An orgasm is defined as a “sudden and involuntary liberation of sexual tension” (Nagoski, 2015), that can be accompanied by contractions of the pelvic floor muscles, intense pleasure, a feeling of fullness, hypersensitivity in the genital region, as well as other bodily and emotional changes, that happens generally after a period of heightened sexual arousal (Mah & Binik, 2002).
Although it’s not the only aim when it comes to sexual practices, it does make up an important part of sexual satisfaction (Laan & Rellini, 2011). Nevertheless, for some people, orgasm can be difficult or even impossible to reach, despite experiencing what is considered to be a sufficient amount of stimulation. These situations are grouped under the terms anorgasmia or orgasmic dysfunction.
Clinical Definitions
In women, orgasmic dysfunction is characterised by the absence, delay, infrequence or a significant decrease in the intensity of orgasms, provoking distinct levels of distress in at least 75% of sexual relations and over a minimum period of six months (DSM V, APA, 2013). Its prevalence changes in different parts of the world: between 16% and 28% in most regions, and up to 46% in certain countries around Asia (Laumann et al., 1999 ; Palacios et al., 2009 ; West et al., 2004 ; Zhang et al., 2017).
In men, anorgasmia or delayed ejaculation is a persistent or recurrent delay or absence of orgasm, after an average period of sexual arousal deemed adequate in terms of concentration, intensity and length. Men diagnosed with this problem experience difficulties reaching orgasm and ejaculating. This problem can cause severe stress or even interpersonal difficulties (DSM V, APA, 2013). Its prevalence is estimated between 1% and 4%, making it one of the least common, least studied male sexual health issues (Chen, 2016).
Orgasmic dysfunction can be permanent (has always been present) or acquired (appears after a period of normal operation), and generalised (in all situations), or situational (only under certain conditions).
Disparities Amongst Gender and Sexual Orientation
Via a large scale study, 64% of women, compared to 91% of men reported having an orgasm during their last sexual experience (Mintz, 2017). What’s more, Garcia et al. (2014) state that women reach orgasm 60% of the time with a male partner, 75% of the time with a female partner, whilst men sit somewhere between 80% and 85%, regardless of their partner’s gender.
This disparity is a reminder of what we call the ‘orgasm gap’, meaning the real difference between the frequency of male versus female orgasms. This sheds some light upon the first social and educational factor surrounding problems related to orgasms.
Biological Causes
For women, this problem can, amongst other things, be due to:
- Pelvic floor muscle issues,
- Hormonal changes (menopause, hormonal contraceptives, hormonal treatments),
- Secondary medical effects (SSRI anti depressives, antihypertensives, analgesics, chemotherapy),
- Chronic illnesses (diabetes, multiple sclerosis, vascular illnesses),
- Nerve injuries after surgery or trauma (Marchand, 2021).
For men, anorgasmia or delayed orgasm can, amongst other things, be due to:
- Chronic, neurological or endocrine illnesses,
- Side effects to medication,
- Erectile dysfunction,
- A masturbating style that’s difficult to recreate with a partner (Perelman & Rowland, 2006).
Psychological Causes
The following psychological factors, amongst other things, can affect any gender:
- Performance anxiety and pressure to orgasm,
- Psychological problems such as depression, anxiety, low self-esteem,
- Negative body image, negative thoughts, and a lack of information surrounding sexuality,
- Cultural or religious pressure that limit the expression of sexual pleasure (Marchand, 2021),
- Unwanted or traumatic sexual experiences (Rowland et al., 2018) and the emotional consequences linked to such experiences (Tavares et al., 2018),
- Relational factors such as communication, relationship satisfaction, the partner’s sexual generosity… (Barnett & Melugin, 2016).
Physiology and Sexual Response
Sexologists Masters & Johnson (1966) described sexual response as the completion of the cycle consisting of sexual arousal (1), the phase in which arousal is held, orgasm (3), and the resolution phase (calming back down) (4). The most recent approaches insist upon a multidimensional nature of orgasm, where emotional, cognitive and relational dimensions are just as important as physical stimulation (Basson, 2000 ; Kaplan, 1979).
During moments where it’s difficult to reach orgasm, the plateau (2) phase notes differences in sexual response, before it passes straight into the resolution (4) phase (Adam et al., 2015). It’s not for a lack of pleasure, it’s actually the opposite, as the plateau phase often lasts much longer. It’s simply that the person doesn’t reach the point of no return that sets off an orgasmic response.
Strategies and Techniques to Promote an Orgasm
- Develop body consciousness: interoception, meaning the capacity to detect internal signals (cardiac rhythm, breathing, muscle tension…), is associated with a higher frequency of orgasms (Klabunde et al., 2024). Practices such as yoga, mindful breathing and body scan meditation are all useful.
- Minimise intrusive thoughts: mindfulness allows you to concentrate on your feelings, reduce distracting thoughts (Brotto et al., 2012) and the experience of spectatoring (watching yourself from an outside perspective and having critical thoughts). A study shows that women who manage to reach orgasm have learnt to direct their attention to their bodily sensations, erotic fantasies, and to redirect them towards erotic stimuli during moments where there’s a loss of concentration (Adam & Grimm, 2023).
- Solo exploration: masturbation helps to identify the zones and rhythms that facilitate reaching orgasm (Herbenick et al., 2010). Having anatomical knowledge is also necessary, as studies show that the rate of orgasm can increase by 41% after one single sex education session aided by an audiovisual medium (Jankovich & Miller, 1978 ; Kilmann et al., 1983).
- Using sex toys (this will be discussed in the next section).
- Communication: explain your preferences, guide your partner and give them clear feedback, ensuring that it’s always well meaning. All of this favours adapted stimulation (Barnett & Melugin, 2016). Thus, over time, knowledge of your own body and that of your partner will increase, favouring pleasure.
Particularities for Women
Clitoral stimulation is necessary for 70 to 80% of women to reach orgasm (Levin, 2003). Women should therefore not hesitate to stimulate themselves manually or with a sex toy to make reaching orgasm easier during relations with a partner, and not rely on penetration alone. That being said, penetration can stimulate the internal part of the clitoris, as it extends about 3.5 inches around the vagina (O’Connell et al., 2005), but external stimulation remains more accessible and more efficient for most women. One study shows, for example, that stimulating the clitoris with a vibrator improved orgasms for 65% of women interviewed (Guess et al., 2017).
What’s more, during penetration, certain techniques can be useful (Hensel et al., 2021) to improve the pleasure experience:
- Angling: angling the pelvis to target specific internal zones.
- Rocking: creating friction against the clitoris during penetration.
- Shallowing: partial penetration, at the vaginal entrance.
- Pairing: simultaneous external stimulation.
- Pompoir (or the Singapore grip, voluntarily contracting the vaginal muscles) can also intensify sensations and promote orgasm. Don’t forget that extended foreplay increases arousal, lubrication and how receptive one is to pleasure.
Particularities for Men
Developing the pelvic floor muscles (specifically thanks to kegel exercises) improves the quality of erections, ejaculatory control and orgasmic intensity (Hall et al., 2018). Moreover, techniques such as edging (alternating between moments of stimulation and taking breaks) can help to better control the moment in which orgasm arrives (Ozbek, 2025). Diversifying forms of stimulation (perineum, prostate, anus, genitals), can enrich the sensory palette and amplify sensations of pleasure. Thus, penis vibrators can help to restore orgasmic capacities in men who are struggling with this type of problem (Nelson et al., 2007). Following the same idea, varying masturbation styles can also diversify sensory experiences in order to help one avoid becoming conditioned to a single form of stimulation that leads to orgasm (Perelman & Rowland, 2006).
Work on Limiting Factors
Fatigue, stress, and anxiety can all inhibit orgasmic responses, as can living a sedentary lifestyle (Salari et al., 2025). On the contrary, good cardiovascular health, regular physical activities and a balanced lifestyle favour sexual good responses (McCool-Myers et al., 2018).
Sex therapy centred around Sensate Focus (an exercise involving gradual bodily and sensorial exploration, without focusing on performing) show positive results in improving the orgasmic response (Binik & Hall, 2014). Likewise, guided masturbation, a technique that stems from cognitive behavioural and mindfulness studies, consists of gradual exposure to genital stimulation that’s associated with:
- Working on paying attention to sexual signals,
- Feeling more comfortable in erotic situations,
- Eventual usage of genital stimulators or erotic fantasies,
- Reducing anxiety and spectatoring,
- Calling into question negative beliefs surrounding sexuality (Heiman & LoPiccolo, 1988).
Don’t hesitate to consult a sexologist if you want to talk about or get started with these techniques!
Conclusion
Orgasms are both a physiological and psychological experience, influenced by individual, relational and contextual factors. For those experiencing problems reaching orgasm, a multidimensional approach that mixes understanding the body, affirming one’s needs, and specific techniques to offer veritable possibilities to improve the situation. The key often resides in patience, exploration and self well-being. As Emily Nagoski points out, orgasms are less adapted to equalling sexual wellbeing than pleasure itself (Nagoski, 2015). Diversifying practices, the frequency, ambiance and emotional intimacy between partners also play a decisive role in sexual satisfaction (Gouvernet et al., 2023).
This article was written by Louise PAITEL , a clinical psychologist/qualified sex therapist and researcher at the Université Côte d'Azur in Nice. Louise brings her scientific expertise and kind, open-minded approach to sexuality to the LOVE AND VIBES Team.
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