Medical Q&As

Orgasm - never happens?

I have been having a sexual relationship with my boyfriend for the last two years but fail to orgasm. What should I do?

Orgasmic difficulty is the commonest sexual complaint in women. Studies have indicated that up to 15% of women never experience orgasm and that less than 50% of married women experience orgasm on a consistent basis. Some women enjoy sexual activity without experiencing orgasm whereas others become frustrated and disappointed and regard orgasmic difficulty as some form of failure. The sensation of orgasm is produced by the involuntary contraction of muscles within the pelvis. Orgasmic difficulty is classified under two headings, primary and secondary. Primary orgasmic difficulty means that the woman has never experienced orgasm. Secondary orgasmic difficulty refers to a number of different situations. It could mean that the woman no longer experiences orgasm but used to in the past or it could mean that the woman can experience orgasm under certain circumstances and not in others. There are many causes of orgasmic difficulty. These include fatigue, alcohol, anxiety, depression or a history of trauma or sexual abuse. Very often the difficulty is emotional or psychological in origin and can include such scenarios as incompatibility, insensitivity, lack of trust or even a power struggle within the relationship. Some experts stress the importance of the woman receiving adequate stimulation of her clitoris during intercourse. It is worth emphasizing that sometimes the determination to have an orgasm becomes an overriding concern, which can actually become self-defeating because the preoccupation with that goal can induce anxiety, which in turn blocks the possibility of orgasm happening. Given the wide range of possible causes for orgasmic difficulty the range of solutions is similarly wide. It could involve generating a more erotically stimulating climate within the relationship. It could involve improved communication within the relationship so that your partner becomes more aware of the sensations that give you particular pleasure. It could involve working through unresolved psychological or emotional issues. Irrespective of the actual cause of the difficulty it would be helpful for you and your partner to learn more about sexual anatomy and the process of sexual arousal.