Defining Orgasm

Q:

What does an orgasm feel like? I'm 30, sexually active, and I don't think I've ever had one. Could something be wrong with me?

A:

I can't tell you what an orgasm feels like because every woman's orgasm is unique. Scientifically, however, it is described as the "sudden release of muscular and nervous tension at the climax of sexual experience."

Most women, except those with certain medical conditions such as severe diabetes or severe multiple sclerosis (MS), or those who have undergone surgery affecting the pelvic nerves, can have orgasms. Aside from physical conditions, other women may not have orgasms because of physiological issues that prevent them from experiencing one. There is more on this below.

A large percentage of women can achieve orgasm readily and reliably with some particular forms of stimulation-like masturbation-but not others. In fact, it is important to recognize that intercourse is not a particularly reliable way for some women to achieve an orgasm.

One of the most effective approaches to achieving orgasm includes learning to be comfortable with your own body and then your own sexuality by changing any negative attitudes and decreasing any anxiety.

Debunking myths and negative impressions about masturbation is a common theme in treatment of sexual problems. Masturbation is an extremely effective way for a woman who has never achieved orgasm to experience her first climax. In a situation of privacy, without the pressure of performing for or pleasing a partner, you can be free to explore your own body and learn what feels good.

If you successfully reach orgasm with masturbation, this should reassure you that there is nothing physically wrong.

The following are also considerations for why you may be having difficulties:

1. Are there factors that could be affecting your relationship? Perhaps you're angry with your partner or feeling resentful. You might be bringing your work stress to the bedroom. Another factor to be considered is if you are self-conscious during sex. If you are experiencing any issues that might be affecting your relationship, then it's time to have an honest conversation with your partner. You also may need to learn to focus more during sex.
2. Are you taking any medications? Certain medications-some types of antidepressants, for example-can cause sexual problems. It's important that you don't stop taking your medication. Talk to your doctor about the possibility that it could be affecting your sex life. If your health care provider determines that your medication may be affecting your sex life, he or she may prescribe a different medication that may not have the same side effects.
3. Have you been diagnosed with any physical conditions? Certain medical problems such as nerve problems, weak pelvic floor muscles or inadequate blood supply to the genitals can affect your ability to achieve an orgasm. For instance, women with epilepsy and multiple sclerosis tend to have a difficult time reaching orgasm and have more sexual problems overall than women without epilepsy. If this is the case, discuss your sexual health concerns with your health care team that helps you manage your condition.

If you are still having difficulty, you may want to see your health care professional, who will likely examine you and take a thorough sexual history to establish whether or not any physical problems could be interfering.