Illustration by Marta Pucci

Anorgasmia: Orgasm Problems in Women

Photo of Dr Katherine Hertlein
Reviewed by Dr Laura Vowels, written by Blueheart
– published on May 16th, 2022


Difficulty orgasming is a common complaint, particularly among women. But with sufficient and effective stimulation, most people can have an orgasm.

  • A lack of sexual arousal is a common cause of orgasm difficulties.
  • Finding ways to relax and reduce anxiety will improve many cases of orgasm dysfunction.
  • Depending on the results of your Blueheart assessment, you will receive a specific orgasm problems course as part of your tailor-made therapy program.
  • Issues with orgasm can be caused by medical conditions but are more often a result of a psychological issue such as anxiety.
  • Sensate Focus can help to increase arousal and improve sexual function through touch exercises and mindfulness practices designed by sex therapists.
Dr Kat says: “So many people think that orgasm is the goal of sex, and that’s absolutely not true. When we think about treating orgasm difficulties, we’re really also treating the entire sexual experience to reduce the focus on orgasm and instead work on enhancing the intimacy and sense of togetherness throughout the sexual interaction.”

Difficulty orgasming may be a common complaint but that doesn't make it any easier if you or your partner are struggling with it. In fact, whether male or female, being unable to climax can lead to feelings of inadequacy that over time can impact confidence and even damage relationships.

The good news is, if you’re struggling to orgasm there are plenty of things you can do to try to resolve the situation and get back to enjoying a healthy sex life with your partner.

Illustration by Marta Pucci

Is it normal not to be able to climax?

A 2018 study published in the Archives of Sexual Behaviour found that there were differences between how frequently men and women orgasm. They reported that heterosexual men were most likely to say they usually-always experienced orgasm during sex (95%), followed by gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%), and heterosexual women (65%).
That’s a marked difference between heterosexual men and women.

And while difficulty orgasming is a common complaint, the fact is that with sufficient and effective stimulation most people can achieve orgasms. Believe it or not, both men and women are capable of achieving multiple orgasms.

In reality, though, it’s not always that easy and can be affected by many things, not least anxiety. If you’re feeling anxious about any kind of sexual dysfunction, the chance of reaching orgasm becomes even smaller as your fears fuel a vicious cycle. Add your partner’s feelings and expectations to the mix and you might find that orgasm becomes very difficult to achieve.

Is inability to orgasm generally a women’s problem?

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While difficulty orgasming (often termed ‘anorgasmia’) is often thought of as a women’s problem, orgasmic dysfunction or orgasm disorder can affect men, too. And in a surprising variety of ways.

There are many types of sexual dysfunction that might impact orgasm. For example, erectile dysfunction (impotence) making it difficult to maintain an erection firm enough to have sex.

Premature ejaculation resulting in ejaculation occurring too soon during sexual intercourse. Even retrograde ejaculation, where the semen enters the bladder instead of coming out of the penis.

But perhaps the most similar to female orgasmic disorder, and most relevant in this discussion, is a condition called delayed ejaculation. This is where, despite sexual stimulation, it takes a long time for a man to orgasm or may even prove impossible.

Illustration by Marta Pucci

What causes difficulty orgasming?

There are plenty of reasons you may find it difficult to orgasm during sexual intercourse. These issues may be temporary or longer-term but rest assured there are things you can do to improve matters.  So if you’re asking ‘why can’t I cum during sex?’ we may have some answers for you below.

Lack of sexual arousal

Sexual arousal is what happens when your body and mind get ready for a sexual experience. Your heart beats faster, your blood pressure rises, your genitals become lubricated and your skin flushes with increased blood flow. But what if you struggle to become aroused? A lack of arousal in women can happen for many reasons, both physical and psychological, and will likely lead to a less enjoyable experience and potentially discomfort or pain during sex and difficulty orgasming.

Lack of knowledge (leading to lack of stimulation)

When you lack sexual experience (and sometimes even when you don’t), the body of another person can feel like a difficult place to navigate. Without practice and communication with your partner, it’s almost impossible to know which areas to apply stimulation to and how firmly to press. Every body is different, after all.

In a 2017 study published in the Journal of Sex and Marital Therapy, researchers found that only 18% of women can orgasm from vaginal intercourse alone, with 36% saying they prefer clitoral stimulation. However, a 2019 YouGov study asking men and women to label parts of the female genitalia found that 29% of women and 31% of men did not know where the clitoris was. From our experience, that seems a little on the low side, but the point stands: learn about your own body as well as your partner’s body and then talk honestly about what you like and enjoy.

Poor communication

Whether it’s a communication issue within your relationship in general or simply a sticky spot when it comes to talking about sex, poor communication can lead to a disconnect.

Unresolved relationship issues can result in a sort of psychological resentment or emotional distance which can make a real difference when it comes to the desire to have sex, particularly for women. Focusing on sharing and communicating wants and needs can really help you to better understand one another and move forward in a fun and positive way.

A medical issue

There are a number of medical issues or health conditions - such as diabetes, depression, or certain vascular or hormone-related conditions - that can impact sexual function. Plus climax can be impacted by several drugs or medication side effects, most notably from Selective Serotonin Reuptake Inhibitors (SSRIs) a common type of antidepressants. Any physical issues that might make sex painful or reduce vaginal lubrication will likely also reduce the chance of reaching orgasm.

Despite this, studies suggest that in a vast number of cases, orgasm issues are due to psychological factors.

Relationship distress

It could be as a result of an extramarital affair. Or it could rear its ugly head after a period of poor communication, emotional disconnection and other insecurities. Either way, relationship distress can cause both psychological and physical issues for both parties involved. 

And when intimacy and connection wane as a result, so too can our ability to become aroused sexually and to achieve orgasm. As women, in particular, if we’re not feeling that bond it can be difficult to find the desire for intercourse.

Anxiety or spectatoring

When we struggle with negative thoughts around sexual performance, due to past experiences, a lack of self-confidence or self-esteem or poor body image for example. It can be difficult to focus on the moment and relax. Instead, you may find yourself over-thinking how you look or whether you’re doing things right, rather than noticing the pleasurable sensations and avoiding distraction. This is known as spectatoring and can lead to a build-up of anxiety around sexual activity making it less pleasurable or even painful.

Tiredness and stress

When your body is fatigued, it is designed to promote recovery, prioritizing its own health and wellness over sexual desire. That’s why in times of stress it’s common for your sex drive to lower and sex to become the last thing on your mind. After all, if you have a brain full of things you need to get done tomorrow, it will be almost impossible to have focused, fulfilling sex without distraction.

Illustration by Marta Pucci

What can you do?

Improving orgasm for both partners is about more than simply the physical aspects of sex, it’s about building an emotional connection, too. That’s why it’s important to work with your partner to explore and understand your sex life as a couple and learn to communicate honestly with each other – something which many people find hard when it comes to sex. Orgasmic disorder or sexual dysfunction in women may be common but you don't have to put up with it.

Stop focusing on orgasm as the ‘goal’

When you make orgasm the be all and end all of sex, it only adds to the pressure and anxiety you’re putting on yourself, resulting in performance anxiety and dissatisfaction. Not only that but you miss out on the journey - those sensual touches and little moments along the way. Always remember you can have great sex that doesn’t end in an orgasm - and you can also have quite 'boring' sex that does. The ‘quest’ for orgasm should never be the most important thing.

Educate yourself and talk

Learn about your partner’s body. Learn to talk about your relationship, day to day. Learn to talk about sex. Then talk about how you can stimulate each other in a way that feels good. If either of you aren't sure, take your time to help one another explore and find out.

Many people don’t realize that, for a lot of women, vaginal intercourse alone doesn't provide the clitoral stimulation they need to reach orgasm. Understanding this small fact, locating the clitoris and providing manual stimulation before or alongside penetration may be enough to make a difference and help your partner climax.

Ask your partner whether they find what you’re about to do appealing and adjust the intensity you’re using depending on your partner’s responses. When you’re having sex, everyone who wants an orgasm should get one, it’s important your partner understands that your satisfaction is as important as their own.

Try masturbating alone

Whether you try with your fingers alone, or introduce a toy to increase stimulation of the clit, find some quiet time when you won’t be interrupted and have a little play. If you struggle to cum even when you’re feeling relaxed, it could be that there is a more physiological explanation for your issues.

Don’t be afraid to see a doctor or physician to talk things through and try to get to the bottom of whatever is going on.

Work on yourself and encourage your partner to do the same

If you think anxiety disorders or self-esteem issues could be holding you back when it comes to sex, consider finding someone to talk to. A counsellor or mental health professional could support you in exploring your thoughts and feelings and help you find constructive ways to work on them. This will have far reaching effects in all your relationships and ultimately on your quality of life.

Of course there is unlikely to be an easy answer, but simply seeing that your partner is willing to do the work to help better themselves, and vice versa, can have a profound effect on your attitude and the connection you feel between you.

Illustration by Marta Pucci

Think about your environment

Getting in the mood for sex is as much about the environment as it is about the person you’re with. Try soft music, low lights, candles and even a bubble bath and you might find it easier to relax and stay in the moment. If you feel like it's right for you, try introducing sex toys to inject some fun, help you relax and aid clitoral stimulation.

Try Sensate Focus with the Blueheart app

Sensate Focus is a sex therapy technique we use at Blueheart to help reduce anxieties around sex and intimacy. It’s a series of touch exercises that are designed to take the pressure away, by reducing sexual anxiety and helping you to explore your own and your partner's body at your own pace and in your own time. Our method helps arousal increase naturally. The goal is not to orgasm, or even to engage in sexual intercourse, until you’re both ready.

There’s even a special plan that focuses on orgasmic disorder or female orgasm issues if it sounds like that’s a problem in your case. Simply complete the Blueheart assessment and we’ll put together a relevant plan for you in the app. You can try out our therapy for free for 14 days, to see if it's for you.

Find out more about how Sensate Focus works to support increased arousal and overcome orgasm difficulties.

Take the assessment