Anorgasmia In Women

Advice For Men On How To Make A Woman Come

Overcoming anorgasmia - difficulty in having an orgasm - is not something to be scared of - quite the opposite!

Orgasms are a source of great joy, physical pleasure and sexual satisfaction, and having orgasms regularly will enhance the quality of your relationship dramatically, since nothing is as arousing to a man as making love to a woman who is herself fully aroused and enjoying her sexual capacity.

It's even possible that you may reach orgasm during intercourse together with your partner.

But our words alone may not reassure you. You may have concerns about what it means to be a fully sexual woman, for social images of sexual women have not always been entirely positive.

First and foremost, having orgasms - or being given orgasm by a man - regularly is not going to change your basic values. It will make you feel more relaxed and possibly more fulfilled.

It may improve your relationship if it's already fundamentally sound. If you're in a poor relationship, becoming orgasmic is unlikely to have much impact on it.

But as you become more able to reach orgasm you are expressing more of who you are, as a woman and a human being. You're likely to be more in touch with your needs, wishes and desires, and you may find that your emotions are easier to express.

Having Orgasms Gives You A Greater Connection To Your Femininity.

For women with anorgasmia, it is essential that their sexual partner is supportive, and will do all he can to ensure she has the help she needs - growing without criticism, judgment, or discouragement from the harsh words of a relationship partner is essential.

It is also incumbent on the partner to learn how to control his premature ejaculation so she can enjoy sex without worrying about his performance in bed.

You'll undoubtedly have moments when you think, "It's not worth it", or "I'm not good enough", or "I'm never going to be orgasmic", or "It's a waste of time", or something similar.

The fact that you're reading this now means that learning how to have orgasms is important enough to you to devote time and effort to the project: and that commitment will guide you through to success, provided you don't allow that internal voice which wants to maintain the status quo to keep you from experiencing your full potential, or to hold you back from feeling the pleasure of reaching climax and knowing what it feels like to enjoy an orgasm when you masturbate.

Be gentle with yourself, give yourself time, and enjoy the journey of discovery to being fully orgasmic. There's no pressure on you to succeed, and no-one except your own internal critic will hold you to account for what happens as you embark on this adventure.


The New Scientist has run a series of articles on the female orgasm which have provided an unexpected insight into the way in which women are able to reach orgasm or why they cannot achieve orgasm.

The first of these articles concerns the difficulty which women have experienced in achieving climax. The article begins by describing a woman aged 45 who had never had an orgasm in her life. Years of therapy had proved completely unhelpful, her sex life was diminishing rapidly, her husband had an affair and her marriage finally broke up. In desperation she went to a surgeon.

He discovered that her clitoris was covered by a fused piece of skin, and the removal of that skin allowed her to reach orgasm freely. So the point here is that sex therapy is not necessarily the route to the female orgasm. Indeed, when a physical problem like this exists, it's obviously not much use at all.

But the story does illustrate one side of the debate about female anorgasmia: while scientists and doctors, as well as pharmaceutical companies, have repeatedly tried to find physical causes for women's sexual dysfunction, and sex therapists have stated that anorgasmia is a cultural phenomenon, there are many women for whom the lack of orgasm may be rooted in a physical problem of some kind.

And since 43% of the female population apparently have some kind of difficulty in reaching orgasm, the issue of the so-called medicalization of the "problem" of the lack of female orgasm is important.

Is anorgasmia a physical disorder, which is treatable with drugs, mechanical aids, or surgery, or is it an emotional or mental problem which results from the social cultural or relationship situation in which women are forced to live in our society?

Widespread female difficulty in reaching orgasm:
Female sexual arousal disorder or FSD.

FSD can only be a meaningful concept when the lack of orgasm causes a woman considerable emotional distress: arguably, there is no problem when the woman isn't affected by her lack of orgasms.

And this in turn raises the question of whether the distress that emerges from anorgasmia is due to pressure from the relationship partner, or the wider cultural context which values sex resulting in orgasm much more highly than it values sex as a means to intimacy or bonding.

Satisfactory sex is of course contingent upon several things - satisfactory ejaculation control from the man, an ability to open up and enjoy orgasms from the woman, and good health, including freedom from genital infections like yeast infections - which, incidentally, can affect both women and men.

In the normal course of events when a woman is sexually aroused nervous impulses from the brain reach the clitoris and labia, causing the smooth muscles in these tissues to relax. Rather like the process of penile engorgement, this relaxation allows cavities within the tissues to fill with blood and makes them erect.

A similar process causes the muscular wall of the vagina to swell and start the process of lubrication: normally this process of engorgement is terminated when the woman reaches orgasm.

It's been observed that in woman with so-called female sexual arousal disorder the clitoris and vagina do not effectively engorge with blood and the result of this is that penetration and intercourse can be difficult without artificial lubrication, and orgasm can be impossible to achieve.

Since nitric oxide is present in female genital tissue, just as it is in male genital tissue, Viagra could work in women as well as it does in men (it works by slowing the breakdown of the Nitric oxide, a compound which relaxes smooth muscles so that the erectile tissues continue to remain engorged.

The longer the period the nitric oxide remains in its natural form, the longer the period of engorgement and arousal of the sexual tissues.)

Viagra has proved to be less successful in women than it is in men. About half of the women who take it do report an increase in sensation, lubrication and their level of sexual arousal. However, the results were more or less the same in a group taking a placebo, which suggests that Viagra is not as useful in this area as it might be.

One issue is that it is not effective as an aphrodisiac, in other words it doesn't increase sexual desire, it only works on the tissues of the genitals in a woman who might already be ready, willing or able to have sex.

It's not a drug for those who are experiencing low libido, just as it is not a drug for men who are experiencing low levels of sexual desire: there is no benefit to taking Viagra for either of these groups.

If female sexual disorder is defined as the condition which precludes lubrication of the genitalia and relaxation of smooth muscles of the vagina, there may be better products to treat it than Viagra, since this only targets erectile tissue.

There's a device called the Eros-CTD, which stands for clitoral therapy device. It's a small suction pump cup which is placed over the clitoris to provide an increase in blood flow and theoretically simulates the experience of oral sex. While it's not a vibrator it does apparently induce orgasms in some women, and there are reports of women who refused to give the device back once the clinical trials were finished!

A sex therapist named Leonore Tiefer at New York University says that treating any kind of female sexual problem from the physical viewpoint is inappropriate. For one thing, since half the female population seems to have a disorder, it may well be that FSD isn't actually a physical problem but a societal, cultural and emotional problem.

For example, in the trial where women were given Viagra you'll recall that a large percentage of the ones given a placebo sugar pill also experienced success in achieving orgasm.

One of the reasons for this appears to be the fact that simply taking a pill and focusing on the expectation of female orgasm changes a couple's behavior so that they set up the situation in a way that is more likely to give the woman an orgasm - for example by taking more time, and by expecting more successful sex.

Clearly, the expectations which a couple bring to sex and female orgasm is almost as important as what happens to the woman physically.

Sex Therapy Or Physical Therapy?

So Tiefer's belief is that while society can't change overnight, sex therapy is certainly a route to allowing women to reach orgasm without having to resort to drugs.

In the way that it's practiced these days, sexual therapy often involves a combination of information, education around sexual techniques, psychotherapy to help women work out what is making sex unenjoyable or inhibiting orgasmic response, and advice that will allow them to focus on sexual objectives other than the sheer number of orgasms they are able to achieve.

Another problem, of course, is that many women are so embarrassed about the discussion of sex that they simply can't bring themselves to undergo sex therapy: it's much simpler to ask for a pill or to use a device which is supposed to assist them in reaching orgasm.

Carol Ellison, a clinical psychologist in California, observed that in more than 2600 women that she asked about sexual problems, the large majority associated their difficulties with simply being too tired, being too busy, having too much to do, or combining home and full-time work.

Ellison takes the view that prescribing pills to help women achieve orgasm more easily and diminish their dissatisfaction with their sex lives is akin to the 1950s practice of prescribing sedatives to housebound women while simultaneously preventing their access to meaningful employment.

And Ellison points out that drugs are often unsuitable for older couples who are the ones most likely to have physical issues that make both male erections and female sexual arousal increasingly difficult.

Ellison talks about the idea of sexual self-acceptance, which in the case of older couples might mean an acceptance that caressing, intimacy and sex talk will replace the actual physical release of intercourse and orgasms.

In any event taking drugs to improve sex life can have a negative impact. Erick Janssen, a psychologist at the Kinsey Institute, has suggested that couples expect too much from Viagra and thus can be very disappointed when they discover that even if they can have intercourse successfully their relationship still doesn't improve in other ways -- that is to say, they have underlying emotional or psychological issues.

And certainly we know that a large proportion of the men who take Viagra do not experience any improvement in their erectile capacity because they have emotional issues between them and their partners. These problems may need traditional sex therapy.

Conversely, the proponents of sex therapy can seriously undervalue how beneficial a drug regime may be to a man or woman experiencing a sexual problem.

Laura Berman, a sex therapist at the University of California in Los Angeles says that female sexual disorder is defined in much more sensitive ways now than it was before Viagra appeared on the scene.

She makes the observation that doctors who specialize in sexual health will probably now have a lot of high-tech alternatives which can identify and then alleviate physical causes of sexual dysfunction.

For example, ultrasound probes may be used inside the vagina to measure blood flow, pH probes can measure the acidity or alkalinity, a measure which depends on how much lubrication a woman is producing, and a third probe can be used to measure changes in length and width of the muscles of the vagina.

As we know there are changes in the size and shape of the clitoris, vagina and labia during sexual excitement. The penis is the most amazing example of tumescence, of growth during sexual arousal, yet the female organs change in size and shape by just as significant a percentage.

I am not sure that anyone has yet worked out how people's view of their own genitals impact their orgasmic ability, yet I think it must do. For men, penis size is one of the key determinants of how confident a man may be sexually. And if you happen to be interested in seeing how you compare, check out the penis pics here.

There are also machines that can determine sensitivity of the clitoris or labia to pressure and heat and cold. Readings taken in a variety of conditions with a variety of sexual stimulation can reveal what may or may not be wrong with a woman's sexual responses.

Again, clitoris size is a critical element of a woman's orgasmic ease - for men and women who may be interested in comparison, there is more data to be gained from the clitoris pictures you can find here.

Taking these measurements and combining them with a psychological interview, often permits an effective sexual therapy, with or without physical solutions like drugs, to be devised.

But she also makes the observation of a lot of women who come to the clinic have already tried traditional sex therapy and found it unhelpful so that their treatment may well involve some combination of the clitoral therapy device, surgery or even drugs.

I think what's clear to me here is that there is no overall solution for female sexual disorder, however one defines the term, and that a "one size fits all" approach is definitely not helpful to anybody.

In particular, one of the sexual disorders that must not be overlooked in women is low libido, because although it's been linked to psychological problems, relationship issues, stress, depression and fatigue, recent research has revealed that testosterone may be just as important.

Clinical practice is gradually waking up to the fact that testosterone is indeed central to a woman's sexual drive, her experience of sexual desire and possibly even her ability to reach orgasm.

In particular, testosterone levels fall dramatically in women after the menopause, and therefore the addition of testosterone to a hormone replacement regime can help these older women become sexually active again. But some doctors are also prescribing it to younger women and claiming great success.

Needless to say medical caution is, as always, preventing the rapid growth of testosterone prescription to women who are experiencing a low sex drive. This is odd, because finding the right dosage (one which avoids side-effects such as hair growth and clitoral enlargement) is not difficult.

It's even been suggested that low testosterone levels stop Viagra working: there is some evidence that lowering testosterone can affect Viagra's activity on the smooth muscle in the genitals, making them impervious to the action of Viagra. You can see the impact of Viagra on penis size in a selection of penis pictures and other images which are available here.

Irwin Goldstein at Boston University has given both pre-and post-menopausal women dehydroepiandrosterone (DHEA), which is a testosterone precursor.

He claims that prescribing both DHEA and Viagra to women produces a much more marked response and gives women hope of achieving a normal sex life with full orgasmic ability. So how are we to reconcile these two apparently opposing views?

On the one hand there are doctors like Goldstein and Berman who are ready, willing and very prepared to use every drug and scientific or medical gadget available to them to improve a woman's chance of reaching orgasm, while on the other side the psychotherapists like Tiefer take a more political position and claim that women's sexual problems are rooted in cultural, social or emotional factors.

Given the chance, they believe, sex therapy can solve most women's sexual problems. Certainly it's true that sex isn't just physical: it also involves emotional, physical and interpersonal issues between men and women. That much is obvious.

However the problem is that where a physical disorder does exist it needs to be identified, and an approach that routinely diminishes the value of physical therapy may prevent women from achieving a normal sex life, which is something that all doctors and clinicians and scientists on either side of this divide would agree is the ultimate objective.


1.Further reading: For Women Only: A revolutionary guide to overcoming sexual dysfunction and reclaiming your sex life by Jennifer Berman and Laura Berman with Elizabeth Bumiller (Henry Holt and Company, 2001, New York)

2.Women's Sexualities: Generations of women share intimate secrets of sexual self-acceptance by Carol Rinkleib Ellison and Beverly Whipple (New Harbinger, 2000, Oakland, California)

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