The phone rang, and a shy-sounding young woman introduced herself.
“Hi. I’m not really sure if I need therapy. Could I tell you my issue, and you tell me if it’s ‘normal’?”
(Too many people are worried about being ‘normal’ which is overrated, but that’s for another post.)
“Sure,” I say. (I can be agreeable like that sometimes.)
“Well, I got married a few months ago. We’re getting along great, and it’s going well… y’know, in bed too. I get turned on, and feel a lot of pleasure, and he does too. We can kiss and make out, and the foreplay and sex are great. But I don’t think I’ve had an orgasm yet. Is that weird? My husband is worried that it means we’re doing something wrong or missing out on something important. I don’t really mind; I’m enjoying what we’re doing in bed. But I feel like maybe I should be doing something about it.”
If I had a dime for every call like this.. (actually that would be annoying- who uses change anymore?)
So- yes, very normal.
But does it need treatment?
Answer: It depends.
Anorgasmia, or the inability to orgasm, is a controversial diagnosis. Some experts believe that not every woman can or needs to orgasm. Others say that almost all healthy women can climax in the right relationship and with the right sexual technique. And there are often other medical and emotional factors that come into play too.
Anorgasmia, like many other (possible) disorders, can be categorized in several ways:
Primary: Never been able to orgasm.
Secondary: Used to be able to.
Situational: Able to under some circumstances but not others, such as “only alone, or with a vibrator, but not with a partner.”
It can be connected to another sexual, biological, or medical issue, or on its own. And it can be connected to psychological, past trauma, or current relational issues, or not.
Bottom line: How important is the female orgasm to a healthy sex life? It really depends.
If a woman says: I’m happy and pleasured in my relationship. I have desire, arousal, and feel satisfied after we’ve been together. My partner feels the same way, but we just wonder if we’re missing out, then it’s possible that it’s really not such a problem for them. There are certainly things that they (or she alone) could try to create more intense sexual stimulation and arousal, to experiment with broadening their horizons and see if orgasm can be reached. But this should be done gently and without urgency, because sometimes, putting too much of a focus on this can create a pressure, or performance anxiety which can detract from an otherwise happy sex life.
People are different from one another. (But you probably knew that already.) Some women have been stimulating themselves to orgasm easily and regularly since childhood or adolescence. Others discovered it immediately upon becoming sexually active. For many women, it can take some time, even years, of getting sexually comfortable before becoming orgasmic. And still others can go many years having a fulfilling, passionate, and pleasurable sex life, without an orgasm.
Conversely, there are many women who can get aroused and technically have an orgasm, but don’t feel pleasure from it; they experience it more as just a physiological phenomenon, like a sneeze, or even as distressing. (This can even sometimes happen during sexual abuse, which is definitely a topic for another post, but worth mentioning because many survivors find this terribly confusing.)
Some men feel that they are failing their wives if they can’t bring them to orgasm. If the wife says she has pleasure without it, then believe her, and know you are “doing your job.” Some women feel they are failing their husbands, by not offering their orgasm as a sort of “5 star review” of his performance. If he is pleasuring you well, you can just tell him so with words, (or moans or touch.)
Orgasm is not the A+ or the finish line of good sex. It is definitely a strong ingredient, but not necessarily indispensable. When a couple comes because one or both are distressed by a lack of female orgasm, I both: offer suggestions for them to try, AND recommend that they focus less on trying to “achieve” the orgasm, and more on just trying to relax and enjoy each others’ touch.
So, some better questions to ask than “do I need to have an orgasm” are:
Are we happy with our sexual repertoire?
Are we enjoying ourselves and each other?
Do we feel safe and secure with each other?
Do we feel pleasured and able to pleasure each other?
Do we feel physically and emotionally intimate together?
Do we share, get vulnerable, problem-solve, and have fun?
If the answer to those questions is mostly yes, then pat yourselves on the back, and give yourselves credit for building a great relationship. If not, then no worries: you just found room to grow.
If you’re not orgasmic but you very much want to try and learn to be, and/ or you’re not happy with your sexual experience, then there are many things you can try to improve it- from therapy, to psychosexual education, to dialogue and experimentation with your partner.
For example: two good books on the subject are: For Yourself and Becoming Orgasmic.
No woman should be made to feel as though there is something defective about her if she has not (yet?) had an orgasm. Nor should she be pressured to ‘keep trying’ if she doesn’t want to. On the other hand, a woman who hasn’t (yet) had one and would like to, could be encouraged by the fact that there are options to try and sometimes they come later with time and getting more sexually comfortable.
It’s totally possible to have orgasms but not feel sexual pleasure. It's also totally possible to have intense sexual pleasure, without orgasm. If there is no pleasure or if there is distress, then treatment is recommended- no one should have to endure distressing sex; it’s awful for both partners. But if there is pleasure but no orgasm, you could research and try different things to invite the orgasm, speak with a professional, or just focus on the fun you’re having, and let the climax come if and when it will. Like with most important values in life, there is rarely a one size fits all prescription. Pursue knowledge, communicate with your partner, and do what works best for you.
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Elisheva Liss, LMFT is a psychotherapist in private practice. Her book, Find Your Horizon of Healthy Thinking, is available on Amazon.com. She can be reached for sessions or speaking engagements at email@example.com More of her content can be found at ElishevaLiss.com