Here’s what you should know about the potential causes of anorgasmia:
Physical causes of anorgasmia
Whether you’ve never orgasmed or you suddenly have trouble climaxing, Dr. Shepherd suggests first scheduling an appointment with your physician to assess whether any medical conditions like diabetes or medications could be at play. For example, certain antidepressants can make it harder for you to orgasm. Your physician may be able to recommend an alternative medication that doesn’t affect your sex life.
If you’ve hit menopause, which happens when your body makes less estrogen and you stop menstruating, then that may explain why you’re not orgasming the way you’d like. Sometimes, your vaginal lining becomes thinner and drier or less sensitive when your estrogen levels drop, which understandably makes it difficult to enjoy sex, according to the Cleveland Clinic.
If your medical history and medications aren’t preventing you from climaxing—and you don’t think your anorgasmia is due to an emotional or relationship cause, which we’ll get to below—Dr. Howell suggests asking your ob-gyn to assess your pelvic-floor muscles.
“Your pelvic-floor muscles contract and relax during arousal and increase blood flow to the clitoris and vagina to increase the likelihood of orgasm,” Dr. Howell says. “If your pelvic floor is extremely weak, tight, or even painful, it can cause difficulty achieving orgasms,” she explains.
There is no single cause of pelvic-floor dysfunction. Some people are born with weaker pelvic-floor muscles; others may develop pelvic-floor dysfunction after injuries, childbirth, or from chronic constipation, according to the Cleveland Clinic. If you have symptoms like vaginal pain during sex, or you accidentally pee while sneezing or coughing, then you may want to ask your physician if you could have pelvic-floor dysfunction.
Psychological and emotional causes of anorgasmia
Of course, sex isn’t only physical, and there are a number of psychological and emotional factors that can affect your sex life. Understandably, people who were taught as children that sex is shameful or that having sex will most likely lead to sexually transmitted infections may have lingering fears about it as an adult. Those stressful thoughts can make it difficult to relax during your experience and orgasm, Dr. Shepherd says.
“I’ve had a lot of patients who grew up in conservative, patriarchal cultures and so sex is taught as something that’s bad, and pleasure is not a part of the purpose of sexual relationship,” Dr. Shepherd says. “They can’t achieve orgasm because they haven’t been taught about it, but also there’s a psychological blunting of pleasure.”
There may be times when you struggle to find pleasure in anything—including sex. If you’re experiencing chronic stress or depression, then it can be really hard to orgasm, according to the U.S. National Library of Medicine. Or if you are anxious about how your body looks every time you’re naked, then your thoughts could distract you from experiencing pleasure, according to Lexx Brown-James, Ed.D., sex therapist and adjunct professor at Widener University. “Once the intimacy headspace is breached, it can be very hard to get back into the pleasure of the moment,” Dr. Brown-James tells SELF. Everyone might have moments of feeling too distracted or stressed to enjoy sex or have an orgasm, but if it happens consistently for significant stretches of time and is upsetting, that’s when it can start to get into anorgasmia territory.
More seriously, having sex after experiencing any kind of sexual abuse or trauma can be emotionally painful. Know that it is completely normal to feel confused or terrified about sex and sexuality after going through this.
Relational causes of anorgasmia
Unless you’re solely having sex with yourself (which, by the way, is totally normal), your sex life likely includes other people. If you and your partner are always arguing or you’re working through other relationship hurdles, then you may not be feeling all that sexy. Even if you don’t have any conflicts, you might be uncomfortable speaking up when you’re not orgasming and communicating your sexual preferences.
People experience pleasure in different ways, so orgasming could be about finding what works best for you and your body. If you’re not sure whether you’ve been having orgasms and you’re in search of a more definitive answer, Dr. Shepherd says pinpointing what you like and dislike can help you better understand if and when you might be orgasming. Let’s say, for example, you realize that you really love a specific kind of clitoral stimulation and that the shivery, relaxed feeling you get during that stimulation is actually an orgasm (even if it’s not as intense as you’ve been led to believe).