‘Help! My orgasm is missing!’ Anorgasmia — sexual health and climax issues
Is your ‘Big O’ more of a ‘Big ‘no’? The inability to climax with or without sex could be hiding something more serious
Text: Jo
Some women claim to achieve orgasm only through sex. Others have to be relaxed and alone to climax. There are those who require the stimulation of a sex toy. And as for the ones who claim to feel fireworks during a simple foot massage — lucky them! What we rarely hear about, however, is anorgasmia in women — when a female cannot climax at all.
We know that everybody is different when it comes to the female orgasm. Indeed, some women don’t need to have an orgasm to feel satisfied and consider sex without climaxing — or even no sex at all — just fine. What’s important is understanding your body, feeling comfortable, and that all sexual shenanigans are 100% consensual. If you are happy and satisfied with your orgasm quota, then yay you. But if you are a woman who has never experienced female orgasm, or it has gone AWOL in the past few months and is causing personal distress, read on to discover the mental health impact of anorgasmia in women and the potential underlying physical health causes.
Come again?
According to Dr Rebecca Daly, a doctor specialising in women’s health and sexual health at the International Medical Clinic (IMC) in Katong, “Anorgasmia is the medical term that describes difficulty reaching an orgasm after sexual stimulation. It can be lifelong anorgasmia whereby you have never experienced an orgasm, or it may be a recent problem occurring only in the last few months. Some women suffer with situational anorgasmia, when you can only reach orgasm during certain sexual situations or with certain partners. To make a formal diagnosis, symptoms must be present for at least 75% of the time and causing significant personal torment.”
Interestingly, Dr Daly reveals that up to 25% of women suffer with anorgasmia at some point in their life. Yet the subject of anti-climax sex is never spoken about despite being a catalyst for feelings such as low self-esteem, inadequacy and potentially depression.
But why?
While a stack of washing up, your partner’s socks on the floor, and a failure to notice your new haircut are undoubtedly going to put a dampener on anyone’s sexy-time, it could be more likely that anorgasmia in women is the result of one of the wide ranges of illness or medications that have been proven to affect the ability to climax.
“Chronic illnesses such as diabetes and multiple sclerosis can affect the nerves involved in sexual response,” explains Dr Daly. “Gynaecological conditions that have resulted in painful sex can also contribute, even after the original condition has been managed. Examples include pelvic surgery, radiotherapy for cancers, vaginal dryness due to the menopause, trauma from a difficult birth, or painful sex from endometriosis.”
Medication can also be a factor, with antidepressants known as SSRIs a common culprit, causing anorgasmia in a surprising 40% of patients. “However,” warns Dr Daly, “in the large majority of patients there will be an underlying psychological cause. Anxiety and depression, stress, relationship difficulties, shame or fear regarding sex, or previous sexual abuse can contribute to the problem.”
What to do?
First, get real about your ‘sexpectations’. In our highly sexualised world, and due to the porn industry, we forget that most people are not having the earth-shattering sex often portrayed in films (we’re talking about you, Bridgerton). In fact, only 18% of women climax with vaginal penetration alone.
Dr Daly recommends getting in touch with your sexual side. “Take a handheld mirror to explore your body. Experiment with masturbation or some audio erotica to discover what you like within the privacy of your own body and mind. Relaxation techniques can help reduce underlying worry and allow women to feel more at ease,” says Dr Daly.
Then you need to be open with your partner. “If it’s considered a problem, anorgasmia in women often causes a knock-on effect to the partner, and in turn, the relationship,” Dr Daly continues, “Some women may harbor feelings of guilt and then the pressure put onto you to climax can exacerbate the issue. It’s important to discuss what you enjoy and what may stop you from relaxing during sex with your partner.”
Who to talk to?
Seeing a doctor may fill you with fear, but it would be helpful (and remember, there is nothing a doctor has not heard before). They may start by asking questions regarding how long your orgasm has been missing, if it occurs all the time or only in certain situations, what you have tried so far, and what your underlying beliefs might be regarding the cause. You’ll also need to talk about your general health (such as any medication you take) and sexual and gynaecological health, especially any vulval or pelvic pain. The doctor will also explore your mental wellbeing and screen for any mood disorders. In some cases, oestrogen therapy may be appropriate.
Couples counselling may be a good idea if there are any relationship issues. Psychosexual counsellors use talking therapies, which help you and your partner to understand more about your needs. Away from the couples thing, cognitive behavioural therapy (CBT) can also challenge underlying ideas or negative thoughts you may have regarding sex and being intimate, allowing you to relax more.
For a list of trained counsellors and therapists in Singapore, log on here.
About Dr Rebecca Daly
Dr Rebecca Daly is a UK-trained doctor based at the International Medical Clinic (IMC) Katong. She has an interest in women’s health and sexual health, having completed the Diploma of Obstetrics and Gynaecology (UK) in 2006 and the Diploma of Sexual and Reproductive Health (UK) 2009.
