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Let’s Talk About Orgasms

Millions of women are frustrated by an inability to achieve orgasm. Historically, most men in North American society have learned to masturbate by the time they reach adolescence. Many women, on the other hand, have been led to believe that their genital area, sex, and sexual touch are taboo. As a result, countless women have not had an orgasm by the age of 18. Fortunately, attitudes have slowly shifted over time; today women are seen as needing and deserving sexual pleasure just like their male counterparts. There are now mental health clinicians specially trained to treat anorgasmia; they can identify and treat underlying causes, helping women to feel more sexually fulfilled.

The term “anorgasmia” refers to women who are unable to achieve orgasm even with ample sexual stimulation, often causing psychological distress. The most common causes for the condition include psychological, relationship, and cultural factors. Other conditions associated with anorgasmia include diseases affecting the human sexual response, gynecological surgeries, medications that interfere with orgasm, alcohol and smoking, and the aging process. Before pursuing counselling/sex therapy for anorgasmia, it is important to rule out a treatable underlying physical condition by seeing a gynecologist.

Counselling/sex therapy for anorgasmia focuses on three main areas: sex education, couple issues, and cognitive behavior therapy (CBT).

Sex Education
Women are taught about their sexual anatomy and physiology. This can include diagrams used in session as well as at-home self-examination exercises involving the use of a mirror. Women will also learn about how they like to be touched through at-home exploration of their bodies and self-stimulation/masturbation. Sometimes women have difficulty achieving orgasm because of insufficient sexual touch/stimulation. Not all women realize that stimulation of the clitoris is necessary to achieve orgasm. Altering sexual touch and sexual positions can increase the chance of clitoral stimulation and orgasm. Once women have a better understanding of their bodies and what they like, they can share this information with their partner(s), enhancing partner-sex and increasing the possibility of orgasm.

Couple issues
Relationship conflicts can affect a woman’s ability to orgasm. As such, anorgasmia is not to be viewed as the woman’s problem alone, rather as a couple issue. Counselling/sex therapy can help you to work through disagreements and tensions, which can improve sex. Couples are often taught the skill of effective communication. Not only can communication improve connection between partners, but it can also be used to enhance connection and satisfaction in the bedroom. For example, women can learn to properly communicate the forms of loving that turn them on. Couples are also likely to learn about sensate focus, which is a form of whole body massage that begins with non-genital touch and ends with genital sex. The goal is to teach couples to be more engaged in the sexual experience. Sensate focus allows for a shift in focus from orgasm to learning about how to touch and please each other. By removing the goal of orgasm, a woman who experiences anorgasmia is able to let go of anxiety and tension and thus increase her sexual satisfaction.

Cognitive Behavior Therapy
CBT is used to treat anorgasmia by focusing on changing negative thoughts and attitudes about sex. Examples of negative thoughts and attitudes include: I am not a good sexual partner, sex is dirty, and my body is unattractive. By challenging and modifying some of these unhelpful thoughts, women see a reduction in anxiety surrounding sex and are more likely to experience sexual satisfaction and have an orgasm. CBT for anorgasmia also focuses on addressing everyday stress, given that a stressed brain impedes the ability to let go and orgasm.

Although orgasm is not essential for satisfying sex, the ability to have one can be reassuring and satisfying. If you or someone you know is struggling with the inability to orgasm, rest assured that we are here to help. Call us at 514 223 5327 to set up an appointment with one of our clinicians.

Written by: Dr. Andrea Guschlbauer, Ph.D., OPQ.


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