Can’t Climax? Why Female Anorgasmia Happens and How to Fix It

Anorgasmia, or difficulty having an orgasm, is a frustrating form of sexual dysfunction that is common among women. It can cause stress, affect your sex life and relationships, and even make you avoid sex. Anorgasmia isn’t all in your head. Personal and psychological factors can certainly contribute, but so can hormonal changes, medications, and health conditions.  

Anorgasmia may cause embarrassment, but it doesn’t mean you’re doing anything wrong. Read on as we discuss the types of anorgasmia, the physical and psychological causes, and how treatment can help.     

What is female anorgasmia, and how common is it?

Anorgasmia is when you have trouble reaching orgasm or can’t orgasm, even when you’re sexually aroused and stimulated. Also called female orgasmic disorder, anorgasmia is very common. It affects between 10% and 28% of women worldwide. Anyone at any age may experience anorgasmia. It’s especially common among postmenopausal women. 

You might be dealing with anorgasmia if your orgasms consistently and persistently:

• Feel weaker or less intense

• Take longer to happen

• Happen less frequently or not at all 

Like all things with sex, everyone experiences orgasms differently. You might need more sexual stimulation than some, and less than others. Your needs may change over time. 

Changes in your orgasm frequency or intensity can be distressing. Understanding the cause of your anorgasmia can help you determine the treatment. 

It’s important to note that not reaching orgasm is only a problem if it causes you emotional distress. If you don’t experience orgasms and are perfectly content with that, that’s fine. There’s no “one right way” to experience sex and sexuality.

What are the different types of anorgasmia women experience?

The four types of female anorgasmia are lifelong, acquired, situational, and general. Let’s define each:

• Lifelong or primary: You’ve never had an orgasm, neither through partnered sex nor masturbation.

• Acquired or secondary: You used to have orgasms, and now you can’t.    

• Situational: You can reach orgasm in some situations but not others. 

• General: Reaching orgasm is difficult or impossible in all situations.

Menopause, medications, communication with your partner, and amount of stimulation can all impact your ability to orgasm. Take time to identify when your difficulty reaching orgasm started, and when you can or can’t orgasm. This can help you understand what’s impacting your sexual response.   

What physical causes contribute to sexual dysfunction, including female anorgasmia?

Physical factors that contribute to anorgasmia include hormonal changes, chronic diseases, and medications. These factors include:

• Dryness, pain during sex, and lack of self-lubrication related to hormonal changes during the postpartum period, perimenopause, and postmenopause

• Health conditions including multiple sclerosis, heart disease, kidney disease, diabetes, and fibromyalgia

• Antidepressant-induced sexual dysfunction: certain antidepressant medications can make it more difficult to reach orgasm. This is a common side effect of SSRIs (selective serotonin reuptake inhibitors).

• Pelvic conditions such as urinary incontinence and prolapse

• Surgeries including hysterectomies (removal of the uterus) and oophorectomies (removal of the ovaries)

• Lifestyle choices including alcohol and recreational drug use

How do menopause and hormonal changes affect a woman’s ability to reach orgasm?

Decreasing levels of estrogen during peri- and postmenopause can make it more difficult to reach orgasm. These hormonal changes can affect how your body physically responds to sex. This happens because, without estrogen, your genitals receive less blood flow and fewer nutrients. Your nerves respond less to stimulation, so you don’t feel as much pleasure.  

During and after the menopause transition, you may notice: 

• You feel less sensation overall during sex.

• Sex becomes painful due to vaginal dryness and atrophy.

• Your pelvic floor muscles become weaker and less responsive.

• You have less interest in sex: you have little or no desire, or you aren’t as aroused when having sex.

What role do vaginal dryness and tissue health play in female anorgasmia?

Vaginal dryness can cause pain during sex of all kinds (including sexual intercourse), which makes it more difficult to feel pleasure. When estrogen levels drop, your vaginal wall tissues become thin, dry, and fragile. These tissues receive less blood flow and struggle to lubricate naturally. 

Even if your mind is prepared for sex and pleasure, your body may not be. Vaginal discomfort affects your sexual response. Pain signals override pleasurable sensations and make it difficult to orgasm. 

What psychological and relationship factors contribute to female anorgasmia?

Mental health conditions can take your focus off pleasure. Relationship stressors can make it difficult to communicate your needs and maintain emotional intimacy. These factors aren’t “just in your head”. Taking care of your mental health and feeling comfortable communicating your sexual needs are essential to treating anorgasmia. 

Here’s how psychological and relationship factors contribute to anorgasmia:

• Anxiety and depression can cause you to have negative expectations about sex. Instead of pleasure, you may feel distracted, disconnected from your body, or ashamed.

• Poor body image can take away your confidence. You may feel you don’t deserve to feel pleasure, so you may disengage during sex. 

• Past negative experiences with sex can cause both emotional and physical stress and trauma. 

• A history of sexual abuse can be a source of sexual trauma, though it is not the only kind of negative sexual experience.

• Difficulty communicating with your partner about what type of stimulation feels good can make achieving orgasm more difficult. 

• Relationship dynamics such as stress, satisfaction, and stability can all impact your ability to orgasm during sex.   

Sexual response involves both your body and your brain. Sex therapy, couples therapy, mental health care, and exploring your sexual preferences can help you reconnect with your body and experience pleasure. 

Sexual excitation vs. sexual inhibition

Research from Erick Janssen and John Bancroft at the Kinsey Institute states that we have two internal systems controlling our sexual arousal: sexual excitation (turn-ons) and sexual inhibition (turn-offs). In her book Come As You Are, researcher and sex educator Dr. Emily Nagoski writes about these systems in language that’s easy to understand.

These systems act like a car’s gas pedal and brake. Both are necessary, but it’s hard to drive a car with the brake fully engaged. Understanding these systems can help you coordinate your “gas” and “brake” pedals, so you can find an avenue to enjoyable sex. 

How does adequate sexual stimulation affect orgasm?

Adequate sexual stimulation can help your body respond better to sexual activity. A better response can increase your odds of achieving orgasm. 

The ideal amount and type of stimulation varies from person to person. For example, vaginal penetration with a penis or toy doesn’t always provide enough stimulation on its own. Many women also need clitoral stimulation to achieve orgasm.

Take time to notice what feels comfortable and pleasurable for you. This can help you better understand your own sexual response. 

How can overall vaginal and intimate health influence female orgasmic disorder?

Pain can create a physical barrier that makes it impossible to enjoy sex and have an orgasm. Vaginal dryness and atrophy can leave you feeling unfamiliar or uncomfortable with your body. Your mind might feel aroused and interested in sex, but your body doesn’t agree. 

Caring for the health of your vaginal tissue can help you enjoy sex and feel like yourself again. Healthy tissues are moisturized, plump, and sensitive to stimulation. Addressing issues such as vaginal dryness and atrophy can help make sex more enjoyable and give your body better conditions for sexual response. 

What natural and hormone-free solutions may help women overcome anorgasmia?

If your anorgasmia has a physical cause, like dryness, painful sex, or lack of self-lubrication, then lube is often not enough to help treat anorgasmia. 

NeuEve’s anorgasmia treatment sends needed nutrients directly to your vulvar and vaginal tissues. These all-natural, OB-GYN-developed treatments can help with some of the physical causes of anorgasmia: 

• Increase your natural lubrication to reduce pain and dryness

• Nourish your nerves to enhance your sensitivity to stimulation

• Restore your sexual comfort and confidence  

Anorgasmia is complicated and common. No single solution will work for everyone. However, caring for your vaginal tissue health, especially after menopause, can improve your sexual comfort and make pleasure possible. 

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Pope, R., Myers, A., & Marino, J. (2026). (022) Anorgasmia After Menopause. The Journal of Sexual Medicine, 23(Supplement_3). https://academic.oup.com/jsm/article/23/Supplement_3/qdag063.022/8614402

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