Anorgasmia is delayed, infrequent or absent orgasms — or significantly less-intense orgasms — after sexual arousal and adequate sexual stimulation. Women who have problems with orgasms and who feel significant distress about those problems may be diagnosed with anorgasmia.
Among all women, the frequency and intensity of orgasms vary. Also, for any individual, orgasms can be different from one time to the next. The type and amount of stimulation needed to have an orgasm also varies.
Multiple factors may lead to anorgasmia. These include relationship or intimacy issues, cultural factors, physical or medical conditions, and medications. Treatments can include education about sexual stimulation, sexual enhancement devices, individual or couple therapy, and medications.
Female orgasmic disorder is another term for the spectrum of problems with orgasms. The word "anorgasmia" specifically refers to not being able to have an orgasm, but it's also used as shorthand for female orgasmic disorders.
An orgasm is a peak feeling of intense pleasure in response to stimulating sexual activity.
Vaginal penetration during sex indirectly stimulates the clitoris. But this may not be enough stimulation for orgasm. Many women may also need direct manual or oral stimulation of the clitoris to reach orgasm.
Anorgasmia, or female orgasmic disorder, is defined as experiencing any of these in a significant way:
Anorgasmia can also be:
Women who don't always reach orgasm during sexual encounters may not find it distressing. In that case, the lack of an orgasm is not considered a disorder.
Talk to your health care provider if you have concerns about your sex life, especially if you're concerned about your ability to have an orgasm.
Sexual arousal and orgasms are complex reactions to various physical, emotional, sensory and psychological factors. Difficulties in any of these areas can affect your ability to have an orgasm.
Past experiences, behaviors, background or mental well-being may contribute to problems with orgasms. These include:
Problems with your sex partner may be contributing factors to problems with orgasms. These may include:
A wide range of illnesses, physical changes and medications can interfere with orgasms:
Women experiencing anorgasmia may have one or more related sexual problems. These may contribute to or complicate the problem with having orgasms. These conditions include:
Your primary care provider or gynecologist will review your medical history and conduct a general medical exam and pelvic exam. These exams may identify physical conditions that contribute to problems having orgasms.
Your provider may ask you questions about your experiences with orgasms and other related issues. You may also receive a questionnaire to fill out that answers these questions. You may be asked about:
Your provider may want to talk with both you and your partner or meet with your partner separately.
Treatment for anorgasmia depends on what's contributing to the problem. Possible treatments include lifestyle changes, therapy and medication. If an underlying medical condition is contributing to anorgasmia, your provider will recommend appropriate treatment.
Treatment for anorgasmia usually begins with one or more approaches to understand your body better, learn what works for you and change behaviors. These treatments may include:
Although some medications have been tested for treating anorgasmia, there's not enough evidence to support their use. Hormone replacement therapies may have some benefit, but they have risks that require careful monitoring. These include:
Natural products, such as those made with L-arginine or Russian olive tree extract, are marketed for improving women's sex lives. They have been studied in very small trials using multiple herbal products or combined with other drugs or lifestyle management programs. There isn't enough data to know if they have any treatment effect.
Talk with your provider before trying natural therapies, which can cause side effects and interact with other medications.
If your lack of orgasm from sexual activity distresses you, make an appointment with your primary care provider or your gynecologist. Here's some information to help you prepare for your appointment.
Make a list of the following items that are important to share with your provider:
In addition to the information you prepare, your health care provider will likely ask questions to understand your sexual experiences, your ability to reach orgasm and your thoughts about your sexual relationship. You might think about answers to the following questions: