No orgasms during penetrative sex

Dear Alice:

I have been going out with the same woman for several years and our relationship has never been better. However, lately I can only have an orgasm when she performs oral sex — never, during sex. It used to be the case that upon entering her vagina I would ejaculate almost prematurely, but now I can't seem to ejaculate at all. Do you have any suggestions or thoughts on how I might cure my little problem?

— Vaginally-Ejactorally Challenged

Dear Vaginally-Ejactorally Challenged,

It sounds like you’re in a strong, happy relationship that has endured the test of time, and that’s something to celebrate! However, that may also render your inability to orgasm from penetrative sex that much more perplexing. The good news is that it’s very common for people to experience delayed orgasm from time to time. Since you’re able to satisfactorily orgasm from oral sex, you may decide that this temporary difficulty with vaginal sex is just a bodily quirk that’s not worth stressing about — after all, everyone has preferences about the sensations and types of touch that feel best to them. However, if this is something that you want to try to address, there are several potential physical and psychological conditions that might be causing the delay. Spending some solo time reflecting and exploring, talking it out with your sweetheart, or seeking out a physical or mental healthcare provider may be great places to start your orgasm journey.

Physical conditions that cause delayed ejaculation include certain medications (including many antidepressants), older age, alcohol or drug use, injuries or surgeries affecting the spinal cord or pelvic nerves, and some medical conditions such as multiple sclerosis. Psychological causes of delayed ejaculation include stress or depression, early sexual trauma or negative experiences, relationship concerns, performance anxiety, cultural or religious taboos, and discrepancies between fantasy and reality during sex. Typically, physical causes of delayed ejaculation affect all sexual situations, while psychological causes may affect ejaculation in some but not all situations. As you consider whether any of these physical or psychological risk factors sound applicable to you, it may also be helpful to think through the types of situations that result in your orgasm arriving right on schedule or annoyingly late. Depending on how you’re feeling about all this, you may consider talking to a health care provider or a mental health professional for additional information and treatment.

In addition, you may find it helpful to discuss your experiences with your partner in a neutral space — that means outside of the bedroom. She may or may not have noticed your inability to climax from vaginal sex, and even if she noticed, it may or may not have affected her level of sexual satisfaction. Vaginal penetration is just one of many ways to find pleasure with a partner, and you may find that she’s satisfied with your current sex life and doesn’t mind that you don’t often orgasm through sex. You may even find that she does worry about it but only because you seem worried about it, not because it causes any direct dissatisfaction for her. However, if after talking together the two of you decide that this is something you’d like to address, you may find it helpful to brainstorm some potential options or strategies that you’d like to try. Your partner may have some great suggestions herself given your extensive experience with each other’s bodies, or you might consider proposing some of the following ideas:

  • Use a sex toy, such as a vibrating cock ring, to keep sensations strong during sex. This might have the added benefit of stimulating your partner’s clitoris, adding to her pleasure as well as yours!
  • Experiment with different positions and determine what feels best. You may find it easier to climax with deeper or shallower penetration according to the position you’re in.
  • Have your partner stimulate you orally until you’re close to having an orgasm, at which point switch to vaginal penetration.
  • Be mindful of what you enjoy about oral sex (for example, the pace or pressure) and try to emulate those sensations during sex.
  • Loosen up that grip when engaging in manual stimulation during sex or masturbation. Hands can apply significantly higher levels of pressure and friction than vaginal sex, and some people find that becoming accustomed to or overly reliant on a tight grip makes it more difficult to orgasm during penetration with a partner.
  • Don’t fixate on orgasm during sex. It sounds counter-intuitive, but concentrating on reaching that Big O may actually make it more difficult to achieve since this may increase feelings of performance anxiety. Instead, you might try refocusing on “pleasure” and being playful and exploratory during sex. This has the potential to reduce anxiety and help you relax to the point that you might be able to orgasm through sex — and if not, no big deal, you still had a pleasant and pleasurable experience!
  • Reassure your partner that your inability to orgasm from vaginal sex is unrelated to your sexual interest. Sometimes, bodies just don’t function like you’d prefer, and that’s okay. It’s not a reflection of your feelings towards her or your satisfaction with your sex life.

Finally, it may be worth considering whether you’re experiencing residual anxiety from your previous experiences with premature ejaculation during vaginal sex. This may be a concern that is best addressed through treatment with a health care provider, mental health professional, or sex therapist. Treatment for delayed ejaculation has a high success rate — between 70 to 80 percent — so you’re in good company. With a bit of reflection, experimentation, and potentially treatment, you’ll be on your way to timely orgasms once again. Good luck!

Last updated Jul 22, 2022
Originally published Jan 19, 1995

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