Learning How To Cope With Female Orgasmic Disorder

Many women may see the inability to orgasm as a cause for concern for their personal and sexual health. However, it could be a sign of female orgasmic disorder—a condition that may cause difficulty in reaching orgasm for some women. If you experience difficulty reaching sexual climax, it can be helpful to remember that you’re not alone and that help can be available. 

Read on to learn about female orgasmic disorder, possible diagnostic and treatment options for this type of female sexual concern, and tips to live with this medical condition.

What is female orgasmic disorder?

Female orgasmic disorder (FOD), or anorgasmia, is generally defined by one’s difficulty in achieving orgasm following typical sexual arousal. This type of sexual dysfunction can be characterized by a persistent or recurrent delay or absence of orgasm for at least six months, and it’s generally estimated to affect at least 75% of female sexual experience.

The causes of female orgasmic disorder can be varied, including psychological factors, hormonal imbalances, and chronic conditions such as multiple sclerosis. Certain medications, like serotonin reuptake inhibitors, commonly prescribed as antidepressants, can also impact sexual activity by inhibiting orgasm. Addressing FOD may require a comprehensive approach involving therapy, medical intervention, and sometimes a reassessment of medications like reuptake inhibitors.

How can anorgasmia affect your sex life?

If you are experiencing sexual arousal and are unable to experience an orgasm despite adequate sexual stimulation, it may be overwhelming or distressing. Anorgasmia can significantly impact a person’s overall quality of life and well-being, often causing marked distress among those affected.  

The inability to reach orgasm can also cause concern in your relationships, possibly causing feelings of frustration, dissatisfaction, or inadequacy in your partner. Such situations are common for most women with orgasmic challenges and can hinder the intense pleasure often associated with sexual activity. If you are concerned about the frequency and intensity of your orgasms, speaking to your healthcare provider or sex therapist can be a helpful first step, as they can help you evaluate your case and determine the best possible step forward for you.

How is female orgasmic disorder diagnosed?

Diagnosing anorgasmia may involve an appointment with your primary care provider or gynecologist, in which various aspects of your medical history might be reviewed, such as problems with the nervous system or other clinical manifestations. You may undergo a general medical and pelvic exam, which could help identify other medical conditions that could affect sexual function and inhibit orgasm. 

You may be requested to answer questions about your experiences with sexual desire, orgasms, and other related subjects over at least the past six months. Preparing in advance can help you feel calmer and ready for your appointment as it occurs. 

• Delayed Orgasm: It may take a long time to achieve orgasm.

• Absent Orgasm: You may not be able to orgasm at all. 

• Fewer Orgasms: The orgasms you experience may be less intense than expected. 

• Less Intense Orgasms: You may have fewer orgasms than you anticipate based on your prior experiences.

Exploring possible types of female orgasmic disorder

While the frequency and intensity of orgasms can vary significantly with any sexual encounter or partner, anorgasmia can also change its presentation per recent research from the Mayo Clinic. The experts have determined that there are generally four main types of anorgasmia, such as: 

Lifelong anorgasmia 

With lifelong or primary anorgasmia, you might have never experienced an orgasm. 

Acquired anorgasmia 

Though you’ve experienced an orgasm before, you may have difficulty reaching that point. Acquired or secondary FOD can involve new challenges with orgasms. You may previously have been able to achieve orgasm but might be having difficulty doing so again, which can be due to some change in your life—such as medication or traumatic events. 

Situational anorgasmia 

This type of anorgasmia generally means that you can orgasm, but only in certain situations or with specific stimulation. For example, although you may not be able to orgasm through sexual intercourse involving vaginal penetration, you may still be able to orgasm through masturbation or oral sex. 

Generalized anorgasmia 

With this type of anorgasmia, you may experience a total inability to achieve orgasm—despite sufficient sexual stimulation and arousal. 

What causes anorgasmia?

For many people, the ability to achieve orgasm can depend on a complicated balance of mental, physical, and emotional factors, according to a recent study. Trouble in these areas can cause anorgasmia, though this is not an exhaustive list. Symptoms can be as unique as the people they affect. 

Some people can experience a complete lack of sexual desire or romantic feelings and may not be troubled by it. Asexuality is a valid sexual identity. This article’s scope focuses on those who wish to achieve orgasm and cannot. Additional research may be necessary for those who find themselves to be aromantic, asexual, or within any scope or spectrum of these valid sexual identities. 

We’ve summarized possible contributing factors across the three main influences below:

Psychological factors

Sexual desire and arousal are generally thought to be complex reactions to various forms of stimulation. As sex can be an intensely mental activity for some, psychological factors may interfere. Examples of possible contributing psychological factors to anorgasmia can include: 

• Mental health conditions like depression and anxiety disorders

• A history of (and subsequent trauma from) emotional or sexual abuse

• Stress brought on by stressors, such as bereavement or financial issues 

• Poor self-esteem and body image

• Embarrassment, guilt, or other unhealthy feelings about sex

• Negative religious beliefs about sex

• Cultural factors that stigmatize or restrict sexual expression and education

Relationship factors

In some cases, interpersonal difficulties may be contributing to anorgasmia. If you’re having trouble with your partner in other areas, it may be difficult to relax enough to reach orgasm. Possible relationship-rooted factors that may contribute to anorgasmia can include: 

• Boredom with sexual activity in a relationship or losing interest in the relationship itself

• Embarrassment about asking for what you want sexually

• A lack of emotional intimacy with your partner

• Poor communication skills in expressing sexual needs and preferences

• Infidelity or lack of trust in the sexual relationship 

• Intimate partner violence or domestic abuse 

• Sexual dysfunction in a partner (such as erectile dysfunction in males)

Physical factors

The condition of your body can impact how well you’re able to enjoy it and reach orgasm. We’ve compiled possible physical factors for anorgasmia below:   

• Medical conditions such as diabetes, multiple sclerosis, polycystic ovarian syndrome (PCOS), or endometriosis

• Inadequate blood flow to the genital area

• Advanced age

• Gynecological surgeries (like a hysterectomy)

• Physical symptoms of stress

• Mental health conditions (such as depression or anxiety disorders)

• Certain medications, such as SSRIs (selective serotonin reuptake inhibitors)

Treating anorgasmia

The treatment for FOD might depend on what caused the problem. If there are underlying medical issues, they may need to be treated. Generally, treatment plans for female anorgasmia might include lifestyle changes, therapy, and medication. Speaking with a clinician can give you valuable insight into what next steps may be most appropriate for your specific experience. 

Tips to live well with female orgasmic disorder

Treatment options and supportive strategies to help someone live well with anorgasmia may include one or more of the following approaches:

Ongoing education

You may benefit from learning about your body, what you like, and how to explain your needs to your partner. Ongoing education about how a woman's anatomy contributes to becoming highly aroused may help improve sexual health and satisfaction. 

Cognitive behavioral therapy

This can provide value in either an individual or couple’s setting. It can help you shift your perspective and mindset about sex, promote positive sexual relations in your relationship, and support you in developing coping skills to manage stress that can affect anorgasmia. 

Sensate touch

This type of sensual focus generally starts with non-erotic touch during at-home instruction to teach you and your partner how to touch each other. It then works up to sexual stimulation. The goal of this type of touch is to teach partners to understand each other’s needs, encouraging them to communicate emotional and sexual desires to one another. 

Directed masturbation

You can use a program of at-home exercises to help you become familiar with your body during sexual self-stimulation, also known as masturbation. You might use this as an opportunity to learn what you like, possibly empowering you to communicate it to your partner.

Use of sex toys

Sexual enhancement devices or “toys” can introduce additional stimulation that can help you achieve orgasm. For example, certain devices are explicitly designed for clitoral stimulation, which can be a pleasurable accompaniment during masturbation or partnered intercourse. 

New sexual positions

Some sexual positions may stimulate the clitoris or other pleasurable areas more than others. Your sex therapist or healthcare provider can recommend certain positions that may be more pleasurable for you and that may help you achieve orgasm. 

Non-sexual methods of support for your experiences with anorgasmia can include: 

Working towards acceptance

It can be understandable that you may struggle to accept that anorgasmia is part of your life, particularly when dealing with significant distress or comparing your experiences to other women. However, once you accept that this condition is confirmed, you can work toward solutions and ways to live well despite the condition.

Talking to your partner

Communication can be an important part of any treatment plan for sexual disorders. Your partner may appreciate this if the inability to give you an orgasm has been weighing on them, and they might be eager to help you explore solutions. While the conversation can feel awkward to approach, the potential benefits can far outweigh the discomfort you may feel in the moment. You might consider expressing your feelings about your disorder and how you want to address it in the relationship or during sex. Additionally, you can explain how you want your partner to help, and eventually, you can speak about what can be done to make sex more pleasurable for you. 

Building up your sexual intelligence and literacy

Improving your knowledge about sexuality and female orgasmic disorders may be helpful. It allows you to figure out what you enjoy and how to communicate that to your partner, promoting a more fulfilling experience.

Learning to enjoy sex (even without orgasms)

Being unable to orgasm can feel frustrating, but it doesn’t mean that sex can’t be enjoyable. You may find FOD isn’t quite as intimidating when you let it fade into the background, instead choosing to focus on the intimacy you have with your partner. 

Remembering that orgasms are possible

Being diagnosed with anorgasmia doesn’t mean you aren’t physically capable of orgasm ever—it may just simply mean that orgasm may look different for a time. You can plan for resiliency by getting into the right mindset and using the methods you know are practical. For example, if your partner cannot help you reach orgasm, you might try it on your own. It can be helpful to reduce your stress level and remember that orgasms can generally be possible, even if you have to achieve them using different strategies that don’t include certain sexual methods. 

Seeking support for sexual dysfunction

Working with a licensed individual or couples’ therapist can help you work through underlying emotional and mental concerns that might be causing sexual problems. Many people prefer online therapy through virtual platforms like BetterHelp to talk about such matters with discretion, as well as for the convenience of receiving treatment at home. They may also appreciate the increased flexibility in appointment scheduling and the shorter-than-average wait times to connect with a professional.  

A 2011 study published in the Journal of Sexual Medicine measured the effectiveness of online sex therapy for women experiencing sexual dysfunction. Experts found it was generally a suitable alternative to in-person treatments for many, with nearly all participants demonstrating an improvement in sexual and relationship function.