Weak or Absent Orgasm

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.

Normal aging of our genital tissues usually slows our response rate. We can still achieve orgasm, it just takes more stimulation—perhaps with lubricantswarming oils, and vibrators—or more time.

Changes in hormone levels also affect orgasm. The drop ipensive womann 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.

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.