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Anorgasmia in Women (Absent or Weak Orgasm) - Symptoms & Causes

Reviewed by Dr. Barb DePree, MD

If you’ve never had an orgasm, or have stopped having them, you are in good company: Women who enjoy sex, love their partners, and wonder, as you might, why not me?

An orgasm is simply this: intense pleasure and release of muscular tension, along with involuntary contractions of your pelvic floor muscles. Some orgasms are deep, muscular, exhausting. Most can be described as fluttering, ticklish, even energizing. However you experience it, an orgasm can increase blood flow to vital organs, release healthy neurochemicals in our brains, and relax us. Midlife women can use more of all of that.

What Causes Absent or Weak Organisms?

anorgasmia in women

Normal Aging Process

Normal aging of our genital tissues usually slows our response rate. We can still achieve orgasm, it just takes more stimulation—perhaps with lubricants, warming oils, or more time. To counter the effects time has brought, try these simplest actions:

  • Use a vaginal lubricant
  • Use a personal vibrator
  • Do Kegel exercises
  • Use a warming lubricant
  • Self-stimulation

Changes in Hormones

Changes in hormone levels also affect orgasm. The drop in estrogen means a drop in both sexual desire and response that can make it more difficult for us to experience orgasm, though sexual pleasure may still be intact. The drop in testosterone, particularly for women in surgical menopause but for all women over time, can affect sexual desire and drive. In our experience, testosterone supplementation does help restore sexual responsiveness for about half of our patients who try it. If you suspect that hormone levels are having a negative effect on your orgasms, review these actions:

Illnesses and Medications

Many illnesses, disabilities, and medications (both over-the-counter and prescription) can weaken or extinguish orgasm, as can street drugs and alcohol. In particular, treatments for pain and depression, diabetes, and any neurological diseases can dampen sexual response. Share your concerns about diminishing sexual response with the physicians who are treating you.

If you have never experienced an orgasm, please don’t consider yourself a sexual failure. Many of us enjoy sex and find it satisfying without orgasm. On the other hand, it’s never too late to try. We can relearn our bodies—and set new goals—as we change.

Learn about the actions you could take, listed at right, to address this condition or see other conditions that could affect you.

What Can You Do About It?

1. Identify the Underlying Cause

Anorgasmia can result from psychological, medical, hormonal, or relationship factors. Identifying the root cause is key to finding the right solution.

  • Medical conditions: Diabetes, multiple sclerosis, pelvic floor dysfunction, and hormonal imbalances (e.g., menopause, low estrogen or testosterone) can contribute.

  • Medications: Antidepressants (SSRIs), birth control pills, and blood pressure medications can affect libido and orgasm.

  • Psychological factors: Stress, anxiety, depression, past trauma, or body image issues can all play a role.

  • Relationship dynamics: Communication issues, lack of intimacy, or unaddressed emotional conflicts may hinder orgasm.

2. Address Psychological and Emotional Factors

  • Therapy: Working with a sex therapist or psychologist can help address underlying emotional barriers, trauma, or anxiety related to intimacy.

  • Mindfulness and Relaxation: Practicing mindfulness, meditation, or guided relaxation techniques can improve body awareness and reduce stress.

  • Cognitive-Behavioral Therapy (CBT): This can help reframe negative thoughts about sex and improve overall sexual response.

3. Improve Sexual Communication

  • Talk to Your Partner: Open discussions about needs, desires, and preferences can enhance intimacy and sexual satisfaction.

  • Experiment with Different Stimulation: Clitoral stimulation, vibrators, different positions, or trying new sensations may help identify what feels best.

4. Explore Pelvic Floor Therapy

  • Kegel Exercises: Strengthening pelvic floor muscles can enhance sexual response and orgasm intensity.

  • Pelvic Physical Therapy: If pelvic tension or dysfunction is a concern, a physical therapist can help with exercises, biofeedback, or manual therapy.

  • Vaginal Dilators: If discomfort or tightness is an issue, dilators can help improve muscle relaxation and increase comfort.

5. Consider Medical and Hormonal Treatments

  • Hormone Therapy: If hormonal imbalances are contributing (e.g., low estrogen, low testosterone), a doctor may suggest hormone therapy.

  • Lubricants and Arousal Gels: Using lubricants or arousal-enhancing gels can increase sensitivity and pleasure.

  • Medications: In some cases, doctors may prescribe medications like bupropion (Wellbutrin) or flibanserin (Addyi) to help improve sexual function.

6. Engage in Sensate Focus Exercises

  • Sensate Focus Therapy: A guided touch-based therapy that helps couples or individuals focus on pleasurable sensations without the pressure to orgasm.

7. Lifestyle and Self-Care

  • Regular Exercise: Improves blood flow, boosts endorphins, and enhances sexual well-being.

  • Healthy Diet: Nutrients like zinc, omega-3s, and antioxidants can support sexual function.

  • Reduce Stress: Managing daily stress through yoga, deep breathing, or relaxation exercises can improve overall sexual response.

8. Seek Professional Help

If anorgasmia persists, consulting a gynecologist, sex therapist, or endocrinologist can help rule out medical causes and provide tailored solutions.