Dear Alice,

When I masturbate, I can never achieve orgasm. I've never had an orgasm and I think I am not concentrating enough. After a while, it just gets annoying down there and I give up. Any tips on how I can concentrate more or what I should think about?

Dear Reader,

Regardless of your gender or genitalia, reaching orgasm isn’t necessarily a simple task. While concentration or fantasy might be the key to your orgasm, physiological, psychological, societal, and interpersonal factors may also get in your way of getting off. There’s no one-size-fits-all method for a person to experience pleasure and orgasm, so your personal journey might involve a fair amount of introspection, exploration, and information gathering. 

Anorgasmia, which refers to difficulty achieving orgasm after sustained sexual stimulation, impacts individuals across the gender spectrum, and is particularly common in women. It may present itself as never having orgasmed, a change in ability to orgasm, or only being able to achieve orgasm in certain situations or contexts. Individuals may struggle to reach orgasm for a whole host of reasons, ranging from emotional to physical. Some of the physical reasons could include:

  • Age: As an individual ages, they may have shifts in hormones, circulation, the neurological system, and anatomy that may influence their sexual desires, responses, and sensations.
  • Alcohol and smoking: Alcohol can inhibit the body’s ability to climax and smoking can decrease blood flow to genitalia.
  • Medications: Certain medications such as antidepressants and blood pressure medications can make it difficult to orgasm.
  • Medical concerns with pelvic organs or nerves: Folks who experience vaginal pain during penetrative sex, hysterectomy, or other concerns with the vagina, vulva, or uterus might find that it affects their ability to orgasm. People with penises and prostates can find it difficult to ejaculate after prostate surgery or injury to the pelvic nerves.
  • Medical conditions: Serious illnesses and infections could inhibit orgasm, along with hormonal conditions. Some examples include multiple sclerosis, hypothyroidism, and urinary tract infections.
  • Conditioning to a sensation: For people who masturbate using a certain method, the body can become dependent on that method to reach climax.

Along with physical factors, whether or not someone orgasms can also be influenced by psychological factors or external pressures. Sex and sexuality can bring up shame, insecurities, and expectations, and these concerns may interfere in folks’ ability to experience pleasure fully. It might be good to take some time to explore your views on sex and sexuality to determine if that’s impacting your ability to orgasm. Some of the non-physical causes of anorgasmia could be:

  • Mental health conditions
  • Poor body image
  • Past abuse or trauma
  • Cultural or religious pressure and expectations
  • Shame or guilt
  • Difference between sexual expectations and reality

Lists adapted from Mayo Clinic.

Just as anorgasmia might look different for different people, so does the orgasm and the process of getting there. Preferences for speed and pressure of stimulation vary from person to person, as does the sensation and intensity of the orgasm. Some folks need lots of foreplay before direct stimulation of the clitoris, penis, prostate, or other erogenous zones and others don’t. The fantasies or sexual acts that turn one person on might not do the same for someone else.

It's also possible for some people to feel fully content with the intimacy and sensation that they experience without an orgasm. It might be worth exploring your body to see if you can discover some new spots or sensations that you enjoy, regardless of whether it leads to orgasm. Sometimes the pressure of seeking an orgasm can make it hard to relax into the moment. It may be helpful to have the goal of making yourself feel pleasure, rather than reaching climax. You might also try introducing a new toy, lubricant, sexy books or films, or touching areas of your body you hadn’t explored previously. There’s no one way to masturbate or experience pleasure. If you’re still frustrated by the absence of an orgasm, consulting with a health care professional may be helpful in finding the origins of your anorgasmia.

Alice!

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