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Disease: Anorgasmia Anorgasmia
Category: Sexual diseases
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Disease Definition:

Anorgasmia, which is the medical term for difficulty reaching orgasm after ample sexual stimulation, is a very common occurrence that causes women personal distress.

An orgasm is a feeling of intense physical pleasure and release of tension, accompanied by involuntary, rhythmic contractions of the pelvic floor muscles.
Some women feel pelvic contractions or a quivering of the uterus during orgasm, while others don’t.
Orgasm is sometimes described as a tingle, and other times as fireworks all over the body.

Orgasms usually change with age, medications or medical issues, and it varies in intensity, frequency and the amount of stimulation necessary to trigger it.   
In case a person is concerned about the intensity or lack of orgasm, lifestyle changes or sex therapy may help them.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Long delays in reaching orgasm or not reaching it at all are the main symptoms of anorgasmia. Anorgasmia has different types, including:


  • Primary anorgasmia is when a person has never experienced an orgasm.
  • Secondary anorgasmia is when a person used to have orgasms, but now is experiencing difficulty reaching climax.
  • Situational anorgasmia is when a woman orgasms only during certain situations.


Orgasm is not a simple thing, rather it is a complex reaction to many emotional, psychological and physical factors, and if a woman is experiencing problems in any of these areas, her ability to orgasm will be affected.

Some physical changes, illnesses and medications interfere with orgasm, such as:

Medical Diseases:
Diabetes, multiple sclerosis (a neurological disease), cancer surgeries or gynecological surgeries, such as hysterectomy, could affect a person's ability to orgasm. Painful intercourse is another sexual problem that can cause anorgasmia.

Blood pressure medications, antihistamines and antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) as well as other prescription and over-the-counter medications can interfere with orgasm. In men, SSRIs can result in both inability to obtain an adequate erection for satisfactory sexual activity (erectile dysfunction) and anorgasmia.

Alcohol and Drugs:
Drugs or too much alcohol can hamper a person's ability to climax.

Aging Process:
Women's sexuality can be affected as they age by normal changes in their anatomy, neurological system, circulatory system and hormones. During the transition to menopause the estrogen levels drop. This dropping can reduce sensations in the clitoris, skin and nipples and impede blood flow to the vagina and clitoris, delaying orgasm or stopping it entirely. Anorgasmia isn’t limited to older women, and many say that sex becomes more satisfying with age.

Psychological Causes:
There are many psychological factors that play a role in a woman's ability to orgasm, some of them are:


  • Stress and financial pressures
  • Cultural and religious beliefs
  • Guilt about enjoying sexual experiences
  • Mental health problems, such as anxiety or depression
  • Fear of pregnancy or sexually transmitted diseases
  • Performance anxiety
  • Embarrassment
  • Relationship issues

Most of the couples who experience problems outside the bedroom will also experience problems in the bedroom. These issues may include:


  • Infidelity or breach of trust
  • Unresolved conflicts or fights
  • Lack of connection with the partner
  • Poor communication of sexual needs and preferences





Usually, treatment of this disorder depends on the underlying cause of the symptoms and it can be difficult to treat anorgasmia. Someone with anorgasmia may be recommended a combination of these tactics:

Understanding their own body better:
If a person needs a reminder course on their genital anatomy, they could ask their doctor for a diagram or they can explore it themselves with a mirror.

Lifestyle changes and therapy:
It is very important to address everyday stressors and relationship issues, because for most women, treatment includes more than medication.

Increasing sexual stimulation:
Most women need either direct or indirect stimulation of the clitoris in order to orgasm and those who haven’t had an orgasm aren’t getting enough effective sexual stimulation. To produce more clitoral stimulation during intercourse, a woman can try switching sexual positions. There are some positions that allow a woman or her partner to gently touch her clitoris during sex.

Couples counseling:
Conflicts and disagreements in the relationship can zap your ability to orgasm. A counselor can help the couple work through disagreements and tensions and get their sex life back on track.

Sex therapy:
Sex therapists can be very helpful in treating anorgasmia because they are therapists who specialize in treating sexual problems. Therapy often includes sex education, help with communication skills, and behavioral exercises that a person and their partner try at home.
A woman and her partner may learn how to combine a situation that allows her to achieve orgasm  ــsuch as clitoral stimulation ــ with a situation in which she wants to achieve orgasm, such as intercourse. She may also be asked to practice “sensate focus” exercises, which are a specific set of body-touching exercises that teach her how to pleasure and touch her partner without worrying about orgasm. With these techniques, a person will learn that orgasm is not the goal of every sexual encounter; rather it is one pleasurable part of sexual intimacy.

Medical treatments:
Although hormone therapies can help in anorgasmia, they aren’t a guaranteed fix.

Treating underlying conditions:
In case a medical condition is hindering a person's ability to orgasm, treating it may end their problem; also, modifying or changing medications that inhibit orgasm could eliminate their symptoms.

Estrogen therapy:
Local estrogen therapy in the form of a vaginal cream or a slow-releasing suppository or ring that can be placed in the vagina can increase blood flow to the vagina which helps improve desire. There is also systemic estrogen therapy by pill, gel or patch, which can have a positive effect on brain function and mood factors that affect sexual response. A person may also be prescribed a combination of estrogen and progesterone.

Herbal supplements:
Herbal lubricants, such as Zestra, help warm the clitoris and increase sexual arousal and orgasm.

Testosterone therapy:
Testosterone, which is a male hormone, plays a crucial role in female sexual function even though it occurs in much lower levels in women. In case estrogen and progesterone aren’t helping, testosterone may help increase orgasm. But this treatment is not approved by the Food and Drug Administration (FDA) for sexual dysfunction in women and still remains controversial. In case a woman chooses this therapy, her symptoms and blood levels will be closely monitored to make sure she doesn't experience negative side effects, such as acne, excess body hair (hirsutism) and personality or mood changes. This therapy seems to work best for women with low testosterone levels as a result of surgical removal of the ovaries (oophorectomy).


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