Why Can’t I Orgasm? 6 Causes and How to Work Through Them, According to a Sex Therapist Turned Neuroscientist

Beyond cultural programming, sexual abuse or traumatic experiences related to our sexuality can shut down our ability to relax into sensations and feel comfortable with and entitled to having sexual pleasure.

The trauma needn’t be extreme to imprint us with a blockage to letting go into the release of orgasmic delights. For example, a client of mine struggled with the ability to orgasm for years that stemmed from something that happened when she was a kid. While taking a bath, her mom walked in and saw her touching her genitals when the soap slipped between her legs and yelled in an uncharacteristically harsh way. Put that together with a Catholic school education, and what you got was a big, fat orgasm blockage.

The solution: If you have been shamed about sex or have traumas big or small, talk to a sex therapist. After some work, that client was able to permit herself to release into orgasm after recognizing how her bathtub shaming experience kept her from exploring pleasure. After a few sessions of unpacking this old learning, she was able to discover her orgasm after making good friends with a vibrator.

3. There’s a physical cause.

Age can also play a role; women 49 years and older are more likely than younger women to experience orgasmic dysfunction. As we age, the production of our sex hormones tends to slow down, making arousal and orgasm potentially more challenging during sexual experiences. Another factor can be a loss of tone in the pelvic floor muscles.

Talk to your healthcare provider if you think there may be a medical condition impacting your sex life. “An often overlooked hormone issue that can contribute to difficulty orgasming is insulin resistance,” says Dr. Brighten. “The nerves and blood vessels of the clitoris, like the penis, can be damaged by elevations in blood sugar, as we see in diabetes. If you’re noticing you’re hungry all the time, developing skin tags or darkening skin, frequently needing to urinate, and often thirsty, it’s worth a visit to your provider. If diabetes is the cause, your eyes, kidneys, and even the feeling in your fingers and toes can be compromised.”

The solution: As mentioned, talk to a healthcare professional if you have health issues. Because if you use it, you’re less likely to lose it. Being physically and sexually active is the most potent way to maximize our ongoing sexual potential by bringing increased blood flow to our genitals and strengthening the pelvic floor.

4. You’re wrestling with depression or anxiety.

Feeling depressed, anxious, or psychological factors can certainly put a damper on our sexual response. And so can the use of antidepressants like selective serotonin reuptake inhibitors, also known as SSRIs (Paxil, Prozac, Lexapro, etc.), that can treat these conditions. These drugs can impact the serotonin system in ways that squash sexual desire and impair the ability to orgasm. And likewise, if you are self-medicating anxiety or depression with alcohol, that also can blunt the sexual response.