Anorgasmia is when an orgasm is absent, delayed, infrequent or lacks intensity despite being aroused. This disorder causes distress and affects your sexual relationships. Several medical, physical and psychological factors play a role in causing it.
Anorgasmia is when a person has difficulty or can’t orgasm even if they’re enjoying sex and it feels good to them. It also describes orgasms that aren’t as strong or don’t happen as frequently as you’d like. It’s a form of sexual dysfunction that affects all genders. It can take a toll on your mental health, causing distress and anxiety, and can even interfere your relationships. Anorgasmia is also called orgasmic dysfunction.
Orgasms (also called sexual climaxing) are feelings of pleasure or sexual excitement that occur after being aroused. It may feel like a release and involve bodily movements beyond your control. They can vary in duration and intensity. Some people need more sexual stimulation to have an orgasm, while others need less.
With anorgasmia, you can still have a desire for sex and feel pleasure. However, you may feel anguish or emotional distress because you can’t have an orgasm. Your healthcare provider can help determine the cause of anorgasmia and recommend treatment.
Anorgasmia in women or people assigned female at birth (also called female orgasmic disorder) is classified into four types:
Problems with orgasm increase as you age, but it can affect people of any age. Up to 15% of women or people AFAB report never having an orgasm.
Healthcare providers often classify anorgasmia in men or people assigned male at birth (AMAB) as a type of sexual dysfunction called delayed ejaculation or inhibited ejaculation. This causes problems with sexual performance and pleasure, often leading to anxiety and avoiding sex. Anorgasmia in men has two types:
Ejaculation is a complex process that involves hormones, nerves and organs, as well as your mental state. A disruption in any part of this process can interfere with your ability to orgasm. Certain medical conditions can also impact orgasm.
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Anorgasmia can affect anyone. It’s most common after menopause in women or people AFAB.
The main symptom of anorgasmia is not reaching sexual climax (orgasm). Other symptoms are delayed climaxing (it takes a long time to orgasm) or not feeling fulfillment from sexual climax.
Many factors can make reaching orgasm difficult. These factors can be physical, mental, emotional or medical (related to a disease or condition). In many cases, a combination of factors make orgasm difficult, and sometimes it’s hard to determine the root cause(s).
Low testosterone may affect the ability to orgasm in men or people assigned male at birth (AMAB). It often has connections with erectile dysfunction, delayed ejaculation or similar problems. Other hormones, such as prolactin, can also affect sexual function in people who have a penis.
Yes, many SSRIs (selective serotonin reuptake inhibitors), often used to treat depression or anxiety, can affect sexual function. If you’re taking this kind of medication, talk to your healthcare provider about your symptoms and discuss alternative medications. Some SSRIs are less likely to cause anorgasmia, and there are other types of antidepressants that may help also.
In addition to SSRIs, other medications may affect your ability to orgasm. Some examples of these are:
Your healthcare provider can diagnose anorgasmia based on your symptoms and a discussion about your sexual history. This discussion could shed light on reasons or underlying causes for sexual dysfunction. They may also perform an exam or tests like ultrasound or blood tests to check for underlying hormonal or medical conditions that could be part of the problem. Your provider may suggest a penile sensitivity test if that’s a suspected factor.
Once an underlying cause is determined, many options are available to treat anorgasmia. Your provider may also refer you to a specialist (such as a gynecologist or urologist) who can help develop a treatment plan that addresses orgasmic disorders.
It depends on the underlying cause. There’s no one method that fits all cases, and treatment may involve a combination of approaches. Some treatments for anorgasmia include:
It depends on the cause. In the case of sex therapy or couples counseling, it may take several months to reach a point where orgasm feels possible. If medications are the likely cause, you have to allow time for the medication to leave your system (which could take weeks). The good news is that most people can orgasm again with proper treatment.
Anorgasmia can’t be prevented, but dealing with the cause of the orgasmic dysfunction can help you cope with the problem. Some of these general recommendations may help:
It’s common for people with this to feel embarrassed, shy or ashamed. If you feel this way, tell your healthcare provider. They can help you understand that this isn’t a rare problem or a cause for shame. They can also help you find resources or specialist experts with specific training and experience in treating sexual dysfunction and related issues.
Anorgasmia can be upsetting and frustrating. It can impact intimacy with your partner and affect your self-esteem. It’s also extremely unlikely that you can solve this problem without proper medical care or guidance. Your healthcare provider can help you with anorgasmia so you can enjoy a fulfilling sex life.
Talk to your healthcare provider if you have any concerns about your ability to orgasm. They can help you figure out why having an orgasm is difficult and find a solution to your problem. Be open with your provider about your sexual and medical history, including your relationship with your partner. Don’t be afraid or embarrassed to seek treatment. It’s the best way to get to the root of the problem and enjoy pleasurable sex.
A note from Cleveland Clinic
Being unable to orgasm can be frustrating and upsetting. You’re not alone — many people seek treatment for orgasmic dysfunction. It’s nothing to be ashamed about. Your healthcare provider can help determine why you’re struggling and discuss potential solutions. This may mean talking to a counselor or sex therapist, or changing medications. With the right treatment, you can enjoy sex — and all the physical and emotional benefits — without worrying about reaching orgasm.
Last reviewed by a Cleveland Clinic medical professional on 01/23/2023.
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