Learning how to cope with female orgasmic disorder

Medically reviewed by Andrea Brant
Updated March 14, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Many women may see the inability to orgasm as a cause for concern for their personal and sexual health. However, it could be a sign of female orgasmic disorder—a condition that may cause difficulty in reaching orgasm for some women. If you experience difficulty climaxing, it can be helpful to remember that you’re not alone—and that help can be available. 

Read on to learn about female orgasmic disorder, possible diagnostic and treatment options and tips to live with this medical condition. 

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Do you struggle to achieve orgasm during sex?

What is female orgasmic disorder?

Female orgasmic disorder (FOD), or anorgasmia, is generally defined by one’s difficulty in achieving orgasm following typical sexual arousal. It can be diagnostically characterized by a persistent or recurrent delay or absence of orgasm for at least six months, and it’s generally estimated to affect at least 75% of female sexual experiences.  Anorgasmia can significantly impact a person’s overall quality of life and well-being.  

How can anorgasmia affect your sex life?

If you are experiencing sexual arousal and have no way to relieve it, the situation can feel overwhelming or distressing. The inability to reach orgasm can also cause concern in your relationships, possibly prompting feelings of frustration, dissatisfaction or inadequacy.  If you are concerned about the frequency and intensity of your orgasms, speaking to your healthcare provider or sex therapist can be a helpful first step, as they can help you to evaluate your case and determine the best possible step forward for you.

How is female orgasmic disorder diagnosed?

Diagnosing anorgasmia may involve an appointment with your primary care provider or gynecologist, in which your medical history might be reviewed. You may undergo a general medical and pelvic exam, which could help identify other medical conditions that could contribute to the orgasm interference. At this appointment, you may be requested to  answer questions about your experiences with sexual desire, orgasms and other related subjects over at least the past six months. Preparing in advance can help you to feel calmer and ready for your appointment as it occurs. 

Anorgasmia symptoms

While there can be a range of symptoms that can be related to anorgasmia, there are also some that are more commonly experienced by many. Acknowledging these can help to promote empathy and understanding at a societal level that can validate the experiences of those living with the condition. The Mayo Clinic generally defines female orgasmic disorder as experiencing any of the following symptoms in a persistent or recurring way:

  • Delayed Orgasm: It may take a long time to achieve orgasm.
  • Absent Orgasm: You may not be able to orgasm at all. 
  • Fewer Orgasms: The orgasms you experience may be less intense than expected. 
  • Less Intense Orgasms: You may have fewer orgasms than you anticipate based on your prior experiences. 
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Exploring possible types of female orgasmic disorder

While the frequency and intensity of orgasms can vary significantly with any sexual encounter or partner, anorgasmia can also change its presentation per recent research from Mayo Clinic. The experts have determined that there are generally four main types of anorgasmia, such as: 

Lifelong anorgasmia 

With lifelong or primary anorgasmia, you might have never experienced an orgasm. 

Acquired anorgasmia 

Though you’ve experienced an orgasm before, you may have difficulty reaching that point. Acquired or secondary FOD can also involve new challenges with orgasms. You may previously have been able to achieve orgasm but might be having difficulty doing so again, which can be due to some change in your life—such as medication or traumatic events. 

Situational anorgasmia 

This type of anorgasmia generally means that you can orgasm, but only in certain situations or with specific stimulation. For example: You may only be able to orgasm through masturbation or oral sex. 

Generalized anorgasmia 

With this type of anorgasmia, you may experience a total inability to achieve orgasm—despite sufficient sexual stimulation and arousal. 

What causes anorgasmia?

For many people, the ability to achieve orgasm can depend on a complicated balance of mental, physical and emotional factors, according to a recent study. Trouble in any of these areas can cause anorgasmia, though this is by no means an exhaustive list. Symptoms can be as unique as the people they affect. 

We do want to note that some people can experience a complete lack of sexual desire or romantic feeling and may not be troubled by it. Asexuality is a valid sexual identity. This article’s scope focuses on those who wish to achieve orgasm and cannot. Additional research may be warranted for those who find themselves to be aromantic, asexual or within any scope or spectrum of these valid sexual identities. 

We’ve summarized possible contributing factors across the three main influences below:

Do you struggle to achieve orgasm during sex?

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Psychological factors

Sexual desire and arousal are generally thought to be complex reactions to various forms of stimulation. As sex can be an intensely mental activity for some, psychological factors may interfere. Examples of possible contributing psychological factors to anorgasmia can include: 

  • Mental health conditions like depression and anxiety disorders
  • A history of (and subsequent trauma from) emotional or sexual abuse
  • Stress brought on by stressors, such as bereavement or financial issues 
  • Poor self-esteem and body image
  • Embarrassment, guilt or other unhealthy feelings about sex
  • Negative religious or cultural beliefs about sex

Relationship factors

If you’re having trouble with your partner in other areas, it may be difficult to relax enough to reach orgasm. Possible relationship-rooted factors that may contribute to anorgasmia can include: 

  • Boredom with sexual activity in a relationship, or losing interest in the relationship itself
  • Embarrassment about asking for what you want sexually
  • A lack of emotional intimacy with your partner
  • Poor communication skills in expressing sexual needs and preferences
  • Infidelity or lack of trust in the sexual relationship 
  • Intimate partner violence or domestic abuse 
  • Sexual dysfunction in a partner (such as erectile dysfunction in males)

Physical factors

Sex can be physical for many. The condition of your body can impact how well you’re able to enjoy it and reach orgasm. We’ve compiled possible physical factors to anorgasmia below:   

  • Medical conditions, such as diabetes, polycystic ovarian syndrome (PCOS) or endometriosis
  • Advanced age
  • Gynecological surgeries (like a hysterectomy)
  • Physical symptoms of stress
  • Mental health conditions (such as depression or anxiety disorders)
  • Certain medications, such as SSRIs (selective serotonin reuptake inhibitors)

Treating anorgasmia

The treatment for FOD might depend on what caused the problem. If there are underlying medical issues, they may need to be treated. Generally, treatment plans for female anorgasmia might include lifestyle changes, therapy and medication. Speaking with a clinician can give you valuable insight on what next steps may be most appropriate for your specific experience. 

Tips to live well with female orgasmic disorder

Treatment options and supportive strategies to help someone live well with anorgasmia may include one or more of the following approaches:

Ongoing education

You may benefit from learning about your body, what you like, and how to explain your needs to your partner. 

Cognitive behavioral therapy

This can provide value in either an individual or couple’s setting. It can help you shift your perspective and mindset about sex, promote positive sexual relations in your relationship, and support you in developing coping skills to manage stress that can affect anorgasmia. 

Sensate touch

This type of sensual focus generally starts with non-erotic touch during at-home instruction to teach you and your partner how to touch each other. It then works up to sexual stimulation. The goal of this type of touch is to teach partners to understand each other’s needs, encouraging them to communicate emotional and sexual desires to one another. 

Directed masturbation

With this method, you can use a program of at-home exercises to help you become familiar with your body during self-directed sexual stimulation. You might use this as an opportunity to learn what you like, possibly empowering you to communicate it to your partner.

Use of sex toys

Sexual enhancement devices or “toys” can introduce additional stimulation that can help you to achieve orgasm. For example, certain devices are explicitly designed for clitoral stimulation, which can be a pleasurable accompaniment during masturbation or partnered intercourse. 

New sexual positions

Some sexual positions may stimulate the clitoris or other pleasurable areas more than others. Your sex therapist or healthcare provider can recommend certain positions that may be more pleasurable for you and that may help you to achieve orgasm. 

Non-sexual methods of support for your experiences with anorgasmia can include: 

Working towards acceptance

It can be understandable that you may struggle to accept that anorgasmia is part of your life. However, once you accept that this condition is confirmed, you can begin to work toward solutions and ways to live well despite the condition.

Talking to your partner

Communication can be an important part of any treatment plan for sexual disorders. Your partner may appreciate this if the inability to give you an orgasm has been weighing on them, and they might be eager to help you explore solutions. While the conversation can feel awkward to approach, the potential benefits can far outweigh the discomfort you may feel in the moment. You might consider express your feelings about your disorder and how you want to address it in the relationship or during sex. Additionally, you can explain how you want your partner to help, and eventually, you can speak about what can be done to make sex more pleasurable for you. 

Building up your sexual intelligence and literacy

If you’re living with anorgasmia, you may learn to identify what you want and build up the skill so you can direct your partner to provide the desired effect. 

Learning to enjoy sex (even without orgasms)

Being unable to orgasm can feel frustrating, but it doesn’t mean that sex can’t be enjoyable. You may find FOD isn’t quite as intimidating when you let it fade into the background, instead choosing to focus on the intimacy you share with your partner. 

Remembering that orgasms are possible

Being diagnosed with anorgasmia doesn’t mean you aren’t physically capable of orgasm ever—it may just simply mean that orgasm may look different for a time. You can plan for resiliency by getting into the right mindset and using the methods you know are practical. For example: If your partner cannot help you reach orgasm, you might try it on your own. It can be helpful to reduce your stress level and remember that orgasms can generally be possible, even if you have to achieve them using different strategies that don’t include certain sexual methods. 

How online therapy can help

Working with a licensed individual or couples’ therapist can help you work through underlying emotional and mental concerns that might be preventing your orgasms. Many people prefer online therapy through virtual platforms like BetterHelp to talk about such matters with discretion, as well as for the convenience of receiving treatment at home. They may also appreciate the increased flexibility in appointment scheduling, and the shorter-than-average wait times to connect with a professional.  

Is online therapy effective? 

A 2011 study published in the Journal of Sexual Medicine measured the effectiveness of online sex therapy for women experiencing sexual dysfunction. Experts found it was generally a suitable alternative to in-person treatments for many, with nearly all participants demonstrating an improvement in sexual and relationship function. 

Takeaway

Many people experience difficulty reaching orgasm—alone or with a partner. It can be a common problem for women worldwide. The information outlined in this article may make it easier to decide to speak with your partner or healthcare provider about female orgasmic disorder. Online therapy can also be a useful tool to reduce the emotional strain of living with orgasmic difficulty. BetterHelp can connect you with an online therapist in your area of need.
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