Anorgasmia in Women

Diagnosis

Your primary care professional or gynecologist will review your medical history and conduct a general medical exam and pelvic exam. These exams may identify physical conditions that contribute to problems having orgasms.

Your care professional may ask you questions about your experiences with orgasms and other related issues. You may also receive a questionnaire to fill out that answers these questions. You may be asked about:

• Your recent and past sexual experiences.
• Your partner or partners.
• How you feel about your sexual experiences.
• The types of stimulation or sexual activity you engage in.

Your healthcare professional may want to talk with both you and your partner or meet with your partner separately.

Treatment

Treatment for anorgasmia depends on what’s contributing to the problem. Possible treatments include lifestyle changes, therapy and medicines. If an underlying medical condition is contributing to anorgasmia, your healthcare professional will recommend appropriate treatment.

Lifestyle changes and therapy

Treatment for anorgasmia usually begins with one or more approaches to understand your body better, learn what works for you and change behaviors. These treatments may include:

• Education. Your healthcare professional likely will begin with a discussion of female sexual anatomy and how different parts of the anatomy respond to stimulation. This conversation can help you address any questions, clear up any misunderstandings and help you understand the purpose of other recommended treatments. Your care professional also may recommend educational materials.
• Directed masturbation. This program of instruction and at-home exercises helps you become familiar with your own body and explore self-directed sexual stimulation. After you have learned to bring yourself to orgasm, the knowledge about what you have learned is practiced with your partner.
• Sensate focus. This approach for couples provides instruction and at-home exercises. It begins with non-erotic touch and gradually introduces more intimate touch and sexual stimulation. A goal is for each partner to understand the other person’s needs and to learn how to communicate and direct each other in order to reach orgasms.
• Changes in sexual positions. Your healthcare professional may recommend changes in sexual positions that increase stimulation of the clitoris during vaginal sex.
• Sexual enhancement devices. Devices that enhance sexual stimulation may assist you in having an orgasm. These include vibrators and air-pulsating devices that stimulate the clitoris. Another device held over the clitoris creates mild suction to increase blood flow. Your healthcare professional may recommend using them alone to understand what works for you and then trying them with your partner.
• Cognitive behavioral therapy. Individual or couples therapy may help you address your thinking about sex in general or with your partner. Therapy can help with behaviors that may promote good sexual relations, such as learning ways to talk with your partner about sex or communicate your needs during sex.