Anonymous on August 29, 2011

I haven’t had an orgasm in 20 years. What can I do?

I’m 45 and I haven’t been able to have an orgasm for more than 20 years…either by masturbation or intercourse. I was able to have them as a teenager and young woman, but they stopped after I had a serious anxiety disorder and left my husband. I do go to a therapist, but not specifically for this. I’m single and this interferes in my relationships with men because they seem to think it’s a reflection on them…which only causes me more anxiety. What should I do?

answered by Annette Fuglsang Owens, MD, PhD on August 29, 2011

I’m sorry to hear about the anxiety you’re experiencing, and I’ll do my best to offer you some helpful considerations.

First, you’re not alone…sexual problems are actually a rather common complaint among both women and men, especially as we get older. While the reasons for not being able to orgasm vary greatly, you’re right in that your anxiety disorder may be creating a psychological block that’s inhibiting your sexuality.

In terms of psychological reasons for not being unable to orgasm or climax...depression and anxiety are known to make it difficult to reach orgasm. You mentioned that you don’t see your current therapist specifically for the sexual dysfunction you describe, so I would encourage you to also see a trained sex therapist. For starters, theAmerican Association of Sexuality Educators Counselors and Therapists provides a clearinghouse of licensed sex therapists around the country. You can also try to bring up the sexual issue with a therapist to see whether he or she can address it with you, or knows of anyone to refer you to in your area.

That said, there are also physical causes of sexual dysfunction. Hormone imbalances, drug side effects and heart problems are just a few health conditions that can affect your sexual response. So, if you haven’t already, I would also suggest that you see your regular doctor for a full physical exam, and to discuss what else might be contributing to your inability to reach orgasm.

Some medications may also make it more difficult to orgasm. For example, if you’re taking medication for your anxiety disorder, you may want to talk with your psychiatrist or prescribing doctor about potential side effects of your treatment.

One type of medication that is sometimes prescribed for anxiety disorders is a type called selective serotonin reuptake inhibitors (SSRIs). While these drugs are helpful in dealing with anxiety issues, many people feel a loss of interest in sex and/or ability to orgasm while taking the medication. To be clear, I don’t suggest that you stop taking any medications without consulting your doctor…rather, I urge you to speak with your doctor about your inability to orgasm, and discuss whether a modified treatment plan is an option for you.

These are just a few ideas for you to look into. I wish you strength and courage in overcoming your anxiety and enjoying a satisfying sex life once again.

Related info:

Annette Fuglsang Owens, MD, PhD

Dr. Owens is an AASECT-certified sexuality counselor. Her areas of expertise include the medical aspects of human sexuality and sexual problems, as well as the impact of STDs ⎼ and other diseases, illnesses and disabilities ⎼ on sexuality. Dr. Owens was educated at the University of Copenhagen in Denmark.

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