What is Anorgasmia?
- Mar 30
- 4 min read
Hey there,
I'm Sadé (shah-day). I'm a licensed marriage and family therapist in Atlanta, Georgia and a certified sex therapist through the American Board of Christian Sex Therapy. I specialize in addressing the intimacy issues that keep couples avoidant and distant. If you are looking to understand your breakdowns in intimacy and make lasting change, you're in the right place.
Let's dive in....
The setting couldn't have been more right.
It was a good week. You felt that the two of you were getting along as a team (as you usually do), and shared little moments of affection. A kiss here, a hand-hold there, a graze of the lower back...
You don't doubt that your spouse loves you. You don't doubt that you love them.
With the opportunity for an impromptu date night, you set out for a meal together at your usual spot. This time, you ordered something new. Getting a chance to catch up in the middle of a busy season is always a treat, and helps you feel close to him again. His laugh, his smile, his eyes. Hey, I remember you...
So, when good vibes and affectionate touches gradually intensified, you were totally open. You missed him, appreciated him, wanted him. The heat between you was welcomed.
But as your breathing quickened and your heart beat faster, you felt.....
you felt....
nothing.
Well, not entirely. You did feel something. You were enjoying sensations and could have welcomed more, but it felt like there was... a ceiling... on your pleasure. Maye even a plateau.
He could sense it, too. You felt him trying to adjust his movements, his eyes intently gazing at you for a reaction - any sign of feedback or pleasure. "Is this working?" his eyes seemed to plead.
But with time and repeated attempts, the previously-pleasureful sensation soon gave way to annoyance. Overstimulation. It didn't feel good anymore.
The setting couldn't have been more right. You felt emotionally close. You had the time and space; no rush, no worries. The mood was on. But your body just...couldn't reach a peak. You could tell that there should have been more intensity, more pleasure, but there wasn't.
No orgasm. No completion.
And although he tries to be understanding, you can tell that he is disappointed as he rolls to his side of the bed.
Again.
---
Anorgasmia: When You Can't Orgasm
According to the DSM-V, anorgasmia - which may also be called Male or Female Orgasmic Disorder - is the inability to reach orgasm (or orgasm with significantly diminished intensity) during sex, on nearly all occasions, for six months or more.
This diagnosis, however, would not be applicable in scenarios where this issue is better explained by another, non-sexual disorder - such a medical condition or severe relationship distress (as may be seen in abusive relationships).
But before jumping to labels, let's pause for a moment. Ask yourself: am I bothered by not having an orgasm?
This piece of the puzzle is really important. If infrequent or nonexistent orgasms does not truly bother you, there is no need to give yourself a diagnosis. It simply may not be your vibe! On the other hand, those who do struggle with anorgasmia will find themselves very frustrated with the physical or psychological barrier that keeps them from more intense pleasure.
Still there? If you've read this far, I'll assume that you are in the camp of individuals who do feel distress with the inability to reach orgasm, and you want to find a solution. Let's dive a little deeper.
Understanding Anorgasmia: When Does it Happen?
The next step is to understand when your difficulty or lack of orgasm occurs. Consider the following variables:
(a) lifelong (I have never had an orgasm)
(b) acquired (I used to have normal orgasms, but now I don't)
(c) generalized (this happens in all sexual situations)
(d) situational (this only happens with my partner, or in specific scenarios)
You are most definitely going to want to schedule an appointment with your OB/GYN and/or a sex therapist in order to get professional help with finding (and interpreting) the root of your symptoms. Treating anorgasmia does not come with a "one-size-fits-all" formula - and every case is different. Some are simple and somewhat straightforward, but many will be layered and complex.
For example, if you have acquired anorgasmia after falling and bruising your tailbone, a consult with a pelvic floor therapist may be quite relevant. Or, if you have situational anorgasmia when having sex with your spouse, a sex therapist (such as myself) may want to ask more clarifying questions about your relationship, the way that you both approach intercourse, or previous sexual habits.
Yes, I Believe I Have Anorgasmia. What Should I Do Now?
This concern is best addressed with a team of sexual health professionals. I'd highly recommend taking the following steps:
Schedule your annual OB/GYN and PCP appointments to share your concerns
Schedule a session with a licensed therapist who specializes in sex therapy
Your medical physicians will be able to test for (and rule out) any physiological factors that are contributing to your condition. If they detect noteworthy findings, they may refer you to the appropriate specialist (such as an endocrinologist or a pelvic floor therapist) for more specified care.
Your sex therapist will be able to address the psychological, emotional and relational components, while also helping you with practical tools and techniques to improve your sexual functioning.
Together, your medical and psychological/relational assessments will more clearly outline why you may have anorgasmia, and how to best address your symptoms. If you aren't ready to schedule an appointment yet, take some time to track your symptoms with the criteria addressed earlier in this article. Over the next six months, take note of when you do/don't experience more orgasmic sensation, and if any other factors in your life could better explain the phenomenon (such as starting a new medication or having relationship issues with your spouse).
Your sexual health may not always have the spotlight amidst the other stressors that life throws your way, but you will absolutely benefit from giving yourself the attention you need. And, if you need a place to start, I invite you to schedule a consult call with me for individual or couples sex therapy. I look forward to meeting you!
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Don't avoid the issue anymore.
Let's chat; I'd love to support you towards a solution.
