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Causes
By Mayo Clinic staffDespite what you see in the movies, orgasm is no simple, surefire thing. This pleasurable peak is actually a complex reaction to many physical, emotional and psychological factors. If you're experiencing trouble in any of these areas, it can affect your ability to orgasm.
Physical causes
A wide range of illnesses, physical changes and medications can interfere with orgasm:
- Medical diseases. Any illness can affect this part of your sexuality, including diabetes and neurological diseases, such as multiple sclerosis. Orgasm may also be affected by gynecologic surgeries, such as hysterectomy or cancer surgeries. In addition, lack of orgasm often goes hand in hand with other sexual problems, such as painful intercourse.
- Medications. Many prescription and over-the-counter medications can interfere with orgasm. This includes blood pressure medications, antihistamines and antidepressants — particularly selective serotonin reuptake inhibitors (SSRIs). In men, SSRIs can actually result in both anorgasmia and inability to obtain an adequate erection for satisfactory sexual activity (erectile dysfunction).
- Alcohol and drugs. A glass of wine may make you feel amorous, but too much alcohol can cramp your ability to climax; the same is true of street drugs.
- The aging process. As you age, normal changes in your anatomy, hormones, neurological system and circulatory system can affect your sexuality. The drop in estrogen that occurs during the transition to menopause can be a particularly notable foe of orgasm. Lower levels of this female hormone can decrease sensations in the clitoris, nipples and skin and impede blood flow to the vagina and clitoris, which can delay or stop orgasm entirely. Still, anorgasmia isn't limited to older women. And many women say sex becomes more satisfying with age.
Psychological causes
Many psychological factors play a role in your ability to orgasm, including:
- Mental health problems, such as anxiety or depression
- Performance anxiety
- Stress and financial pressures
- Cultural and religious beliefs
- Fear of pregnancy or sexually transmitted diseases
- Embarrassment
- Guilt about enjoying sexual experiences
Relationship issues
Many couples who are experiencing problems outside of the bedroom will also experience problems in the bedroom. These overarching issues may include:
- Lack of connection with your partner
- Unresolved conflicts or fights
- Poor communication of sexual needs and preferences
- Infidelity or breach of trust
- Frank JE, et al. Diagnosis and treatment of female sexual dysfunction. American Family Physician. 2008;77:635.
- Kammerer-Doak D, et al. Female sexual function and dysfunction. Obstetrics and Gynecology Clinics of North America. 2008;35:169.
- Kingsberg SA, et al. Female sexual disorders: Assessment, diagnosis and treatment. Urologic Clinics of North America. 2007;34:497.
- Giustozzi AA. Sexual dysfunction in women. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/169332872-5/912912390/2088/600.html#4-u1.0-B978-0-323-05609-0..00028-9--s2040_12318. Accessed Nov. 6, 2009.
- Becker JV, et al. Sexual desire disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed Nov. 6, 2009.
- Ginsberg TB. Aging and sexuality. The Medical Clinics of North America. 2006;90:1025.
- Shifren JL. Sexual dysfunction in women: Management. http://www.uptodate.com/home/index.html. Accessed Nov. 6, 2009.
- Shifren JL. Sexual dysfunction in women: Epidemiology, risk factors, and evaluation. http://www.uptodate.com/home/index.html. Accessed Nov. 6, 2009.
- Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 7, 2009.
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