A common question I get in sex therapy is “Why can’t I have an orgasm?” The answer can be complicated, and there are often more than one contributing factors.
Because a lack of education is often involved, let’s start with a definition: The orgasm is considered the climax of sexual excitement. It is a strong feeling of physical pleasure and sensation; a release of accumulated erotic tension. In men, it includes ejaculation.
Not much is known about the orgasm. Since the 1920s, theories about it have changed radically. Healthcare experts have only in the last 50 years come to understand the female orgasm—many doctors as recently as the 1970s claimed it was normal for women not to climax!
No wonder many people are confused about this sensitive topic. Here are some reasons it can be difficult for women and men to have orgasms:
Lack of knowledge
Sometimes, women and their partners mistakenly think women should climax from intercourse alone. In fact, only 25% of women can have an orgasm without direct stimulation of the clitoris.
We aren’t taught how to have healthy sexual lives in school. A lot of us were taught that “good girls don’t,” which has led to another reason women sometimes can’t orgasm. Either consciously or unconsciously, they think it is wrong for women to express pleasure in bed.
Anxiety often blocks women from being fully present in their sex lives. They are not in touch with their desires, or how to express them. They are not in the practice of talking about their needs with their partner—it can be embarrassing, to say the least. They also may have negative past sexual experiences–including sexual trauma–that contribute to present anxiety.
There are sometimes physical reasons women can’t orgasm, and if you see a sex therapist, they should rule these out right away. They might refer you to a doctor or gynecologist if they suspect your body is incapable of orgasm.
Many women do not experience a high desire for sex. It may seem like a chore to meet their partners needs, and having their own orgasm is just not high on the priority list. For some couples, this is fine. For others, not so much.
For men, erection and orgasm problems are often about anxiety—especially in younger men. As women do, men frequently have trouble being fully present during sexual activities. They worry about the end goal instead of the process. Mindfulness and meditation can help.
Shame or Low Self-Esteem
Sexual or relationship trauma can cause both men and women to feel uncomfortable during sex. Psychological or psychiatric counseling is often needed in these cases.
Older men sometimes have trouble maintaining an erection for the amount of time they or their partners expect. This can be addressed with medications, but often just as effectively through rethinking the “sex act.” Taking the emphasis off performance can be freeing. It opens up new ways of being intimate that can be even more satisfying than the Big O.
What Can You Do About It?
A first good step is your doctor or gynecologist to see if there is a medical problem contributing to your distress.
If nothing presents, make an appointment with a sex therapist, who can discern the mental or emotional roots of your challenge. Often, the problem can be solved with sex therapy methods that help the couple feel closer. Exercises, done in the privacy of your home, can often remove communication barriers and increase feelings of intimacy, which usually pave the way for satisfaction.