Treatment for No / Weak Orgasms
“Orgasm” is the word used to describe the intense sensation experienced at the peak of sexual excitement. Most women (hovering somewhere around 96%) can have orgasms. There is a direct correlation between ability to experience orgasm and sexual satisfaction (as most women who have them will assure you.) The corollary, that the inability to achieve orgasm lowers a woman’s level of sexual satisfaction, is also true.
There have been numerous books that try to describe what women (and men) feel during orgasm. And as you might expect, describing a feeling or an experience of a feeling is quite difficult. Here’s how I describe it to my patients: When you get aroused (or turned on) you usually build that arousal, getting more and more turned on, until something happens. That “something” feels discreet, (that is different from what came before and what comes after), is a physical reaction and “takes over your body” kind of like a sneeze. Strikingly, although the descriptions vary widely, there is a great deal of overlap between the descriptions given by men and women. Usually, if you’ve had an orgasm, you know it.
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What happens when a woman has an orgasm?
During the excitement phase, when a woman becomes “turned on” typically her breasts swell up, her nipples become erect and her uterus tips downward. At this point additional stimulation to her clitoris, vulva, and vagina will bring on general body tension and will increase blood flow to the vulvar/vaginal area. As the blood keeps building in the vulvar/vaginal area, a woman will experience her genitals as tense and tight.
This feeling, often accompanied by tingling, swelling and wetness is generally experienced as pleasurable. During this time a woman is also receiving neurological stimulation. The nerve endings in her clitoris, vagina and vulva are being stimulated and are experiencing greater and greater stimulation.
At the point where the stimulation reaches a crescendo, the nerves “shoot off” to release tension. A series of involuntary contractions occur in response. The contractions, which occur in the uterus and vagina, carry the blood away from the genitals and back to the rest of the body (unless she tries to have another orgasm). Most women experience this resolution time as one where tension fades away and there is a general relaxed feeling in the genitals.
If you want to have this explained further, click on this YouTube video and download our free mini e-book, “Orgasms Explained.”
Is there a difference between a vaginal orgasm and a clitoral orgasm?
There is no such thing as a “clitoral” or a “vaginal” orgasm. There are orgasms. Period. Some women enjoy stimulation more in one part of their genitals than other parts. Some women have more nerve endings in one part of their genitals than other parts. No orgasm is “better” than another and there is no evidence that one type of orgasm is more intense than another! However, wherever and with whomever you choose to have an orgasm, enjoy yourself. They are good for you, helping to bring blood into the vaginal area, keeping your vagina moist and supple. Best of all, they feel great!
I can’t seem to have an orgasm with intercourse. Why not?
Only 30% of women achieve orgasm through intercourse. In many women the position and stimulation of the clitoris, during sexual intercourse is not conducive to orgasm and there is no way that intercourse alone can produce an orgasm. A good analogy might be to consider attempting to bring a man to orgasm by rubbing his testicles only. It is unlikely that without proper stimulation of the penis he will reach orgasm and it is unlikely that without proper stimulation of your clitoris you will reach orgasm.
If you fall into this category, you need to realize that you are not anorgasmic, merely typical, and there are many alternatives for you: your partner can stimulate you manually either during, prior to, or after intercourse, you can stimulate yourself manually during intercourse, or you can try out alternatives to your love-making including oral sex or manual stimulation or a vibrator. There is a device available that functions as a small vibrator specifically meant for use during intercourse. Generally a combination and variation of the above methods allow couples to have intercourse and also allows the woman to have the release of an orgasm.
As an older woman, it seems it is harder to have an orgasm. Can more mature women still have orgasms?
It is not uncommon to hear women talk of having less-intense orgasms or having a harder time reaching orgasm as they get older. The physical factors that cause this may include hormone insufficiencies or reduced blood flow to the vaginal area.
Hormones are a critical component of normal sexual response. Low levels of testosterone-related hormones are often associated with peri-menopausal and post-menopausal women, and can have a large impact on both a woman’s level of desire and her level of response. Understanding the hormone balance is complicated and a very new area for most physicians.
Additionally, as you get older, you may see differences in your blood circulation. If the blood flow in the vagina is insufficient it will not fully engorge the clitoris — much like a man who can’t get an erection. If your clitoris does not become engorged you may not have the intensity of orgasm that you are used to. This can also be caused by certain medical conditions, medications or surgeries. Some medical providers are using topical and oral medications to enhance blood flow to the vagina.
The medications you may be taking can also be affecting your ability to experience orgasm, particularly if you are taking antidepressants. Additionally, birth control pills can throw off the balance of hormones and create an inability to reach orgasm.
If you have experienced pleasurable orgasms in the past, it is likely that with the proper combination of medical and emotional support you can do so again.
I’m currently taking anti-depressants. Can that effect my ability to have an orgasm?
We know that SSRI and NSRI’s (Selective serotonin reuptake inhibitor anti-depressants like Prozac, Effexor, Lexepro) can cause sexual problems. The most common sexual side effects in women include decrease in libido, and decreased ability to have an orgasm, or weaker orgasms. In most cases these side effects go away after someone stops taking the medication.
Post-SSRI Sexual Dysfunction (PSSD) is a new term which doctors and patients are using for the condition in which sexual function does not completely return to normal after the discontinuation of SSRIs or another antidepressant medication.
If you had a healthy desire for sex or have experienced pleasurable orgasms in the past, it is likely that with the proper combination of medical and emotional support you can do so again. We have had good success with treating PSSD, and encourage you to contact us to discuss your situation.
What is the G-spot?
The G-spot (named after a Dr. Grafenberg) is a sensitive area near the front of the vagina on the upper wall. If you or your partner insert a finger in your vagina and make a “come hither” movement, you should be able to find the G-spot. If you touch that spot and the surrounding area you will be able to tell if it is a particularly sensitive area for you.
Erogenous zones vary for different women. Although some women find this spot to be very sensitive and enhancing to their enjoyment of sex, others do not report having such a spot or finding its stimulation particularly exciting.
For some women, when this area is stimulated during sex, the result is an orgasm that feels different from, or more intense than, the orgasm they have with clitoral stimulation only. The orgasm may also include a gush of fluid from the urethra. No one is quite certain what the liquid is composed of, but many women find the “ejaculation” pleasurable and their partners find it exciting.
What is the O-Shot treatment?
The O-Shot, or “orgasm shot,” is a relatively new treatment that is used to promote sensitivity in the vaginal canal and to help in achieving orgasm. Learn more about the O-Shot and see if it’s right for you!
In A Patient’s Own Words:
The hardest thing about going to Maze Women’s Sexual Health was trying to figure out how I was going to talk to them. I kept practicing the words in my head and I couldn’t figure out how to tell them that I wasn’t getting “turned on.” I wasn’t getting wet and sex just didn’t feel “good.” Like I thought it was supposed to. I didn’t even realize I wasn’t having orgasms.
The first visit was only hard for about the first two minutes. The doctors at the center were so great about asking questions. Talking to them seemed so normal that I forgot to be nervous. I felt like I was talking about shopping.
They prescribed some creams, some medicine and let me try out some vibrators.
I couldn’t believe I was using a vibrator. Me! I’ll never forget the first time I tried it by myself and all of a sudden I understood what everyone was talking about and what I had been missing! But then I had to break the news to my husband. We had been having sex for about 10 years and he thought everything was fine.
I never told him the truth. The doctors at the center helped me with that too. We spent time talking about how to talk to him, how important it was to tell him the truth. Eventually I did tell him. He was pretty upset initially, but then, when he got over it, he seemed really excited and happy that things were changing for me.
We have a great sex life now and I feel “normal,” thanks to everyone at Maze.
Read more patient testimonials about treating orgasm challenges.