Overview of orgasm difficulties in females
This topic describes treatment of difficulties in orgasm in individuals presumed female at birth, other than those undergoing (or who have had) gender-affirming hormones or surgery; see resources on sexual health relating to gender-affirming treatment on the TransHub website.
Healthcare providers are encouraged to use a sensitive approach that avoids assumptions about gender identity, sexual orientation or sexual practices.
For guidance on healthcare issues specific to individuals of diverse sexual orientation, see A guide to sensitive care for lesbian-gay-and bisexual people attending general practice at the Rainbow Health Victoria website.
Difficulties with orgasm are common; in a survey of females in Australia, 29% reported experiencing difficulties for at least 1 month in the previous year1. If someone has never had an orgasm and is distressed by this, consider possible causes such as a lack of sexual education, sexual communication with partners or experience with self-stimulation.
Acquired anorgasmia can occur with medications (eg psychotropics, narcotics, antiandrogens, amfetamines, cancer therapies), as well as conditions such as hypothyroidism and neurological disorders. If orgasm occurs with self-stimulation but not during sex with a partner, then underlying biological causes are unlikely. Difficulties within the relationship or with communication about sexual needs may be factors. Some changes in orgasmic response may be expected with normal ageing, such as less intense or delayed orgasms.
See Screening and assessment for sexual difficulties for advice on how to broach sexual issues and a general approach to assessing sexual difficulties.