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Female Orgasm

I've never been able to have an orgasm. Why not? Is there anything I can do?

I used to be able to have an orgasm but I can't seem to anymore. Why not? Is there anything I can do?
My orgasms are not as intense as they used to be. Why is that?

I can't seem to have an orgasm with intercourse. Why not?

What is the g spot?

 

I'VE NEVER BEEN ABLE TO HAVE AN ORGASM. WHY NOT? IS THERE ANYTHING I CAN DO?

If you have never experienced orgasm, you are not alone. Many women have not, and for most, it is something that can be learned. When we speak of "never" having had an orgasm, we mean by any method of stimulation including masturbation, manual or oral stimulation, vibrator or intercourse. Again, sex is about much more than orgasm, and there are people with satisfying sex lives who do not experience orgasm. But for many, it can be physically and emotionally frustrating not to have an orgasm.

Orgasms are a natural release of sexual tension. A sense of well-being or relief often follows, perhaps because orgasms are thought to release pain inhibitors in the body. Contrary to popular myth, most women don't achieve orgasm through intercourse alone. In the majority of women, the position for intercourse and the way in which the clitoris is stimulated through intercourse is not conducive to orgasm. There are many alternatives for you. Your partner can stimulate you manually either during, prior to, or after intercourse; you can stimulate yourself manually during intercourse; or you can try out alternatives to your lovemaking including oral sex, manual stimulation or vibrators.

Just because you have never experienced an orgasm, doesn't mean that you can't. The first step should be to have a physical evaluation to make sure that there is no medical problem. Low hormone levels, poor blood circulation and lack of lubrication can all contribute to a woman’s inability to experience an orgasm. One theory, which is being explored as a contributor to women’s orgasmic problems, is insufficient blood flow to the vaginal area. Much like a man who will have problems with his erection if the blood is not flowing properly, there is some thought that a lack of blood can keep the clitoris from becoming properly engorged. If the clitoris does not become engorged it cannot have the release we know of as a female orgasm.

This can be caused by certain medical conditions, medications or surgeries. In certain cases prolonged stimulation or more intense stimulation can help. Some medical providers are trying both topical and oral medications to enhance blood flow to the vagina and there is an FDA approved vacuum device that can help with this as well. Interestingly, exercising prior to sex may also have a significant effect on those women who have blood flow problems. There have been some preliminary studies which show that women, immediately after exercising, have increased blood flow, increased lubrication, become aroused more quickly and orgasm more easily.

Another reason why you may not be able to reach orgasm may be due to medications. There are a number of medications, most notably some widely used anti-depressants that significantly hamper a woman's ability to have an orgasm. Finally, there are women who are “blocked” psychologically from experiencing orgasm. For some reason, at this time in their lives, they are facing situations or relationships where it may be difficult to let go or experience pleasure. This can be explored further in sex therapy sessions.

Along with medical help, a woman may need to learn how to have an orgasm. Although it is a natural physical response, it often must be learned. For most women it is a combination of learning about your body, relaxation and finding what kind of stimulation works for you. Most people, women and men, first learn to experience orgasm through self-stimulation (masturbation.) It cannot be stressed enough that this takes time and patience and cannot be rushed or pressured. And remember that our bodies don’t respond mechanically. Your mind and body are in this together. A physician who specializes in female sexuality or a sex therapist can recommend books, videos and specific techniques that can help you.

I USED TO BE ABLE TO HAVE AN ORGASM BUT I CAN'T SEEM TO ANYMORE. WHY NOT? IS THERE ANYTHING I CAN DO?

MY ORGASMS ARE NOT AS INTENSE AS THEY USED TO BE. WHY IS THAT?

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It is not uncommon to hear women, as they get older, talk of having less intense orgasms or having a harder time reaching orgasm. The physical factors that cause this may often include hormone insufficiencies or reduced blood flow to the vaginal area.

Hormones are a critical component of normal sexual response. Low levels of testosterone related hormones that are often associated with peri-menopausal and post-menopausal women can have a large impact on both a woman's level of desire and her level of response. Understanding the hormone balance is complicated and a very new area for most physicians. Therefore a woman troubled by her low sex drive should have a full battery of bloods run under the supervision of a physician who specializes in the area of female sexuality.

Additionally, as you get older, you may see differences in your blood circulation. If the blood flow in the vagina is insufficient it will not fully engorge the clitoris - much like a man who can't get an erection. If your clitoris does not become engorged you may not have the intensity of orgasm that you are used to. This can also sometimes be caused by certain medical conditions, medications or surgeries. Some medical providers are using topical and oral medications to enhance blood flow to the vagina and there is an FDA approved vacuum device that can help with this as well. In certain cases prolonged and more intense stimulation can help and certain vibrators may be recommended.

The medications you may be taking can also be affecting your ability to experience orgasm, particularly if you are taking anti-depressants. Additionally, birth control pills can throw off the balance of hormones and create an inability to orgasm.

If you have experienced pleasurable orgasm in the past, it is likely that with the proper combination of medical and emotional support you can do so again.

I CAN'T SEEM TO HAVE AN ORGASM WITH INTERCOURSE. WHY NOT?

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Only 30% of women achieve orgasm through intercourse. In the large majority of women the position for intercourse and the way in which the clitoris is being stimulated through intercourse is not conducive to orgasm and there is no way that intercourse alone can produce an orgasm. A good analogy might be to consider attempting to bring a man to orgasm by rubbing his testicles only. It is unlikely that without proper stimulation of the penis he will reach orgasm and it is unlikely that without proper stimulation of your clitoris you will reach orgasm.

If you fall into this category, you need to realize that you are not anorgasmic, merely typical and there are many alternatives for you: your partner can stimulate you manually either during, prior to, or after intercourse, you can stimulate yourself manually during intercourse, or you can try out alternatives to your love making including oral sex or manual stimulation or a vibrator. There is additionally, a device available that functions as a small vibrator specifically meant for use during intercourse. Generally couples find that a combination and variation of the above methods allow couples to have intercourse and allow the women also to have the release of orgasm.

WHAT IS THE G SPOT?

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The G-spot (named after a Dr. Grafenberg) is a sensitive area in the vagina, somewhere between the pubic bone and the cervix. The only way to find it is through vaginal penetration (ideally with a finger) and to touch the surrounding area to find any sensitive spots that seem particularly sensitive to stimulation. Erogenous zones clearly vary for different women. We should point out that although some women find this spot to be very sensitive and enhancing to their enjoyment of sex, others do not report having such a spot or finding its stimulation particularly exciting.

When this spot is stimulated during sex (either by a finger or a penis) some women have an orgasm that feels different or more intense than the orgasm they have with clitoral stimulation only. The orgasm may also include a gush of fluid from the urethra and no one is quite certain what the liquid is composed of but many women find the “ejaculation” pleasurable and their partners find it exciting.

 

Read Dr. Bat Sheva Marcus' article on orgasms.

Free sexuality information packet for women.

Contact us for more information about the Center or call us to make an appointment at (914) 328-3700.


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