their partner, as a result of which highly sensitive erogenous zones do not receive the necessary stimulation.

Lack of orgasm may be due to disturbances in the process of pubertal development. In this case, the sexual relationship stops at the platonic stage and does not feel like a serious disorder. In addition, the lack of orgasm can be triggered by gynecological diseases, anomalies in the development of the genital organs. In this case, it is necessary to consult a highly qualified ON CLINIC gynecologist!

Symptoms

The symptoms of anorgasmia depend on a whole range of factors: the characteristics of the course, the duration of the disorder, and, of course, the root cause. Manifestations of anorgasmia can vary within a wide range of sensations: from a slight decrease in brightness to their complete absence. Symptoms of anorgasmia are a combination of three manifestations of varying severity: a decrease or absence of orgasm, sexual desire, sensations during sex.

Firstly, in a woman, sexual intercourse can be accompanied by positive emotions, but the achievement of the highest point of sexual satisfaction does not occur. Secondly, in a woman, sexual intercourse can be associated with unpleasant sensations and a complete lack of orgasm. Thirdly, intimacy can be completely indifferent to her.

For example, if anorgasmia arose as a result of depression, then the woman's condition will be characterized by a gradual decrease in the brightness of sensations during intercourse, up to the complete absence of orgasm. With depression, it is libido (sexual desire) that suffers one of the first.

If the lack of orgasm is due to insufficient stimulation of sensitive areas or the woman's insufficient readiness for sexual intimacy, then the disorder is manifested only by the absence of orgasm. But gradually, leading a woman to despair, this condition can develop into a neurotic disorder and cause a decrease in libido and the appearance of discomfort during sex. In this case, family disharmony in the field of sexual relations is the starting point for establishing the cause of sexual disorder, the treatment of which should be carried out by an experienced ON CLINIC sexologist.

Treatment at ON CLINIC

Treatment of anorgasmia is always complex, individual, due to the cause of the development of this condition and concomitant diseases. Only a specialist doctor (gynecologist or sexologist ON CLINIC) can diagnose and prescribe the necessary course of treatment after taking an anamnesis and an objective examination. Treatment of anorgasmia is aimed at restoring the optimal conditions for the manifestation of female sexuality and, if necessary, at eliminating the sexual disorder in the partner.

Psychotherapeutic consultations are one of the leading methods of treating anorgasmia, regardless of the root cause of its development. Even if the disorder is provoked by the presence of any disease or anomaly in the development of the genital organs, the mental sphere suffers for the second time. Psychotherapy helps to eliminate psychological barriers and clamps, restore interest in sexual life, especially if the lack of orgasm was the result of depression or chronic fatigue.

Sexologists, gynecologists, urologists and psychotherapists at ON CLINIC provide a comprehensive approach to solving such a delicate problem as anorgasmia. This allows you to achieve impressive results, completely eliminating the problem. Timely treatment will help you return to a full-fledged sexual life and establish harmony in the family!

Author of article

Share

Anorgasmia - symptoms, causes, stages

Anorgasmia is diagnosed in most cases in women and occurs in 15% of those who live a regular sexual life. The likelihood of achieving orgasm depends on the circumstances of the sexual life. Sometimes the disease occurs after prolonged abstinence or a change of sexual partner.

Male anorgasmia is extremely rare, and the pathology is not as well understood.

Disease definition

Anorgasmia or orgasmic dysfunction is a disorder in which there is no orgasm, however, sexual stimulation is sufficient. Patients suffer from the inability to get sexual release and sexual satisfaction. The diagnosis is established on the basis of the collected information. Sometimes the reasons for the lack of orgasm are malformations and cicatricial changes in the genital organs, which require surgical intervention.

Do not confuse anorgasmia in women with frigidity, which is the lack of sexual desire in general. At the same time, the very fact of sexual intercourse does not interest her either, and erogenous zones are not sensitive to caresses. With anorgasmia, a woman experiences pleasure during intercourse, retains a degree of arousal, however, she cannot achieve the final stage of intercourse.

In the ICD-10, anorgasmia is listed under F52 as "Sexual dysfunction not due to organic disorders or diseases." There is no connection between the lack of orgasm and self-satisfaction. The prognosis depends on the causes (usually psychological) of the development of pathology.

Signs of anorgasmia

The basis for the diagnosis of anorgasmia is the extremely rare onset of orgasm or its complete absence. At the same time, the psychological perception of the disease is different for everyone. If some patients have a good attitude towards sexual intercourse, while experiencing a certain pleasure, then others are completely indifferent and consider sexual life a kind of duty. In some cases, patients show somatic symptoms of anorgasmia: sleep disturbance, pain in the abdomen, which occurs due to the lack of sexual discharge and congestion in the pelvis.

Other manifestations of anorgasmia may depend on the duration and degree of its severity, the preservation or loss of certain components of sexual intercourse, namely: attraction and excitability. Often, anorgasmia is accompanied by disorders of the orientation of sexual desire:

  1. Perversion is an unnatural form of attraction.
  2. Paraphilia - the test of sexual arousal from various objects.

With a long-term preservation of the disease, sexual desire gradually fades away, causing a feeling of oppression due to unrealized sexual arousal. At the same time, the patient has a feeling of filling the genitals with blood, a psycho-emotional disorder.

Causes of anorgasmia

The disorder belongs to the polyetiological category of conditions. Among the main causes of the onset of the disease, the main ones can be distinguished:

  1. Somatic.

    2. Among somatic disorders:

  • Defects of the reproductive system.
  • Injuries or diseases of the pelvic organs and genital organs.
  • Postpartum complications.
  • Inflammation in the pelvic area.
  • Congenital anomalies, injuries, diseases of the spinal cord.
  • Hyperthyroidism, hypothyroidism.
  • Hyperprolactinemia.
  • Diabetes.
  • Obesity of the abdominal type.
  • Metabolic disease.
  • Diseases of the thyroid gland.

  • Psychological.

    • These include the following types of features:

    • Problems of psychosexual attraction. This is a violation of the gender-role model of behavior, a gender identity disorder, and a distortion of psychosexual orientation.
    • Personality features. Shyness, false shame, inability to switch and relax - all this also does not allow you to get sexual release.
    • psychogenic factors. Any past trauma (violence, early and gross defloration) can provoke the manifestation of anorgasmia.
    • Mental disorders. Depression, thinking disorder, generalized anxiety disorder, eating disorder disorder.

  • Neurological.

    • Diseases of the peripheral system reduce the sensitivity and conduction capacity of nerve fibers, which blocks the transmission of nerve impulses from erogenous zones to the brain, or transmits them with a delay.

    Often the cause of anorgasmia is insufficient stimulation before sexual intercourse, a rude and inattentive attitude on the part of the partner.

  • Gynecological.

    • Organic disorders occurring in this case do not allow sexual reactions to proceed fully.

  • Medicinal.

    • In some cases, long-term use or certain medications can cause anorgasmia.

    Anorgasmia pathogenesis

    The pathogenesis of anorgasmia consists in disorders of the course of sexual reactions - combinations of emotional and physiological changes that follow each other in a strict sequence that lead to the onset of orgasm.

    There are 3 phases of the sexual response:

    1. excitation;
    2. plateau phase;
    3. the orgasm phase is a powerful physical pleasure accompanied by contractions of the pelvic floor muscles.

    In both sexes, the reactions are almost the same. The difference is only in the duration of each of the phases and the intensity of the reactions, which is individual for each. So, the first phase lasts from a couple of minutes to a couple of hours and is accompanied by muscle tension, increased heart rate, high blood pressure, increased blood flow in the mammary glands. In addition to the clitoris, labia and vaginal walls, the uterus also swells, taking up a vertical position due to blood flow. The tone of the muscles surrounding the opening of the vagina is noted. During this period, the psycho-emotional mood is important.

    The plateau phase precedes the onset of orgasm. Blood flow increases, breathing and pulse quicken, excitement increases. Delaying this phase can lead to sexual dissatisfaction.

    The last phase - orgasm, lasts a few seconds and is accompanied by involuntary muscle contraction, a sharp increase in pulse and pressure, followed by the removal of sexual arousal, and euphoria. The female orgasm plays a key role in fertilization. It is the rhythmic contractions of the vagina and uterus that help sperm move in the right direction.

    The final phase is accompanied by muscle relaxation, a decrease in blood pressure, and blood outflow.

    The process of obtaining an orgasm is associated with the location of erogenous zones, most of which in men are located in the head of the penis, which is irritated during intercourse. The most sensitive female erogenous zone is located outside of vaginal contact, so the ability to experience an orgasm in women is many times lower.

    Among the main factors contributing to the achievement of orgasm:

    1. Sufficient level of male sex hormones in the body of a woman.
    2. Pronounced tension of the muscles of the perineum and vagina during intercourse.
    3. Good reactivity of the nervous system (the absence of stress and disorders of the nerve impulse contribute to this).
    4. The beginning of sexual activity not earlier than 18 years (allows you to form the "psychological" basis of sexual relations).
    5. The prelude phase is at least 15 minutes.
    6. The duration of sexual intercourse is more than 10 minutes.
    7. High level of sexual education.
    8. Active relationships with others.
    9. Psycho-emotional connection with a partner.

    Stages and classification of anorgasmia

    Experts distinguish 2 stages of anorgasmia:

    1. Primary anorgasmia. The stage at which a woman does not experience an orgasm from any type of stimulation. This species is extremely rare and is associated with congenital disorders of the reproductive system.
    2. Secondary anorgasmia. The stage at which it was possible to achieve orgasm at least once in a lifetime.

    The following types of anorgasmia are also distinguished:

    1. General. It is not possible to achieve orgasm under any conditions, regardless of stimulation and partner. This type of anorgasmia accounts for about 20% of cases. As a rule, it is accompanied by a disorder of psychosexual development - a delay at the stage of erotic or platonic libido.
    2. Coital. In 40% of cases, a woman gets an orgasm not through vaginal contact.
    3. Situational. A woman achieves orgasm only in a certain position, with the stimulation of specific erogenous zones, the embodiment of taboo sexual behavior.
    4. Sporadic (partial). Sexual discharge with different types of stimulation rarely occurs.
    5. Nymphomaniac. High excitability is accompanied by dissatisfaction and lack of a sense of completeness of sexual intercourse.

    There are also 3 degrees of anorgasmia:

    1. At first, libido is preserved, there is a feeling of satisfaction, however, orgasm is never achieved.
    2. The second degree is characterized by an indifferent attitude to sexual intercourse.
    3. At the last attitude to sexual intercourse is negative.

    With orgasmic dysfunction, sexual desire is reduced or its complete absence is observed.

    Complications of anorgasmia

    The disorder can cause depression and various neurotic disorders, or aggravate the already existing symptoms of these disorders. In some cases, it causes the appearance of migraine, the development mechanism of which is associated with the accumulated psycho-emotional load and changes in the hormonal background. This, in turn, leads to a violation of the exchange of serotonin in the central nervous system, provoking the appearance of frequent headaches.

    Often anorgasmia causes cooling to the partner, leading to family conflicts. At the same time, sometimes even touching can cause a negative reaction, not to mention the sexual intercourse itself.

    Among other consequences of anorgasmia is varicose veins of the small pelvis, which is accompanied by pain in the lower abdomen and the area of ​​the external genital organs, heaviness, and discomfort.

    Also, prolonged orgasmic dysfunction (more than 1 year) introduces an imbalance in the genital system, disrupting the menstrual cycle and increasing their soreness. This can lead to the development of various gynecological diseases (uterine fibroids) and diseases of the mammary glands (mastopathy).

    Seeing a doctor for a disorder depends on how concerned the woman is. It can cause stress, affect the psycho-emotional state, cause neurotic disorders. In other cases, women do not suffer from anorgasmia and do not experience its symptoms, so they do not seek qualified medical help. However, even in the absence of symptoms and physical manifestations of the disorder, it is necessary to consult an experienced specialist in order to avoid the occurrence of gynecological and neurological complications.

    Anorgasmia diagnostics

    The diagnosis is established by collecting an anamnesis, as well as, based on the complaints of the patient himself. To identify the causes of this disorder, various examinations are prescribed, drawn up individually, taking into account personal characteristics. These are the following types of surveys:

    1. Gynecological. Assign if you suspect a developmental anomaly or an acquired pathology of the reproductive organs. This is a consultation with a gynecologist, examination, ultrasound of OMT, collection of tests.
    2. Endocrinological. Conducted in the presence of a diagnosis of infertility, menstrual disorders, hirsutism, disorders of fat metabolism.
    3. Psychiatric. It is necessary to carry out in the presence of symptoms of depression, emotional disturbances and insomnia, feelings of increased anxiety, and also, with excessive emphasis on issues related to sexual dissatisfaction, complaints of unusual sensations in the genitals. A psychologist or psychiatrist conducts special tests, pathopsychological examination and other methods.

    Differential diagnosis is carried out along with pseudo-anorgasmia - a condition when a woman experiences multiple, but dim orgasms or a wave-like peak of pleasure.

    Treatment of anorgasmia

    Treatment in each case is prescribed individually. Correction of the identified pathologies is carried out by a narrow-profile specialist. So, when a tumor or a congenital defect of the reproductive system is detected, surgical correction is performed.

    The treatment regimen for the diagnosis of anorgasmia is as follows:

    1. Conversation and consultation aimed at increasing sexual literacy.
    2. Getting rid of addictions, increasing physical activity.
    3. Performing Kegel exercises - a technique aimed at training the muscles of the pelvic floor in order to increase their tone and improve blood flow.
    4. Development of relaxation techniques.
    5. Physiotherapy. Includes massage of the lumbar, relaxing, as well as general strengthening and gynecological massage, electrosleep, acupuncture, balneotherapy and other procedures.

    If necessary, the doctor prescribes treatment for anorgasmia with pills, prescribes sedatives, antidepressants and tranquilizers. It is important to remember that such medicines must be taken strictly under the supervision of a physician. For a general effect, a vitamin complex, general strengthening agents and biogenic stimulants are prescribed.

    A significant role in the treatment of anorgasmia is played by psychotherapy aimed at correcting neurotic disorders, strengthening the emotional connection with a partner, and working out stressful situations.

    An individual or joint consultation with a sexologist will also be effective, at which it will be possible to work out all the fears and reasons that prevent getting discharge, overcome anxiety about your sexual unattractiveness and discuss problems that arise in bed with a partner.

    +7 (495) 121-48-31


    Prevention of anorgasmia

    The prognosis of anorgasmia depends on the causes that caused it. In the absence of severe somatic and mental disorders, the prognosis depends on how ready the partner is to listen to the desires of the other and change sexual behavior.

    Among the recommendations for anorgasmia:

    • Formation of the correct gender role model in the family.
    • Increasing the level of sexual literacy.
    • Compliance with the regime of the day and rest.
    • Establishing emotional bonds with a partner.
    • Timely seeking medical help for gynecological and somatic diseases.

    References :

    1. Airyants I. R., Yagubov M.I. Modern ideas about anorgasmia in women // Russian Psychiatric Journal. - 2018.
    2. N.M. Sumerova, A.N. Krizhanovskaya, D.Yu. Pushkar, L.R. Toktar / Sexual dysfunctions in women // Bulletin of the Peoples' Friendship University of Russia. Series: Medicine. - 2011.
    3. Ivanova I.N., Kozlova M.A., Morozova V.N. / Influence of the parental family on the formation of anorgasmia in women / Tyumen medical journal. - 2010.
    4. Rozhanovskaya ZV, Svyadosh AM On the issue of orgasm in women / Proceedings of the scientific-practical conference "Issues of sexopathology". — M.: Medicine, 1969. - S. 128-130
    5. Domoratsky V. A. Sexual disorders and their correction. Brief practical guide to the diagnosis and treatment of psychogenic sexual dysfunctions.
    6. Heffner L. Reproductive system in norm and pathology / Per. from English. A. G. Gunina. — M.: GEOTAR-MED, 2003. — 126 p.
    7. Shigapova VI, Yagubov M. Ya. Clinical features and therapy of mental disorders in women suffering from orgasmic dysfunction // Social and clinical psychiatry.
      Learn more