Female Anorgasmia…Why Can’t I Orgasm?!

In my last article, I spoke about female sexual dysfunction (FSD). During this, I mentioned types of FSD, including difficulty in achieving orgasm. Female Orgasmic Disorder (FOD) or female anorgasmia, is a condition where there is a complete absence or markedly decreased intensity or frequency of orgasm after a sexual arousal/foreplay phase. This can happen on all or almost all sexual encounters for at least 6 months leading to great distress to a female. The female orgasm results from a complex interaction of biological, physiological, and cultural processes. Imbalances in either may affect a woman’s ability to orgasm.

Here are some of the types of Anorgasmia:

  1. Lifelong

   Never experienced orgasm before

  1. Acquired:

    Had previous experience of orgasms and now having difficulty achieving one

  1. Generalized

   Having difficulty experiencing orgasm regardless of the type of stimulation,    

   situation, or partner

  1. Situational: Experiencing difficulties with orgasm only with certain types of stimulation, situations, or partners

The reason behind Female Orgasmic Disorder (FOD) is usually multifactorial. Patients often present with multiple underlying issues that need to be addressed first by a doctor. Here are some examples that may lead to FOD.

  1. Medical Problems

Underlying medical conditions are known to have a negative impact on both psychological and physical health that often interferes with orgasm. Diseases such as Diabetes Mellitus, Atherosclerosis, Heart disease, Stroke, and Multiple sclerosis have been associated with orgasm difficulties.

  1. Psychological Concerns

Shame, guilt, or anxiety around sexual activity, body image issues, or a history of trauma also contribute to FOD. Mental health issues such as depression and anxiety can also lead to difficulty in achieving an orgasm.

  1. Substance Use

Consuming too much alcohol, cigarettes, and recreational drugs interferes with the body’s process of orgasm by impacting neurological function or blood flow to the genitals.

  1. Medication Side Effects

Many medications have the side effect of reduced libido. Antidepressants, antipsychotics, antihistamines, and blood pressure medications have been shown to reduce the ability to achieve orgasm.

  1. Aging

Anatomical and hormonal shifts through pregnancy, childbirth, and lactation may impact the ability to orgasm. Reduction in estrogen levels during perimenopause and menopause decreases blood flow to the genitals and may contribute to FOD.

How to get help for Female Orgasmic Disorder

If you think you’re suffering from FOD, the first step would be to seek help from a healthcare professional. During the visit to a doctor, a medical examination, which includes a pelvic exam will be performed. This is to help rule out any anatomical reasons for your lack of orgasm. Your doctor will also take a detailed medical and social history to explore possible causes and to help understand you better.


In general, sex therapy for FOD focuses on promoting healthy changes in sexually relevant thoughts, decreasing anxiety, and increasing orgasmic ability and satisfaction. Sex education and communication skills training is often included as adjuncts to treatment. Lifestyle changes, estrogen therapy, medication adjustments, physical therapy, and addressing underlying medical conditions are some of the treatments used for FOD.

Two of the newer kids on the block known as the ‘O-shot’ and ‘Shock-wave therapy’ can also be used together to help individuals with FOD. The O-Shot is a non-invasive treatment using an individual’s own platelet-rich plasma. It has been shown to increase the ability to have a vaginal orgasm and increased sexual arousal. ‘Shock-wave therapy’ is a low-intensity shock wave treatment that is non-invasive and helps stimulates tissue repair and cellular regeneration. Which in turn increases the ability to have stronger and more frequent vaginal orgasms.

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