“In 1,749 randomly-sampled U.S. women, 24% reported an orgasmic dysfunction.” I think it is helpful to see the statistics on how often anorgasmia occurs because many women think they are alone in facing this issue. Often women we see at the Center feel unclear about exactly what an orgasm is. Orgasms are different for every woman. I recently had a patient explain that watching amateur porn was helpful because she did not know what an orgasm was supposed to feel like and she certainly did not know what it looked like. Education is a big part of what we do and it is great to find new ways to help women understand their bodies and their sexuality.
Orgasm is complicated because it involves so many parts of the body. The mind must be involved, usually through creating or maintaining a fantasy, the nervous system is involved because pathways running from the brain through the spinal column to your genitals are activated, the proper hormones must be available, and one must generally be in a state of low stress and anxiety, to be open to being turned on. All these systems must be working in concert for a woman to have an orgasm. Though it seems so easy in the movies, I tell women over and over again that it is not always easy and it rarely looks like it does on TV.
The patients we see with this issue generally fall into two groups. There are those who have not been seriously troubled by not having orgasms and they are usually coming to us because it bothers their partners. Those that have not been that bothered by their inability to have an orgasm are sometimes easier to help, because they may not have tried much to rectify the problem. For these women, they may just need more intense stimulation, which a vibrator can provide, or a slight dopamine boost which medications can provide. They may need both and often when we give them these tools and then they have success, sex becomes a much more enjoyable experience for them.
For those women that have tried everything, the problem may become more challenging. I have recently had success with several from this group by helping them to add stimulation to other areas of their bodies simultaneously. The research on treating anorgasmia is minimal. The great news is that often, once you have the first one, all the others after that become easier. Once you have had that first one, the pathway in the brain and through the nervous system is then primed for future use. So, what we suggest is to keep trying things until you find what works. We have had a lot of success with patients who continue to explore new areas of pleasure and sometimes something surprising is just what they need to get them over that threshold from anorgasmia to orgasm.