Dear Dr. Kate: Am I Wired Not to Orgasm?

Dr. Kate is Dr. Kate is an OB/GYN at one of the largest teaching hospitals in Boston, and she answers your medical questions on EMandLO.com. To ask her your own question, click here.

Dear Dr. Kate,

I’m a sex-positive, reasonably experienced 27-year-old woman who enjoys sex and being sexual. But I’ve never experienced any pleasure from my clitoris, be it alone, with various toys, or through oral sex or manual stimulation from various partners. It doesn’t hurt, but it does feel “intense” in a way that can sometimes be unpleasant.

The pleasure that I get from sex comes more from the feeling of “fullness” and from the psychological/emotional aspects. My doctor tells me that nothing’s wrong with me physically and that I should try new techniques, but I feel like I’ve tried everything.

I’ve never had an orgasm, because while I do enjoy sex, the pleasure is never very intense. Is there anything else I can try? Should I just accept that this is the way I’m wired?

— Button Pusher

Dear Button Pusher,

The bottom line is that there’s always something else to try. We know that some medical conditions or treatments can affect the ability to orgasm, but the list of things is not long — diabetes, spinal cord injury, many antidepressant medications. And any chronic, debilitating medical condition can affect your sexual functioning. But if you’re healthy, and not on any medications, there’s no evidence that someone like you is not “wired” to climax — you just haven’t figured out what works for you.

It’s wonderful that you feel such fulfillment from sex without orgasm — it’s a great start, and frankly necessary for a lifetime of pleasure. It certainly sounds like you’ve been experimenting in many ways – I don’t know if you’ve tried these approaches, but these have worked for some of my patients:

1) Indirect stimulation. For many women, direct contact on the clitoris is way too intense, and often too painful, to lead to pleasure. Try touching your clit (fingers, tongue, vibrator) on the side, through the labia minora, or through your underwear.

2) Lubrication. It’s not just for him — using lube on yourself can mean the difference between pleasure and pain.

3) Slow it down. The clitoris is not a tiny penis — often it’s a slower or lighter touch that starts the fire.

If you’re saying “been there, tried that,” then it may be time to seek professional help. No, not a male escort. A women’s health provider who has experience/training in issues around sexual functioning. If you don’t think your doctor can give you specific advice, you can find such providers in your area using this directory.

I wish you the best of luck.

— Dr. Kate


dr_kate_100Dr. Kate is an OB/GYN at one of the largest teaching hospitals in Boston. She also lectures nationally on women’s health issues and conducts research on reproductive health.




One Comment

  1. My girlfriend is exactly like you. Here’s what we figured out: I insert my thumb (trimmed nail facing up) all the way and then apply pressure downward. I don’t do anything with her clitoris except that my wrist is there. She squeezes her legs together interlocking her ankles. I push down and release and then push etc. By the end I’m pushing as hard as I can with my thumb. Maybe that will work for you.

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