What is pre-orgasmic?

Dear Pre-Orgasmic and Foreigner Boy,

Being young (and perhaps in love!) can be a beautiful thing, but having trouble orgasming may not seem so beautiful. To ensure a shared understanding, the term “pre-orgasmic” doesn’t actually mean much; you might have also heard about anorgasmia, which is the catch-all term for those who regularly experience difficulty reaching orgasm and feel distressed about it. More specifically, anorgasmia can affect folks who are bothered by:

• Never having experienced an orgasm
• Having been able to orgasm in the past, but not currently
• Only being able to reach orgasm under certain circumstances (i.e., via specific types of stimulation)
• Not being able to reach orgasm in any situation with any partner

So, the situations described in each of your questions seems to fall under the umbrella of anorgasmia. It can be caused by any number of factors including (but not limited to) medications, substance use, stress, or relationship issues — the good news is there is hope for a more orgasmic future! Exploring your body, experimenting with some sex toys, or some old-fashioned relaxation techniques could pave the way towards the big “O.”

Every woman experiences her first orgasm at a different point in her sexual timeline; believe it or not, orgasming is, in some ways, a learned behavior that takes time and experience to master. One thing to remember is that other aspects of sex and masturbation can be just as fulfilling as the so-called "climax" —the fact that a person still enjoys sex and being intimate without orgasming is a positive thing in and of itself. In fact, only about a quarter of women are able to regularly orgasm from plain old sex (most women need a little extra attention to the clitoris!), and only half of women who haven’t orgasmed feel distressed about it. Foreign Boy, if your girlfriend is still feelin’ good even without an orgasm, then maybe that’s ok. The only way to know is to talk with her about it.

Nonetheless, anorgasmia can be distressing, and may warrant seeking help. You could start by trying to pinpoint the reason behind the elusive orgasms. Some women have trouble orgasming because they simply haven’t figured out which position(s) or erogenous area(s) are best for them yet; for others, it might be that they’re anxious or having trouble “letting go” or relaxing enough to allow an orgasm to happen. Alternatively, it could even be due to an underlying medical condition, medications (especially some medications for anxiety or depression), vaginal dryness, alcohol or tobacco, psychological conditions (e.g., body image concern, guilt or religious concerns, or a history of abuse), or relational reasons (e.g., a history of infidelity or poor communication).

If you and your partner want to experiment a bit, here are a few “in-bedroom” tricks to try. Also check out Easing orgasms for women for additional tips.

• Self-sexploration: A woman can explore her own body and get familiar with what makes her feel good. She can share this knowledge with her partner the next time they hop in the sack. Communicating about preferences (i.e., “mmm, that feels good” or “do that again!”) can greatly improve the chances of getting to the big “O.”
• Vibrators, toys, and lube, oh my!: The industry is booming with creative, kinky, and pleasurable options to add to your sexual repertoire, so it may be worth trying some of these on for size. They may be able to stimulate parts you didn’t even realize you had!
• Getting from “ohm” to “Oh yeah!”: Practicing yoga or meditation (not during sex, of course) are two strategies that are sometimes suggested as ways to clear your mind and increase the chance of orgasm. And, bonus: you’d likely feel more relaxed in general!

More often than not, researchers and sex therapists find that stress, anxiety, or relationship issues are at the center of most cases. If this is indeed what’s cramping your or your partner’s orgasmic style, you may wish to see a health care provider. The most common treatment tends to be therapy — either alone or with your partner — to work out stress or anxiety hindering sexual pleasure. However, a health care provider would also be able to sort out whether underlying conditions, such as diabetes or multiple sclerosis, may be affecting a person’s ability to get her/his motor in full gear.

As for the biological purposes for the orgasm, it's not entirely clear, though there’s no reason to believe that a woman who doesn’t orgasm is at any sort of biological disadvantage. Orgasms may be purely for pleasure or may have evolved to improve reproductive success (by making intercourse more pleasurable so people would partake more often and be more likely to reproduce, or by making it slightly easier for semen to pass through the cervix). It remains one of the great unsolved mysteries of human sexuality!