Why can't I orgasm? 8 causes and how to address them
If you can't climax, it could be because of medication side effects, sexual shame, medical conditions, and more.
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- Inability to orgasm might be due to the side effects of antidepressants, blood pressure meds, and more.
- Sexual trauma and shame can also create negative feelings around sex that prevent orgasm.
- Placing too much emphasis on having an orgasm may create pressure that stops you from climaxing.
- Visit Insider's Health Reference library for more advice.
For many people, the goal of sex is to reach an orgasm, so it can be very frustrating if you're engaging in sexual acts or having sex and finding that you can't climax.
This phenomenon is known as anorgasmia, and it can happen in both people with penises and people with vulvas. The causes of this may be mental, physical, or both.
Here are seven things that may be preventing you from orgasming, and how to address them.
1. Stress and anxiety
If you're feeling stressed out or anxious, it's likely that you're distracted and disconnected from your body, which can result in trouble orgasming, says Michelle Herzog, LMFT, certified sex therapist and founder and clinical director of The Center for Modern Relationships.
On top of the mental distraction and not being totally present during your sexual experience, there is a physiological aspect that may be getting in the way of your pleasure, too. Stress can affect your blood flow, which may inhibit the flow of blood to your genitals, making it less likely for you to orgasm, Herzog says.
How to address it:
- Have a self-care routine that you do prior to sex: Herzog says this can mean whatever works for you, whether that's meditating for a few minutes, listening to calming music, or getting a sensual massage from your partner.
- Practice mindfulness: Practicing mindful breathing during sex can help you focus on the present moment and enjoy your own pleasure.
- Communicate with your partner: If you're too caught up in your thoughts, you can tell your partner that you need a couple of minutes to pause from sex so you can recenter yourself.
2. Too much emphasis on the importance of orgasm
While orgasms do feel amazing, placing too much emphasis on having an orgasm can actually backfire on you. Herzog says that sometimes the more you stress about trying to climax, the less likely it is to happen.
This can contribute to stress and sexual performance anxiety, reducing your likelihood of orgasm. Plus, focusing only on an end goal and getting too hung up on orgasming can cause you to lose focus on the overall pleasure of sex.
How to address it: Instead of looking at orgasm as the main goal of sex, aim to put more emphasis on the whole sexual experience and pleasure in general.
Herzog says you can mindfully focus on the sensations you're experiencing and enjoy the pleasure that you're feeling rather than thinking about what sex is "supposed to" look like. The key here is being flexible and switching your mindset to the fact that sex doesn't need to be a certain way, Herzog says.
3. Sexual shame
Herzog says negative associations with sex or sexuality can make it difficult for someone to orgasm. One big culprit is shame related to religion, says Herzog. For example, if you grew up in a religious household that taught you that sex and pleasure are something to be ashamed of, this can be something that's internalized and can affect you even in adulthood, preventing you from experiencing pleasure to the fullest.
How to address it: It's going to take work to unlearn the negative associations you have with sex and become open to thinking in new ways. Here are some steps to start:
- Take an inventory of various messages you've received throughout your life that you think might be affecting your sexuality, whether they're from your family, religion, society, or the media, says Natasha Helfer, LMFT, certified sex therapist and founder of Symmetry Solutions.
- Next, give yourself permission to consider your sexual self outside of these messages. It will take practice to rewrite the story of your sexuality and the beliefs you have around it. "Guilt and shame oftentimes can dissipate greatly as people start allowing themselves new ways to show up sexually," says Helfer.
All of this is easier said than done, and working with a certified sex therapist can be very helpful to unpack your sexual shame and rewrtie the narrative of your own sexuality, Herzog says.
4. Sexual trauma
If you have undergone any type of sexual trauma, such as sexual assault or rape, this may negativelly affect your sexual functioning, ranging from arousal to your ability to orgasm.
People who have experienced sexual trauma tend to be more likely to have sexual issues than those who haven't, Helfer says. This is due to the body and brain holding onto those traumatic experiences, which can certainly throw a wrench in your pleasure.
How to address it: Sexual trauma should not be ignored or pushed aside. Helfer says you should remind yourself that you are deserving of professional help, and reach out to a trauma-informed therapist to start working through your trauma so that you can not only improve your sex life but also your life as a whole.
5. Inadequate arousal or stimulation
If you aren't turned on or stimulated enough, this can take a toll on your sexual pleasure as a whole, including, of course, your ability to orgasm.
This can particularly be a problem for people with vulvas, as Herzog says it may take up to 20 minutes for full arousal to occur, including vaginal lubrication and expansion.
Additionally, for many women, penetrative sex alone is not enough for an orgasm. In fact, a 2017 study found that only 18.4% of women surveyed said that sexual intercourse was enough for them to reach an orgasm, and 36.6% said that clitoral stimulation was necessary for them to orgasm during sex.
How to address it: You can take control of your own orgasm by communicating your needs to your partner, says Herzog. This may mean telling them that you need more foreplay time before diving into sex, or asking for them to touch you in a specific way that you like to be touched.
Additionally, if you're still having trouble orgasming due to inadequate stimulation, or if you simply want to switch things up, you can try incorporating a sex toy such as a vibrator during sex to increase your likelihood of orgasming.
6. Medication side effects
Certain medications can interfere with sexual functioning, including arousal and the ability to orgasm, says Herzog. She says common types of medications that may be the culprit are:
- Antidepressants
- Antipsychotics
- Blood pressure medications
How to address it: You should never just stop taking a medication that is prescribed to you, Herzog says. Instead, if you have a concern about your medications and their side effects, speak to your provider.
Herzog says your doctor may be able to recommend a different medication or dosage. Additionally, a "drug holiday" where you stop taking you medication for a set number of days may be an option, but none of these changes should ever be made without approval or instruction from your doctor.
7. Medical conditions
Various medical conditions affecting both mental and physical health can contribute to sexual dysfunction, ranging from libido to the ability to orgasm.
Helfer says some mental health conditions that can affect your orgasms are:
- Anxiety disorders
- OCD
- PTSD
- Depression
Herzog says some physical health conditions that can affect your orgasms are:
- High blood pressure
- Diabetes
- Sleep apnea
- Pelvic floor issues
How to address it: If you have or think you might have any of these conditions, it's important to discuss your symptoms, including anorgasmia, with your doctor. From there, any necessary testing can be conducted and a diagnosis can be made so that you can receive the treatment you need to be in better health — and have better orgasms.
Insider's takeaway
Everybody deserves sexual pleasure and great orgasms. First, try to identify the cause of your inability to orgasm, and then take the necessary steps towards resolving the problem.
Don't hesitate to talk with your doctor to determine any underlying medical causes, and if you need extra help, speaking with a certified sex therapist can help you address any concerns you may have. Finally, remember that orgasms aren't necessary for satisfying sex and you shouldn't feel any guilt about not having one.