What Is Orgasmic Dysfunction & How Can It Be Treated?

By Dr Claire Giuliano

You’re with your group of best friends. You’re a couple of drinks (or bottles) in. One of your friends jokingly mentions they have never had an orgasm. You all gasp, laugh and tell them to invest in a good toy. Despite appearances, this is not necessarily a joking matter, and could potentially allude to a deeper problem - including orgasmic dysfunction.

There are many individuals experiencing orgasmic dysfunction, which makes for a big buzzkill between the sheets. However, sharing conversation about this condition is not a cocktail conversation people like to have. So, we’re going to have it for you. We’re going to cover everything you need to know about orgasmic dysfunction, from what it is, how it differs between males and females, and how you can seek help for the condition.

What is orgasmic dysfunction?

Orgasmic dysfunction is exactly what is sounds like – the inability to orgasm or reach a climax during sexual intimacy. This can lead to low libido or lack of attraction to a partner if orgasm is not occurring with sex. Some individuals are still able to feel aroused when experiencing this issue, but they simply don’t climax. This can be a frustrating and deflating condition to live with, but thankfully there are tools to help individuals navigate intimacy and find enjoyment during sex.

Are there different types of orgasmic dysfunction?

Many individuals experiencing this condition do not categorize the type they have. However, there are three different types of orgasmic dysfunction considered by the medical community: primary, secondary, and general.

Primary orgasmic dysfunction

Primary orgasmic dysfunction is when an individual has never achieved an orgasm. This is also sometimes referred to as anorgasmia. This excludes individuals who have never been sexually active, and refers to individuals who engage in sexual activity but cannot reach climax.

Secondary orgasmic dysfunction

Secondary orgasmic dysfunction is when an individual has achieved an orgasm but has difficulty experiencing one with most sexual activity. This type of dysfunction often benefits from longer foreplay, sex tools, or changing inhibitory environmental factors. This individual may have acquired anorgasmia from a disease process or surgery.

General orgasmic dysfunction

General orgasmic dysfunction is when an individual is unable to reach orgasm or arousal. This type is similar to primary, but refers to individuals who have taken measures for treatment or sex tool use and are still unable to reach climax.

How common is orgasmic dysfunction?

Statistically, it is reported that orgasmic dysfunction occurs in 11-41% of the female population, and 1-4% in the male population. However, this number is likely underreported due to shame and embarrassment of the diagnosis. Many individuals will not seek medical help for this reason. The wide statistical range also speaks to a lacking body of research that deserves attention to better understand why individuals are experiencing a disruption in their sex life.

Orgasmic dysfunction in women.

Female orgasmic dysfunction may be present from the first time an individual engages in sexual activity, and other times it may be acquired at some point during life. Contributing conditions and factors to this condition include (but are not limited to) dyspareunia (pain with sex), hormonal changes, history of sexual assault, stress, and/or cultural or religious beliefs about sex. Orgasmic dysfunction can take a big toll on mental health, so it’s important to find a sex counselor or psychologist who can help.

In women, hormonal changes naturally occur postpartum and during menopause, and can ultimately contribute to female orgasmic dysfunction. Other times hormonal changes may also occur from a surgery that removes a pelvic organ or hormonal gland in the body. Being prepared ahead of time to better support your sex life is key. Using plenty of lube during foreplay and penetration will help things go smoothly (literally). Using extra stimulating toys will also optimize the sexual experience.

Orgasmic dysfunction in men.

In men, orgasmic dysfunction involves inability to ejaculate, or a delay in ejaculation. This is medically classified as taking 30 minutes or more to ejaculate. The DSM-5 states that only 25% of men regularly ejaculate with sexual activity. Studies do not include detail as to the type of sexual activity participants are engaged in and if tools or foreplay is involved, which may be a key indicator to optimal sexual intimacy. At Pepper, we always encourage finding the right add-ons to your sex life so you can bump up your chances for climax.

Furthermore, it is important to consult with a medical provider who can screen for hormonal issues and pelvic health dysfunction, such as blockages in the urethra or vesicles of penis, or other potential tissue restrictions. Your doctor may prescribe hormone medication, as well as erotic sex toys to assist with ejaculation and intimacy with yourself or your partner when experiencing this issue.

What causes orgasmic dysfunction?

Like any medical condition, each person may have an individual presentation or cause.

Lack of intimacy

Lack of emotional intimacy with a partner can lead to orgasmic dysfunction and render couples no longer interested in sex. In this case, using creativity in the bedroom with new toys and props can work wonders. Perusing sex toys with your significant other can be a stimulating activity to do together as a couple.

Vaginismus and erectile dysfunction

The most common conditions coupled with this condition are vaginismus in women, and erectile dysfunction in men. Both conditions may inhibit sex entirely, which do not allow for orgasm or stimulation. Working with a pelvic floor therapist to first resolve the root of the issue will help individuals lead to achieving orgasm with sex.

Trauma

Sexual trauma or violence is an unfortunate cause for many individuals with orgasmic dysfunction. Overcoming past sexual trauma is a reality for many individuals and working with a counselor is of paramount importance as a foundational step before returning to comfortable and safe sexual intimacy.

Surgery

Removal of a pelvic organ due to cancer, acute trauma, or severe infection may lead to this condition because of structural anatomical changes in the body. This does not mean orgasm will not be achievable; the body may still be able to reach orgasm with muscle retraining. Working with a pelvic floor therapist will help guide an individual through this process.

How can you treat orgasmic dysfunction?

See your doctor

Your doctor may prescribe a topical hormone or oral hormonal pill if you’re experiencing orgasmic dysfunction. To receive a thorough evaluation, your practitioner should also screen for thyroid function.

Eliminate alcohol and cigarettes

Alcohol and smoking are known to decrease circulation in the body and have long term effects that are detrimental beyond sexual function. Eliminating these two things can be one line of defense in treating orgasmic dysfunction and improve sexual intimacy in more ways than orgasm.

Use sex toys

We’ve said it before and we’ll say it again: sex toys aren’t solely for pleasure, they can also be used to help treat a number of different issues. Get comfortable with them because they should be your new best friend, and find a toy that is aesthetically appealing so you have a stronger desire to use it.

Shameless plug time. Pepper has an extensive assortment of sex toys. If color matching is important with the interior design of your room, you can easily find a match at Pepper. Supplement your sex toys with other sexually stimulating agents like candles and massage oil to fuel the fire of your sex life. There is truly something for everybody and every body - we’ve made sure of it.

Regardless of the type of orgasmic dysfunction an individual is experiencing, a good sex toy will help you navigate your path to orgasm. Foreplay is of paramount importance to get the juices flowing and ready for optimal intimacy.

Starting with a foundational piece like the Bougie Bullet keeps things uncomplicated with penetration. Lighting a massage candle and using massage oil for a pre-penetration rub down can be a stimulating precursor for orgasm to start things slowly. Sometimes, stimulating the genitals from multiple angles can also help things move more effectively toward climax, and the Duo Vibe should be on your bedside table in close reach to help assist you and your partner.

Ultimately, this condition does not have to be a permanent one, and can be overcome with time, tools and treatment. Finding a medical support team to help you navigate this process is the best thing you can do for your sex life if you are living with orgasmic dysfunction. Also, remember to go easy on yourself, and know you don’t have to battle it alone.

Claire is a pelvic floor therapist with a distinct specialty certification in pelvic rehabilitation (PRPC). She is the private clinic owner of Rooted Pelvic Health & Hand Therapy in Sun Valley, Idaho. She treats all gender diversities for pelvic floor-related conditions including sexual dysfunction, gynecological cancer recovery, and chronic pelvic pain. Claire's mission is to improve overall function and quality of life with lasting results for her clients. As a contributing writer to Pepper Together, Claire seeks to provide education about a subject that deserves more attention. She hopes that by spreading the word about pelvic floor conditions she can break the stigma about conversations around sex, and provide simple solutions to improve sexual intimacy.