Do you struggle to reach orgasm? You are not alone. Anorgasmia is a condition that 10 - 40% of the vulva owning community experience.

Put simply, it’s the absence of, or difficulty in, reaching orgasm after a good amount of sexual stimulation. Anorgasmia can present in a number of different ways. It can be categorised as 1) lifelong, which is when a person has never experienced an orgasm, or, 2) acquired, which is when a person was previously able to orgasm but no longer can. Anorgasmia can also be context dependent, so only experienced in certain situations or it can occur across all sexual situations. It’s important to note that anorgasmia is complex, this means it appears in diverse ways and your experience might look very different to another person’s.

Before we jump into this topic, it is also important to say that having an orgasm is not important to everyone! It’s important not to pathologize diversity preferences. We only treat people who are distressed by this experience.

For some vulva owners, this condition can be frustrating as orgasms aren’t paired with a physical marker (semen) like they are with most penis owners. This is because when the majority of penis owners orgasm, they ejaculate simultaneously and at that point they can be fairly certain what they’ve experienced is an orgasm. Vulva owners on the other hand don’t have this kind of visible marker, which adds an element of ambiguity that can leave each sexual experience open to interpretation.

Vulva orgasms also occur on a continuum. That is, orgasms can sometimes feel robust and powerful and at other times dull and weak. This fluctuation between each sexual experience also leaves room for some confusion as many aren’t sure if what they’ve experienced is actually an orgasm or not. Does this sound familiar? You might have had a time when you think you have orgasmed, but on second thought you aren’t completely sure. In these circumstances it’s possible that you did have one. Just one that occurred on the weaker end of the spectrum.

In relation to causal factors, there are many reasons that can underlie a condition like Anorgasmia. It can be caused by physiological, psychological, social, or cultural factors.

On a physical and biological level, these factors might be:

Chronic illnesses such as diabetes, MS, urinary incontinence, fibromyalgia, vascular disease, hypothalamic-pituitary disorders or arthritis.
Genital surgery or trauma
Hormonal issues such as thyroid disease, low testosterone or diminished oestrogen
Age
Medications such as SSRIs and antihypertensives

On a psychological, social, and cultural level, these can include:

Anxiety
Depression
Fatigue
Body image issues
Sexual inexperience
Ineffective sexual communication
Past trauma
Performance anxiety
A partner’s sexual dysfunction

To overcome anorgasmia, there are a number of treatment options available to suit your needs. Did you know that our brain is the body’s most important sexual organ? At SHIPS, we treat clients from a psychological perspective and use evidence-based approaches such as CBT, sensate focus (a program based on gradual exposure to tactile stimulation), and directed masturbation (a treatment program based on genital exploration and gradual exposure to sexual self-touch).

Other factors to help those with anorgasmia are increasing ones comfort with vulnerability, boosting their sexual desire, exploring sexual positions that enhance control and stimulation during solo and partnered sex, and developing communication skills with sexual partners. Another approach is to work on accepting one’s lack of orgasm and to promote less goal-oriented and more pleasure-focused sex. So that orgasms aren’t the focus, instead maximising pleasure is. And who doesn’t love pleasure!?

Overall, anorgasmia is common among vulva owners and if you’re experiencing it you don’t have to suffer in silence. It’s important to note that many people choose not to have orgasms or are completely comfortable with their inability to do so - if this sounds like you then great job, keep doing your thing! However, if you’d like to overcome anorgasmia or work on accepting it, there are treatment options available for you. A great place to start is to book in with one of our practitioners who can support and guide you throughout the process.