Defining the cause of anorgasmia, or an ongoing inability to reach orgasm, can be as frustrating as the experience itself. Even before you track down the condition's roots, you need to recognize that it's a problem at all. It can't be emphasized enough that sex must be pleasurable in the first place to even near orgasm. I wish that were a given, but since most cultures notoriously set a ridiculously low bar for female enjoyment of sex, and even participation in their own sex lives, it's important to highlight that, yes, you should be climaxing when you want.
If you're otherwise healthy but suffering from anorgasmia, consider reclaiming masturbation. This goes both for folks in relationships and single people. On a purely logistical level, reclaiming masturbation means rejecting feelings of shame or a lack of worthiness associated with the act and the time spent. This is an opportunity to focus on your body, plain and simple.
Pleasure doesn't have to look like scented candles and bubble baths, although it absolutely can. Reclaiming masturbation in its simplest form means prioritizing your body by focusing on your pleasure. Thoughts are difficult to clear, and mentally reciting a grocery list or work worries is a surefire way to kill the mood, whether with a partner or solo.
Watching pornography or enjoying a private fantasy can serve as a distraction from thoughts, but if those outlets only trigger more thoughts, it might be time to go back to basics. Following your breath—in and out—is a way to concentrate your attention without interfering on the larger goal of focusing on physical sensation.
Medical conditions that can cause sexual dysfunction
Let's assume the problem isn't unresolved sexual trauma and that the sexual relationship with your partner (or your own body) is relaxed and enjoyable, both in the bigger picture and in the moment. In that case, you may want to check if the following health conditions are behind your sexual dysfunction (SD).
It's a common refrain in scientific studies to say far more research has been done on men's sexual dysfunctions than on women's. Sexual dysfunction in women with type 1 diabetes has been theorized to be psychologically rooted and correlated with depression, but many health concerns in women historically get chalked up to being purely mental, perhaps in part to compensate for the dearth of solid research. Other studies recognize SD as an early sign of type 2 diabetes.
It's frustrating to be told a health condition is "all in your head," but at least that means the solution may be more in your control. Anxiety and depression are psychosomatic conditions, meaning emotions turned into physical symptoms. While these conditions can have physical or genetic origins, the influence of a situation and thinking patterns can't be underestimated.
Basically, in a stressful environment, someone who's never had mental health concerns can experience depression and anxiety—that's why an unprecedented number of folks with no history of mental illness reported depression and/or anxiety in the pandemic. Similarly, becoming accustomed to spiraling thoughts without learning proper "mental hygiene," or ways to recognize and resist these awful projections, is just like any other bad habit. The obnoxious irony of depression and/or anxiety hindering sexual response is many antidepressants carry similar side effects.
In a study of alcohol-dependent Indian women, at least half reported some form of sexual dysfunction, from reduced desire to inability to reach orgasm or dissatisfaction with orgasm. Initially, drinking can result in higher levels of arousal, but constricted blood flow leads to alcohol's infamous sex-hindering effects.
Female sexual dysfunction in women with Parkinson's disease isn't very well researched or understood. While age seems to be a factor, sexual dysfunction goes hand in hand with any condition that causes nerve damage. Nerve damage is most easily recognized as numbness, pain, unprecedented sensitivity and a lack of physical awareness. That said, Parkinson's and depression also go hand in hand (both in people with depression developing Parkinson's and Parkinson's causing depression), which exacerbates stress, the enemy of any orgasm.
High blood pressure has long been associated with male SD, and research is emerging that the same is true for women. It's only logical that any circulatory disease would impact blood flow to the genitals and impede orgasm, but hypertension carries the same catch-22 as depression. Not only does the condition correlate with SD, but medications for hypertension may also inhibit sexual functions.
You deserve an orgasm
It's too easy for scientists to gloss over female SD as a result of some mythical complexity or to use research conducted on men to define and situate female anorgasmia. Orgasms generally rely on our neural and vascular health—anything impeding nerve sensitivity or relaxation should be managed in order to improve your sex life.
If you've determined that your lack of orgasm has an underlying medical cause, don't be shy about discussing it with your doctor. This is as real and important a health problem as anything else you might bring up during a checkup, and if you are worried about being embarrassed, you can send questions in advance. Although there may not be a magic pill to resolve the problem, you could at least learn what choices you might have for treatment. You deserve the pleasure of orgasm, and it's a goal worth working for.