What Is Anorgasmia? Experts Explain Everything to Know About Difficulty Reaching Orgasm

What Is Anorgasmia?

There are few things more frustrating than being right there—and then…nothing. Or maybe you’re not even getting close, despite being turned on, enjoying yourself, and doing all the things that usually get you off. Despite what sex scenes and porn make it seem like, not orgasming is actually pretty common. Not entirely fun, but it happens.

But if difficulty reaching orgasm happens consistently and is causing you distress, you could be experiencing something called anorgasmia, explains Carolyn Wheeler, CEO and co-founder of Vella Bioscience. And while the name may sound intimidating, the term is pretty straightforward, even if the reasons behind it—and what to do about it—aren’t so much.

And it can often be hard to figure out WTF is going on if you’ve either A) never had an orgasm or B) usually get off pretty easily. How do you know whether you’re dealing with anorgasmia or just the occasional orgasm that refuses to cooperate? And more importantly, what can you actually do about it?

Ahead, experts explain what anorgasmia actually is, what can cause it, and what to do if orgasms have become frustratingly hard to come (heh) by.

Anorgasmia is the persistent or recurrent difficulty, delay, or inability to reach orgasm despite being aroused and receiving enough stimulation. And importantly, we’re not talking about a frustrating night here and there. For anorgasmia to be diagnosed, symptoms typically need to persist for at least six months and cause you distress, explains Roxanne Pero, MD, FACOG, an OB/GYN and member of O Positiv’s Medical Advisory Board.

Anorgasmia can also show up in different ways. It can be lifelong, meaning you’ve always or almost always had difficulty reaching orgasm, or used to orgasm and now struggle to. It can also be generalized, meaning orgasm is difficult regardless of the situation, partner, or type of stimulation, or situational, meaning you can orgasm under some circumstances but not others. For example, you might be able to get off easily when you masturbate but have trouble reaching orgasm with a partner.

One thing that doesn’t automatically qualify as anorgasmia? Not being able to orgasm from vaginal penetration alone. “The vast majority of women require direct or indirect clitoral stimulation to reach orgasm,” says Pero, adding that not climaxing through penetration alone is considered a normal variation of human sexuality.

In other words, needing clitoral stimulation to get off doesn’t mean there’s anything wrong with your ability to orgasm. It just means your clitoris would very much like to be included in the proceedings.

What Causes Anorgasmia?

Bad news: There’s no single cause of anorgasmia. In fact, orgasm involves a pretty complicated combination of your nervous system, blood flow, hormones, thoughts, emotions, and whatever is actually happening during sex, which means there can be multiple factors at play at once.

On the physical side, anything that affects your nerves, blood flow, hormones, or pelvic floor can potentially make orgasm more difficult, explains Melanie Eichhorn, sexologist and head of Sexual Education and Diversity at Satisfyer. That can include conditions like diabetes or multiple sclerosis, pelvic floor dysfunction, spinal cord injuries, and hormonal changes associated with menopause. Certain medications can also interfere with orgasm—particularly antidepressants like SSRIs and SNRIs, though some blood pressure medications, antipsychotics, mood stabilizers, and other drugs may play a role, too. If you notice orgasm becoming more difficult after starting or changing a medication, Eichhorn recommends talking to your prescriber rather than stopping or adjusting it on your own.

Then there’s everything happening in your brain and your relationship. Stress, anxiety, depression, performance pressure, body-image concerns, shame or guilt around sex, past sexual trauma, relationship conflict, and difficulty communicating what you want can all make it harder to reach orgasm. “When you're busy watching and judging yourself instead of feeling, your body has a hard time letting go,” Eichhorn says.

And sometimes? The explanation is much simpler: You’re just not getting the kind of stimulation you need to orgasm. Maybe there isn’t enough clitoral stimulation, you need more time to get fully aroused, or the pressure, rhythm, or type of touch that works for you isn’t happening. That doesn’t necessarily mean there’s something deeper going on—it may just mean the sex you’re having needs a little tweaking.

What Can You Do If You Can’t Orgasm?

First, try not to make having an orgasm your only goal. Easier said than done when the entire reason you’re reading this is because you can’t have one, we know. But putting pressure on yourself to climax can make it even harder to stay present and actually enjoy what’s happening.

Pay Attention to When You Can—and Can’t—Orgasm

Start by looking for patterns. Do you have trouble reaching orgasm all the time, or only in certain situations? Did something recently change? Can you orgasm when you masturbate but not with a partner?

If you can get off solo, Eichhorn recommends comparing what you do on your own with what happens during partnered sex. Think about the type of touch, pressure, rhythm, and stimulation you use when you masturbate, then consider how you might bring more of that into sex with a partner.

Experiment With What Actually Feels Good

If you’re not sure what gets you off yet, masturbation can give you space to figure it out without worrying about anyone else. Explore different kinds of touch, pressure, speeds, and stimulation, and yes, absolutely bring in a vibrator or another sex toy if you want to. For people with vulvas in particular, making clitoral stimulation a bigger part of the equation can make a major difference.

Once you know what works, communicate it. Tell your partner what you want, guide their hand, use a vibrator during partnered sex—whatever helps recreate the stimulation you know your body responds to. And give yourself enough time to actually get aroused instead of treating orgasm like something you need to hurry up and accomplish.

Get Some Backup If You Need It

If changing up your stimulation isn’t helping—or you suspect there’s something else contributing to the problem—you don’t have to troubleshoot it entirely on your own. Depending on what’s going on, support might involve talking with a gynecologist or urologist, reviewing medications with your prescriber, working with a pelvic floor physical therapist, or seeing a sex therapist or counselor.

The right approach ultimately depends on why orgasm is difficult for you, which is why figuring out what changed, when it happens, and what does or doesn’t work can be so useful.

When Should You Talk to a Doctor About Anorgasmia?

The short answer? Whenever it’s bothering you. You don’t need to wait until difficulty orgasming reaches some arbitrary level of seriousness before you’re allowed to ask for help. “There’s no such thing as too early,” says Eichhorn.

That said, it’s especially worth talking to a healthcare provider if your difficulty reaching orgasm persists, starts suddenly, coincides with a medication change, or happens alongside physical symptoms like pain or numbness.

As for who to call, it depends on what might be going on. A primary care provider, gynecologist, or urologist can help investigate potential physical causes or medication side effects, while a sex therapist may be helpful if stress, anxiety, past experiences, or relationship factors seem to be contributing. And if your provider brushes off your concerns? You’re allowed to find someone who won’t. Your sexual health is health, and you deserve to have it taken seriously.