Physical reasonsThe most common physical cause is lack of adequate stimulation to the clitoris. The majority of women need direct touch to achieve orgasm, which often doesn't happen through intercourse alone.
 Our bodies aren't machines - you can't get an orgasm just by pressing the right button
The second most common factor is tiredness or general illness. Our bodies aren't machines - you can't get an orgasm just by pressing the right button. If you're feeling rundown, your body's priority is sleep and recuperation, not sexual gratification. Medical reasonsThere are some illnesses that make orgasm difficult. Broadly speaking, they're vascular, neurological or hormone-deficiency disorders. The problem could be a side effect of a particular medication. Very occasionally, pelvic surgery can cause nerve damage and loss of sensation. If you think any of these conditions may apply to you, talk to your GP. If, however, you're in good physical health and you're getting enough sleep, it's more likely there's some kind of psychological block. Self-help techniques- If you're not getting the right kind of stimulation, you may need to show your partner what you really enjoy.
- First, get to know yourself by starting with some basic self-pleasuring, taking particular note of the type of stroke that pushes you over the edge.
- Then, next time you're making love, put your hand on top of your partner's and gently guide them as they stimulate you. If that feels a bit pushy, ask them to show you what they enjoy first, then wait for your turn!
- For more help, see the section on practical exercises.
Psychological reasonsWell-meaning friends may tell you to just "try to relax", but if it was that easy you'd have done it by now. The trouble is, these kinds of psychological blocks aren't rational - you can't simply "pull yourself together". Below is a list of some of the most common types of problems women have talked about. See if any apply to you: - Being a perfectionist. Sex has to be just right. The environment has to be just so and you have to be in the right mood.
- Fear of losing control. This is a character trait in many areas of your life, not just sexually.
- Poor self-esteem or body image. Worrying about whether your bum looks big rather than enjoying your physical sensations is a major passion wrecke.
- Shame or guilt about sexuality. This might be due to negative childhood messages or a sexual trauma.
- Distractions. Are the children asleep? Will the phone ring? Can the neighbours hear? Did I put the cat out? Did I email that report? Whatever the distraction, it means your mind is not on the job.
- Being a spectator. You know the saying "a watched pot never boils"? Well it's also true of orgasms. If you're waiting for the moment, you're not enjoying the moment.
- Relationship problems. You can't expect to have enjoyable sex with an enemy. If there's tension in your relationship, sort it out before you enter the bedroom.
Orgasm triggersThere are several ways in which you can help yourself achieve a more fulfilling sexual experience: - Breathe deeply or pant to get oxygen to those tensing muscles.
- Arch your back or try a different position to maximise clitoral stimulation.
- Rhythmically squeeze your pelvic floor muscles.
- Escape into your favourite fantasy to block out any negative thoughts or distractions.
Further helpIf some of these points have rung a bell for you, you may find that simply talking it through with your partner will help. You could also try some of the practical exercises on our site. These have tips and techniques that you can print out and try. It may also be helpful to get advice from a sex therapist or couple counsellor via Relate or the British Association for Sexual and Relationship Therapy. See related links. In the meantime, there are many self-help books available.
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