Stefani* is a 23-year-old writer from New York City. Despite masturbating and being sexually active since she was a teenager, she has never had an orgasm. Like an estimated 10 to 15% of women, Stefani has anorgasmia, which means she's unable to achieve an orgasm, something both men and women can experience. While the term "anorgasmia" is also used in research to refer to delayed orgasm, some people like Stefani can't orgasm at all, and that's known as "primary" or "lifelong" anorgasmia.
Anorgasmia can be caused by anything from physical pelvic trauma to the side effects of certain medications to the emotional toll of sexual abuse, and the treatments are as varied as the causes. As for Stefani, her anorgasmia is due to her medication, an SSRI antidepressant (she suffers from both generalized anxiety disorder and major depressive disorder).
Unfortunately, this particular side effect of her medication is only causing her further stress (and the reactions from some of her sexual partners in the past haven't helped, either). That doesn't mean she doesn't derive pleasure from sex, though. Even without orgasm, those who have anorgasmia can, and do, enjoy sex — and Stefani's story acts as an important reminder that making orgasm the sole goal of sex creates pressure for everyone involved, and causes people to miss out on the many things to enjoy about sex aside from climaxing.
To shed light on Stefani's particular experience, we spoke with her about what it's like living with anorgasmia, her attempts at treatment, and how you can still be a sex goddess even if you don't get off.
How did you first learn you had anorgasmia?
"I didn't realize what was going on until I was about 17. I had been masturbating for years, and then started hooking up with guys who would finger me, and it felt good, even though I wasn't having orgasms and didn't even fully understand I was supposed to be. One time, this guy I was hooking up with asked, 'How do I know when to stop?' And I was like, 'Wait...now that I think of it, I have no idea.' Because I had never felt any huge release, either by myself or with a partner. So then I started researching, and I learned that it's super common to develop anorgasmia while on the meds I was taking, which are SSRI antidepressants. I've been on them since I was 11 and still am."
Did you bring it up with your doctor? How did that go?
"Yes, and my psychiatrists have said that we have to see and think about if the pros would outweigh the cons. They say it's likely if I got off of my psych meds, I'd be able to orgasm, but is that worth the risk of what could come along with being unmedicated? I have generalized anxiety disorder and major depressive disorder. I've tried switching meds to help treat the anorgasmia; I've been on Zoloft and Lexapro and then Paxil, which I'm on currently, but it hasn't helped [treating anorgasmia]. And once I find something that finally works to treat my anxiety and depression, I get scared about trying to switch again. I asked my gynecologist to check if anything physically was wrong, and she assured me that nothing was, anatomically. She very sheepishly told me I should try masturbating more. I would love to try to go to a sex therapist one day, but that's not in the cards right now, financially."
If I got off of my psych meds, I'd be able to orgasm, but is that worth the risk of what could come along with being unmedicated?
How do romantic partners react when you tell them about it?
"Everyone is always totally shocked, or they'll be, like, 'Yeah, a lot of girls can't orgasm from sex — that's normal!' But when I tell them I can't even [orgasm] through masturbation, they're dumbfounded. Plus, almost every guy who I tell assures me that he's going to be the one who will make it happen."
So how has that changed your relationships?
"I get frustrated a lot, both physically and mentally. Sometimes, I'll have mini breakdowns about it and get really upset, so then my partner will have to deal with that. I also had a boyfriend once who said he wished we could come together, and then I felt sad and guilty that I couldn't give that to him. I think it affects me and my mood more than it affects and changes relationships. I feel like my body is broken, but that's not really a burden that a partner needs to carry around."
Has anyone ever been rude to you about it or taken it personally?
"Absolutely. The guys who have actually cared if I orgasm or not will ask if I'm close, and I'll be like, 'No...' And when I explain the situation, they'll seem dumbfounded, and sometimes I can tell that they're taking it personally, so I have to tell them that it's not them; it's me. And then — I guess this is something men do in general to women, sadly — they will kind of just give up early fingering me or eating me out. I feel like they're thinking, 'I'm tired; she's not gonna come; what's the point?' One episode that was really upsetting was when a guy was going down on me, asked me if I was close, I said no and explained the situation, and he literally just got out of bed and put his clothes back on. That was pretty devastating."
That's awful; I'm so sorry. What are some other misconceptions about anorgasmia you've encountered?
"Everyone thinks that everyone can orgasm from masturbation, but if you have primary anorgasmia, and you've never had an orgasm, you can masturbate all you want and still not 'get there.' Another misconception is that I can't enjoy sex, which is totally not true. A lot of people don't seem to understand that.
"I'm a very sexual person. I love foreplay and sex and still feel a lot of pleasure. All the sensations that everyone else feels, in general, I feel too. I think the main thing that helps sex be more enjoyable is to stop focusing on whether or not you'll finally orgasm. Just focus on the sensations and the journey. This is easier said than done. Also, I've found that when I'm in serious relationships and I'm in love and having sex, it's a more spiritual act, and the connection is so strong that I'm not as annoyed that I'm not orgasming, because I get to feel that deep love."
What advice would you give to someone dealing with anorgasmia?
"Know that you're not alone. This isn't something that's talked about widely, so you can feel like the only one. If you feel comfortable with your partner, talk to them about your anorgasmia up front. This has been helpful for me in avoiding an even more awkward situation later on in the act. Also, as hard as it is, try to view sex as something to be enjoyed where you don't need to have an end goal of an orgasm. The goal should just be to feel pleasure. Try not to hate yourself or knock yourself down. Try not to tell yourself that you're broken. I think once you've accepted it, it becomes easier to be at peace with yourself."
*Name has been changed to protect her identity.
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