Anorgasmia or Orgasm Disorder: Difficulty Reaching Climax


Anorgasmia or orgasm disorder is one of the most common sexual dysfunctions. It consists of the absence or difficulty to reach orgasm and can affect both women and men. Failure to reach the climax, or delaying too much can damage relationships since they might feel completely unsatisfied and their partner incapable of satisfying. Why do some people fail to reach orgasm? In most cases, anorgasmia is a psychological problem. Discover a complete guide to Anorgasmia: What are its causes? How is it solved? Treatment, exercises, and tips to overcome it.



What is Anorgasmia?-Definition

Anorgasmia can be defined as the absence or deficiency of orgasm during a normal erotic arousal phase. This orgasm disorder might appear regardless of receiving an adequate excitation, having an important sexual desire, or having the right conditions to reach the climax. When we talk about anorgasmia, it usually refers to women, however, this disorder can also affect men.

In order to establish an anorgasmia diagnosis, different factors must be taken into account, such as the patient’s sexual experience, age, duration or suitability of the erotic stimulation being received, the level of arousal, etc. Each of us is different and we all need a certain impulse to trigger the climax.

As in other sexual dysfunctions, anorgasmia can produce relationship problems and psychological distress.

How do I know if I am Anorgasmic? If you are not able to have orgasms or you find it very difficult in more than 75% of the times that you engage in sexual acts you might have anorgasmia. Many times the absence of orgasm can be accompanied by low sexual desire or might be due to stress.

The orgasm disorder is more frequent (between 16% – 30%) in females. In men, its frequency is about 10%.

This orgasmic difficulty can be of several types: primary or secondary, situational or generalized.

  • Primary type anorgasmia: People who suffer from it have never reached the climax, neither through coitus or masturbation. Even though men may ejaculate, or not, in these cases, reaching an orgasm has always been difficult.
  • Secondary type anorgasmia: This difficulty has not always been there, but arose at a certain time. After not having a problem to orgasm, difficulties start to appear. Normally, when you learn to reach an orgasm, you generally don’t lose this ability unless there is a problem such as poor sexual communication, a relationship conflict, a traumatic experience, a mood disturbance or a physical disorder, etc.
  • Situational type anorgasmia: When it isn’t possible to reach an orgasm in certain situations or a condition we call it situational anorgasmia. That is when a person has difficulty reaching climax with someone but with others not. Or when we can only reach an orgasm when we are stimulated one way only but otherwise not.  A common type of anorgasmia is coital anorgasmia in women, who are unable to achieve orgasm during intercourse but can achieve it with other types of sexual activity (direct stimulation of the clitoris, caresses, masturbation, etc.).
  • Generalized type anorgasmia: It happens when you can not have orgasms in any situation or with any partner.

Female Anorgasmia

The incidence of Anorgasmia is much more frequent in women than in men. Data shows that between 16% -30% of women suffer from this orgasm disorder. The term currently used to refer to anorgasmia in women is, according to the Diagnostic Manual of Mental Disorders (DSM-5), female orgasmic disorder.

Female orgasm refers to the culmination of the arousal of a woman manifested by rhythmic contractions of the vaginal wall and the discharge of muscle tension accompanied by varying levels of pleasure. Reaching the climax regularly is associated with high self-confidence, good self-esteem, and a desire to increase sexual activity.

There are important individual differences in intensity of orgasms and female response. Kaplan has described different stages in which he found on one end, women who can reach orgasm only with their erotic fantasies, and in the other extreme, those women who only manage to reach orgasm through an intense and continuous stimulation for hours. However, most women are at an intermediate point between these phases, achieving orgasm through direct stimulation of the clitoris, or indirect through intercourse.

Difficulty in the ability to reach orgasm in women can lower self-esteem, body self-image, and satisfaction in their relationships.

The most common type of female anorgasmia is the primary, women who have never reached orgasm. Anorgasmia can last a lifetime if you don’t find ways to remedy it. If you have difficulties to reach an orgasm or climax you should go to a professional. 

Today, women increasingly claim their active role in sexuality, making it easier for female anorgasmia to be treated. Female pleasure recognition and the desire to experience more satisfying and fuller sexual relations make more and more women ask for advice. Advice not only about problems reaching orgasm but also to achieve more intense orgasms through different types of stimulation.

What causes female orgasmic disorder? This disorder may be due in part to the poor sex education we receive. We are taught, explicitly or implicitly that women should please a man and we shouldn’t be too active in bed. We have learned that we must yield the responsibility of our pleasure to our partner. Based on this, we assume our partners must know or “guess” what we like, and worst case scenario you will have to take care of your own pleasure.

Another problem experienced by women is the issue of knowing our own body. Very few women really know what their genital area is like. As it is partially hidden, you can only get to know your genitals through a mirror. However, who is going to do such a thing? We have been taught that it would be shameful and dirty and we must close our legs.

Female masturbation is also taboo. While male masturbation is considered normal (first censored and later praised) while female masturbation has been precluded. It was believed that it was something that women don’t do, they don’t have that need, and if anyone showed it then you were a pervert or something worse. All this has greatly influenced female repression leading to anorgasmia. Fortunately, this has gradually been changing, however, there is still a long way to go and much sex education to convey.

Male anorgasmia

Male anorgasmia is the difficulty of feeling the pleasurable sensations that accompany the orgasm. The clinical term to define male anorgasmia is that of delayed or inhibited ejaculation.

Male anorgasmia is less frequent, but the symptoms are similar to women. They have difficulties to reach pleasurable sensations or t reach climax even if they are very excited and want to have sex.

It is believed that men’s orgasm and ejaculation always occurs at the same time, however, it is not always so. You can have orgasms without ejaculation, the so-called “dry” orgasms. Retrograde ejaculation, which ejaculates inward, into the bladder is also possible.

The prevalence of delayed ejaculation usually increases with age. Although it shouldn’t surprise us, since the sexual function, especially in men, usually diminishes as we grow old.

Male anorgasmia has been closely related to religious orthodoxy. Some of these beliefs limit sexual awareness, causing these men to “learn not to ejaculate” or to experience a great inhibition.

A large proportion of men with anorgasmia have deep religious beliefs and some of them have poor sexual knowledge, masturbate little or not at all or and feel guilty when they do.

Sometimes men feel pleasure and satisfaction with masturbation but do not experience the same pleasure with their partner. These people have found a very precise way of obtaining pleasure that can’t be copied by another person.

Another important aspect in the development of the absence of orgasm in men is anxiety about sexual performance. In these cases, the man has no confidence that he can perform the act adequately, or is attractive enough, to satisfy his partner, etc. The inability to ejaculate can generate anxiety and stress because the person is distracted by these feelings that the erotic stimuli that would normally excite them don’t anymore. As a result, the man is not excited enough to reach the climax.

Is male anorgasmia the same as impotence? The answer is no, male anorgasmia refers to the inability or difficulty to reach orgasm once it is excited, and the erectile dysfunction or impotence refers to the inability to achieve or maintain an erection that allows a sexual relationship to be performed with satisfaction.

Coital anorgasmia

This type of situational anorgasmia consists of the inability to reach orgasm during intercourse. However, the person is able to reach an orgasm through other forms of stimulation, such as during masturbation. It’s very frequent in women.

Sexual relations usually focus on coitus too much, making intercourse the ultimate goal of any sexual activity. However, such a rigid belief can greatly limit our sex life. You have to open your mind and stop thinking that intercourse is the main goal. There are many other things that can be done. The so-called “foreplay” does not have to become the “toll” that has to be paid to reach the final destination.

Foreplay can become the main sexual activity. Particularly for women, intercourse is not the best way to have an orgasm. Freud’s saying that clitoral orgasm is childish and the vaginal orgasm is mature is now ancient thinking. Most women need the simultaneous stimulation of the clitoris to achieve orgasm during penetration and it is believed that this may have an anatomical origin.

Certain studies have shown that the relative distance from the clitoris to the entrance of the vagina influences the ability to have orgasms during intercourse. That is, the closer the clitoris is to the vagina, the more likely it is that the woman will have an orgasm during penetration due to the casual friction of the vagina. Therefore, even if we talk about coital anorgasmia, I don’t think this is a “disorder” but rather something common that can be solved by stimulating the clitoris simultaneously or by choosing a posture in which there is more friction.



Causes of Anorgasmia

Orgasm is a rather complex process that has biological, psychological and social component. Anorgasmia is related to ignorance of one’s own sexual anatomy and genital function and the lack of adequate and efficient stimulation.

The causes can be very diverse, from biological to psychological and are usually similar in men and in women. The main causes of anorgasmia are psychological. The main reasons are:

Psychological causes of anorgasmia:

It is estimated that about 90% of anorgasmia cases is related to psychological problems.

  • Negative emotional states
  • Hypervigilance. Sometimes people with orgasmic or other sexual dysfunctions are overly vigilant for their sexual performance. That is, they pay so much attention to themselves that they see themselves as if they were an external spectator, instead of being carried away by the experience
  • Inadequate sex education
  • Negative feelings about sex
  • Personal or couple dissatisfaction. Sometimes sexual boredom, trust issues or unresolved conflicts with your partner can result in anorgasmia.
  • Anxiety about sexual performance. This is quite common in men as they have the pressure of having to be always available for intercourse. This causes stress, the number one enemy of desire, arousal, and orgasm.
  • Sexual abuse experiences. This type of traumatic situations can generate a negative association with sex and sexuality preventing enjoyment.
  • Negative Attitudes towards Sex
  • Rooted religious beliefs, which can see sex and female enjoyment as something sinful and despicable.

Biological causes of anorgasmia:

  • Diabetes
  • Hormone deficiency
  • Perivaginal muscles alterations in women
  • Pelvic injuries
  • Substance use
  • Medication. Antidepressant drugs have as a side effect the decrease in libido, desire, as well as orgasmic difficulty.
  • Chronic pain
  • Hypertension
  • Multiple sclerosis
  • Damage to the spinal cord

Situational Causes of anorgasmia:

There are situational factors that affect mainly female orgasms, related to culture and sex education. In fact, a shortage of sex education is one of the major causes of sexual dysfunction.End of sexual intercourse before the woman is excited enough to reach orgasm.

  • End of sexual intercourse before the woman is excited enough to reach orgasm.
  • Absence of foreplay
  • Inappropriate stimulation
  • Lack of understanding of our genitals or tastes.
  • Lack of partner’s knowledge of what turns you on or how to stimulate.
  • Lack of communication about sex. Failure to communicate with your partner about what we like or dislike about sex affects negatively the partner’s sex life. We often believe that the other person should know how to satisfy us which is totally false. It is true that something can be intuited but we should not leave our enjoyment to our partner because who better than us to know what we like or not? Although it is essential to discover what satisfies us.

8 Myths About Orgasm

1. There are two different types of orgasm: one vaginal (coital) and one clitoral

This statement is a little controversial but the truth is that these orgasms can be reached with different forms of stimulation and feel differently.

In fact, if you have vaginal orgasms, as we mentioned before is because your clitoris is being stimulated indirectly. The clitoris is not only the cap that can be seen with the naked eye. The clitoris is a much larger structure, whose ramifications extend throughout the genital area. That is why it is believed that really the female G-spot does not exist, but when you stimulate this point you are actually stimulating an inner zone of the clitoris. The existence of a G-spot as a structure with its own entity is not yet proven. In fact, there are women who don’t feel pleasure when stimulating that area.

2. Non-coital orgasm is less satisfactory than coital orgasm

This is totally false. The orgasms that arise from the stimulation of the clitoris are much more intense than those that can be reached only with intercourse. As we mentioned before, there are women who are not able to have orgasms during intercourse.

3. What is normal is to have vaginal or coital orgasms

As we have said, the most common and normal thing is that a woman can have orgasms stimulating her clitoris and it is more difficult to do it through intercourse.

4. Having orgasms by stimulating the clitoris is immature or abnormal

This statement, as expressed by Freud, has no scientific basis.

5. Women who masturbate are lesbian, perverts or sex addicts

A woman who masturbates gets to know their body like no other. She is responsible for her own sexuality and its a sign of good sexual health. Sex addiction or nymphomania or hypersexuality is something completely different.

6.  A man must know how to satisfy a woman

This myth has done much harm to sexuality. There is a great deal of pressure on men almost expecting them to be born experts in sex. Both men and women must communicate and express how we want them to touch us, what we like and what we don’t. 7. Women take longer to have an orgasm than men

7. Women take longer to have an orgasm than men

If a woman is properly stimulated, it may take the same time as a man to reach the climax. Similarly, some men may take a while to become sufficiently aroused. It depends on the person, the partner, the couple, the situation and the type of sexual practice.

8. To enjoy sex you have to reach orgasm

It is true that orgasm is a fantastic experience, but you can also enjoy sex without it. Fun, intimacy and excitement can provide very fulfilling encounters as well. You have to stop obsessing with orgasm if you climax, great, but if not, nothing happens.

Anorgasmia Treatment

Anorgasmia treatment is very effective and the vast majority of cases are successfully resolved. The orgasm disorder is a relatively easy problem so if you think you suffer from anorgasmia or your sex life is not satisfactory, don’t hesitate to consult with a psychologist, sex therapist or a sexologist. In addition, going to a professional will rule out the existence of biological problems or other associated psychological problems, such as depression or anxiety symptoms.

Anorgasmia treatment can be individual and/or in pairs. It usually includes sex education in order to break myths and false beliefs about our sexuality. Communication problems will also be a subject of discussion. There will also be a self-exploration and self-stimulation in order to get to know yourself thoroughly. Subsequently, couple exercises are performed so that the sexual relationship or intercourse can satisfy both and can reach orgasm.

In addition, psychological therapies, not focused on anorgasmia, can also be very useful. For example, you can treat insecurity, low self-esteem, depression, stress, etc.

Practicing mindfulness can also be helpful. It can help us pay attention to sexual feelings without making judgments. Keep in mind that the more open you are or curious the less pressure you will feel.

Female Anorgasmia Treatment

To treat female anorgasmia the first step is the self-exploration program. First, explore the whole body, know it and discover which areas provide you with pleasure. Vaginal muscle training may also be recommended, in which the muscles of the genital area contract to strengthen and improve orgasms.

Then a self-stimulation program is followed, in which the patient is asked to try to reach orgasm by stimulating the clitoris. This step is more active, the person might use erotic toys or vibrators to make it easier to orgasm. This allows the woman to learns how are her orgasms and discover her own orgasmic ability.

Relaxation and sensory focusing exercises are also performed with the partner. This involves, in turn, stimulating your partner’s body to discover what they each like.

In the next phase, intercourse is performed with previous clitoral stimulation, sexual toys and fantasies can also be used as a form of sexual enrichment.

As we have said, only some women can reach orgasm during penetration without stimulation of the clitoris, so if you can’t reach orgasm only with penetration don’t worry about it.

Male Anorgasmia Treatment

Treatments to improve orgasmic function in men usually consists of:

  1. Provide information about the problem
  2. Encourage the participation and mutual responsibility of the members of the couple
  3. Modify negative attitudes towards sex
  4. Training in communication skills and other specific skills: masturbation, stimulation, etc. 
  5. Promote a positive association to their partner with pleasure. Foreplay is encouraged and non-intercourse ejaculation in order to eliminate any anxiety or pressure to intercourse.  
  6. Manual stimulation by their partner until they reach orgasm.
  7. It is suggested that they perform intercourse with the partner on top, leaving all the work to the other person so that the patient can focus on their own pleasure and thus enable orgasm.
  8. Finally, perform normal intercourse.


Exercises and tips for anorgasmia

If you think you might have anorgasmia and it is something that generates a lot of distress, it is best to go to a professional. This person will help you determine if there is a problem. However here are some tips and exercises to overcome anorgasmia that may help you.

1. Know your body

It is essential to know your body. Stand in front of a mirror and look at yourself completely naked. Don’t judge yourself.  Women have more difficulty knowing our genital anatomy. To know this part, take a hand mirror and see what your genitals look like. Many women dislike it and see it as a dirty part of their body, but it is just one more body part like the rest. Try to do it as many times as possible until you feel comfortable with yourself.

2. Self-Stimulate

Masturbation and knowing one’s own body is essential to having a satisfying sex life. First, caress your whole body and focus on the areas that give you more pleasure. Gradually increase the intensity of the stimulation. Over time you can increase it until you approach orgasm.

3. Try vibrators, sex toys, lubricants either alone and/or with your partner.

4. Communicate with your partner.

Dare to tell him what you like and don’t like or what you want. Talk about sex, experiences, fantasies.

5. Relax, let yourself go.

You can try practicing relaxation and mindfulness exercises, to lessen anxiety about sexual performance.

6. For women, try different positions in which there is friction with the clitoris, or stimulate it during intercourse.

Please feel free to leave a comment below!

 This article is originally in Spanish written by Andrea García Cerdán, translated by Alejandra Salazar.

Psicóloga General Sanitaria y sexóloga. Deseosa de mejorar la calidad de vida de las personas mediante la práctica clínica y la comunicación a través de la red.