Okay, so here’s the truth about female orgasm. We live in an orgasm-focused society. Orgasm is perceived as the proverbial icing on the already tasty sexual cake. Despite our misguided notion that orgasm is the primary ‘reason’ to have sex, when it comes to women, it is no sure thing. Read on to learn about the 5 most common barriers.

The sobering truth is that as many as 80% of women are unable to reliably achieve orgasm from intercourse alone. That means that up to 8 out of 10 women need some sort of supplemental stimulation (manual, oral, vibrator, etc.) to reach orgasm. This statistic can be very validating to women who feel like something is wrong with them. They come in with the misinformed belief that all of their female friends, neighbors, family members, etc. are orgasmic from intercourse alone.  When they learn that they are actually in the majority, they often feel immediately relieved and normalized.

Still, millions of women feel ‘jipped’ or ‘broken’ if they are unable to achieve the coveted climax. Sadly, many partners feel ‘responsible’ for a woman’s orgasm, as if it is their ‘job’ to bring her to orgasm. Although a partner certainly helps facilitate a woman’s orgasm, ultimately women are responsible for their own sexual response—especially orgasm. If a woman is not in the right frame of mind, all the stimulation in the world will not be enough to bring her to climax.

Why do so many men feel sexually inadequate if their female partner does not achieve climax from intercourse? They interpret it as a direct reflection of their masculinity. Women must be open and honest with their partners about the type of stimulation that feels best. In my clinical experience, partners are almost always receptive to feedback in this area, but many women find it difficult to give this feedback. We don’t want to hurt our partners’ feelings or damage their sexual ego. Many women, in an attempt to stroke their partners’ ego, ‘fake’ orgasm. Although this may seem like the right thing to do in the moment, it sets a precedent that is robbing both parties of long-term sexual satisfaction.

In order to allow someone to witness them in the sometimes awkward state of orgasmic euphoria (arched spine, eyes rolled back in their head, curled toes, etc), a woman must be reasonably comfortable with her body and the context of the sexual interaction. Women who know their own bodies (and can bring themselves to orgasm) are much more likely to be orgasmic with a partner than women who have never masturbated.

5 Barriers to Female Orgasm

1) Illness and Medication: A wide range of illnesses, including Diabetes, Multiple Sclerosis, Cancer, heart disease and spinal cord injury can damage physiologic processes necessary to achieve orgasm. These illnesses may also affect a woman’s sense of femininity, disrupting her sexual confidence.  Medication can also affect the orgasm phase of sexual response. Blood pressure medications, antihistamines, and certain psych meds can make it difficult to achieve climax. In particular, selective serotonin reuptake inhibitors (SSRI‘s), the most commonly prescribed class of anti-depressants and certain antipsychotics (which raise prolactin levels) are common culprits of orgasm disorders. If you had no trouble ‘getting off’ until you started Zoloft or Prozac last year, it is likely the drug that is causing your orgasm woes.

2)  Cultural Messages: Many of my female patients report unresolved cultural and religious beliefs that make it difficult to achieve orgasm. Negative messages about sex often become deeply ingrained, subconsciously shaping the way we allow ourselves to respond during erotic situations. “I didn’t want to be one of those ‘bad’ girls,” a 29 year old graduate student told me. “I denied my sexuality for so long that now I can’t take it back.”

What does it mean for a woman to achieve orgasm with a partner? It means she ‘owns’ her sexuality. It means she ‘deserves’ pleasure. It means she can ‘allow’ her partner to witness her in a vulnerable state. It means she knows her own body and is not dependent on her partner for sexual stimulation and gratification. It means she can comfortably communicate with her partner about her sexual expectations and preferences.

Research suggests a link between EQ (Emotional Quotient) and a woman’s capacity to achieve orgasm. The higher a woman’s EQ (the ability to identify and manage emotions of one’s self and others), the more likely she is to achieve orgasm. Click here to read more on this study.

3) Discomfort with Intimacy: ‘Amy,’ a happily married mother of four, sought treatment for her inability to achieve orgasm. “I can sing in front of my kids,” she said. “But I could never sing in front of my husband. What if I sing off key? What if I look stupid?”

My response to her: “When you can sing in front of your husband, you will be able to have an orgasm in front of him, too.” She thought I was crazy! So how can Amy allow herself to ‘let go’ during sex when she can’t tolerate intimacy and vulnerability in non-sexual situations?

Shame and eroticism are commonly paired during sexual development. ‘Annemarie’ was sexually abused by her older brother from age seven to nine. To avoid acknowledging the abuse, Annemarie feigned sleep when her brother entered her room at night. “It was easier to pretend I was asleep than to attempt to deal with all of the confusing feelings.” Annemarie invariably associates sexual response with shame. She can’t allow herself to achieve orgasm because she can’t bear to recall that profound shame from her past. She had not had an orgasm 20 years when she finally sought treatment.

4) Anger/Resentment: Problems experienced between couples outside the bedroom are often played out inside the bedroom as well. ‘Joan,’ a 42-year old, married mother of two, reported intense contempt and anger toward her husband during a recent session in my office. When I questioned her as to why she is unreceptive to an orgasm, she tells me “I don’t want him to think he has any affect on me.” She further explained “He can make me do it, but he can’t make me like it.”

And what about the woman whose husband threatens her? “You better be fun in bed,” he says, “Or else! If you don’t loosen up and enjoy yourself, I’m going to divorce you.” ‘Laney,’ who suffers from Generalized Anxiety Disorder, is already distracted by intrusive thoughts during sex. Now she has the added pressure to “be fun” in bed. Imagine trying to achieve orgasm under these conditions. And what of the many women who were taught that sex is dirty? A 71 year old client shared that she has been closing her eyes during sex for 50 years because she is so ashamed of what she is doing that she needs to separate herself from the act by ‘checking out.’

5) Aging and Menopause: The normal aging process can also take a toll on a woman’s ability to achieve orgasm. As we age, we have fewer hormones, especially estrogen. This affects all phases of sexual response. As estrogen levels decline, sensations in the clitoris and nipples are decreased, causing limited blood flow to the genitals. As vascular efficiency decreases, orgasm difficulties increase. Also, dryness can cause micro-tears which make intercourse painful. Take your sex life back! Get a good lube (one that is paraben-free) and get a vaginal moisturizer. Pelvic floor physical therapy and topical hormones may also help. Treatment is available!

The good news—a little education goes a long way! Simply sharing statistics or debunking myths can have significant therapeutic value. Women are comforted to hear that they are not alone in their orgasm difficulties. Providing women with an opportunity to explore their shame, anger, fear, or other negative emotions can be extremely liberating. Most women appreciate the chance to gain insight into their sexuality. Centuries of stigma around female sexuality will not disappear overnight, but we are starting to see subtle shifts in the pendulum toward a healthier outlook. Let me know what gets in your way of achieving orgasm and I’ll try to help!

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