Never Had an Orgasm? What You Should Know About the ‘Big O’

Clinically speaking, an orgasm is the peak of sexual arousal. But what counts as a peak, exactly? And how can you tell when you’ve reached your destination if you’ve never been there before? What if you reach a summit, but the view isn’t very impressive?

Without a map, trail or guide, the science and sensations of sexual climax can be difficult to navigate. Add any emotional or cultural baggage to the equation, and it’s natural to feel frustrated — and maybe even a little embarrassed.

It may help to know that you’re not alone on this particular journey. Lots of women and people assigned female at birth (AFAB) either can’t climax or need help from medical professionals before they can get there. Gynecologist Talia Crawford, MD, explains why orgasms can be so elusive and walks us through a range of potential solutions.

Is it normal?

There’s no such thing as “normal” when it comes to sexual function. Everybody — and every body — is different. Your orgasm, or lack thereof, isn’t just a product of sexual arousal. It’s impacted by everything from the medications you take and your stress levels to your mental health and your relationship with your partner.

So, you can rest assured, you definitely aren’t the only person out there who’s never climaxed. In fact, there’s a medical term for it: anorgasmia.

“It’s actually a pretty common concern,” Dr. Crawford says. “And even people who can and do orgasm aren’t necessarily getting the experience you read about in books or see on screen.”

The way sex is represented in popular culture, you could easily get the impression that climaxing is always an earth-shatteringly profound event. For most people, that’s not the case. Sometimes, that much-anticipated release of sexual tension, while pleasurable, isn’t much more than a blip on your body’s radar. And frequently, it doesn’t happen at all.

The research on this topic is spotty at best and tends to focus on the experiences of cisgender, heterosexual women. But both scientific studies and not-so-scientific online sex surveys suggest that many people AFAB either:

• Aren’t having as many orgasms as they’d like.
• Feel it takes them too long to orgasm.
• Find the orgasms they do have underwhelming.

Here are some reasons you might not be reaching the “big O”:

• Lack of stimulation. “Without direct clitoral stimulation, many people assigned female at birth (AFAB) don’t climax during vaginal intercourse,” Dr. Crawford shares. Research suggests that about 50% of people AFAB do not usually climax during penetrative sexual intercourse. If clitoral stimulation isn’t doing the trick, try stimulating other erogenous zones — both the standard ones, like your anus and nipples, and more unexpected areas, like your armpits, ears, toes and scalp.
• The vibes are off. If you’re exhausted, under a lot of stress, feeling pressured or self-conscious, it can be difficult to climax. Even temporary distractions can throw you off course.
• Relationship issues. When we say “relationship,” we mean it in the broadest sense. Good sex requires communication, consent and trust. If something about the dynamic feels off, that could be enough to derail the love train.
• Health conditions. There are many different kinds of physical conditions that can interfere with desire, arousal and completion. Conditions that impact hormone regulation, blood flow and the nerves that sensitize the genitals can all cause anorgasmia. Menopause, thyroid disease, multiple sclerosis and diabetes are all possible causes. Sometimes, the issue is muscular: Your pelvic floor muscles could be too tight or too weak.
• Your meds. Selective serotonin reuptake inhibitors (SSRIs), blood pressure medications, chemotherapy and radiation are all examples of medications that can dampen desire, reduce arousal and interfere with your orgasm.
• Psychological concerns. Mental health and sexual health are intimately related. Anxiety, depression, post-traumatic stress disorder (PTSD) and grief are a few examples of the many psychological conditions that can impact your ability to experience sexual pleasure.
• Your mindset. You don’t have to have a mental health condition to struggle with your sexuality. Sometimes, it’s a question of your personal history or worldview. Maybe you grew up in a sex-negative environment. Maybe you’re still figuring out your gender identity or sexual orientation. Maybe you’re worried about things that have nothing to do with your sex life at all. Whatever the reason, where you’re coming from mentally can easily impact your ability to climax.
• Alcohol and smoking. If you’ve been having a drink or taking a drag to “get in the mood,” you could be doing more harm than good. Drinking, smoking and other kinds of substance misuse can cause sexual dysfunction in both the short and long term.

What you can do about it

If you’ve never had an orgasm (and want to change that), the first and most important step you need to take is having a discussion or two. If you’re in a relationship, that conversation should be with your partner.

“To increase your chances of climaxing, talk to your partner about massage of the clitoris during sex,” Dr. Crawford advises. If you’re flying solo, DIY it and see what happens.

If clitoral stimulation doesn’t work, it’s worth bringing the issue up with your primary care provider or an Ob/Gyn. They’ll review your medications and perform an exam to determine if there’s a medical reason you aren’t able to climax. Sometimes, additional testing may be needed. Your provider will help you determine the best course of treatment after your evaluation. This may include meeting with a pelvic floor physical therapist, sex therapist or psychologist.

“It may feel a bit embarrassing to share the details of your sex life with a healthcare professional, but your sexual health is a very important part of your overall well-being, so it is important to address these concerns,” Dr. Crawford states.

While you’re talking, be sure to mention any other symptoms that you think may be impacting your ability to climax, like:

• Pain during intercourse or stimulation.
• A lack of interest in sex.
• Difficulty becoming aroused.
• Vaginal or vulvar dryness.
• Involuntary tightening of the vagina (vaginismus).
• Any history of sexual trauma or negative sexual experiences.

Here are some things you can try right now:

• Masturbate. Don’t believe the myths. Touching yourself for sexual gratification isn’t unhealthy. In fact, it can be crucial for learning what you like, getting comfortable with your body and exploring your sexuality.
• Do kegel exercises. If your pelvic floor muscles are weak, it can interfere with your ability to orgasm. Pelvic floor exercises can help strengthen those muscles.
• Experiment with toys, lubricants and other sex aids. When it comes to sex, everybody’s a little bit different. And not everybody can climax from manual stimulation alone. To the extent that you’re comfortable, try varying your routine a bit and see what happens.
• Set the stage. Make sure you’re giving yourself plenty of time to become aroused. Whether that means extended foreplay, experimenting with sexually stimulating media or masturbating, it’s worth the extra effort.
• Consider counseling. If you suspect that your upbringing, a mental health condition or past trauma could be interfering with your ability to achieve orgasm, seek out a therapist who’s trained in either psychotherapy or sex therapy. If you think your relationship is the root of the problem, marriage counseling or couples therapy is also a great option.
• Address your stress. Embracing mindfulness practices and reducing the stressors in your life can make it easier to get out of your head and into the moment.
• Ask your provider about pelvic floor therapy. You don’t often hear about pelvic floor therapy outside the context of pregnancy, but it’s helpful for treating a wide range of gynecological issues, including vaginismus, bowel and bladder issues, and pelvic pain.

Give yourself some grace

Have you ever heard the phrase, “A watched pot never boils”? The same goes for orgasms … sort of. Anxiety is a total mood killer, so do the best you can to relax and go with the flow. If it happens, it happens. If it doesn’t, you can try again later.

Dr. Crawford explains that being patient with yourself is key.

“If you’ve never experienced an orgasm, it might require an hour of stimulation to produce results the first time,” she says. “It might even take multiple tries until you get comfortable with the feelings of strong arousal.” If there are physical or mental obstacles standing between you and the finish line, it could be a while before you’re ready.

Her advice? Focus on the journey, not the destination.

“There are lots of different ways to experience pleasure and they don’t always involve orgasm,” Dr. Crawford adds. “Think about sex as not so much a means to an end, but as an opportunity to learn about your body, your partner (if you have one) and different kinds of intimacy.”