A Forum For Women's Health







Orgasms: They Don't Always Come Easy
What causes problems with orgasm?
Although some women may have trouble reaching orgasm during intercourse, many mistakenly attribute their difficulty to a physical problem. However, failure to climax often arises from several transient circumstances that can be readily amended.

Stress or fatigue in a woman's life can make it difficult for her to experience orgasms. If she is worrying about, say, an upcoming deadline at work or her sister's visit, she may not be able to relax and enjoy herself during sex as easily. Another source of stress is, of course, the relationship itself. It isn't easy to let go if the man's little quirks have been especially annoying the past few days. Difficulty with orgasm may disappear when those stresses do, too.

Both drugs and alcohol have been linked to reduced libido, and are also implicated in making orgasm difficult to achieve for both men and women. While a couple glasses of wine may heat things up for the two of you, more than that may make the follow-through disappointing.

Certain medications also affect orgasm. Considerable research has explored the role of antidepressants in sexual functioning. Decreased libido and orgasmic ability is a frequently reported side effect of certain antidepressants, called selective serotonin reuptake inhibitors (SSRIs). SSRIs encompass the most popular antidepressants, including Prozac, Zoloft and many others. Physicians often fail to ask their patients taking antidepressants whether they are experiencing this side effect, so if you notice any changes in your sex habits, be sure to bring this up during your next doctor visit. Taking the lowest possible dose is one strategy for avoiding this side effect. If the drug is short acting, like Zoloft, it is possible to take a drug holiday. Because SSRIs have been successful in treating depression, research is now turning towards correcting the accompanying side effects. Currently, preliminary results indicate that psychostimulants such as dextroamphetamine and methylphenidate (Ritalin) may work. Studies indicate that the bupropion (Wellbutrin) has relatively few side effects, so switching may be the answer for some.

What You Can Do
For most women the answer is very simple. Focus more on the clitoris during sexual activities. Both manual stimulation and cunnilingus (oral sex on a woman) are quite effective. A woman is not considered to have a problem with orgasm unless she has had 30-45 minutes of direct clitoral stimulation, using a method such as the ones suggested above. The standard missionary position in sex often fails to do the trick, since the shaft of the penis misses or barely touches the clitoris. Few men are able to keep going for this length of time. While it is still possible to have an orgasm in this position - for example, when libido is high due to hormones, a new relationship, or a long time since the last orgasm - this should not be considered standard. In other words, there's nothing wrong with you or your orgasmic potential. There is something wrong with the expectation that this rather minimal stimulation to the clitoris should produce an orgasm in anything less than ideal circumstances. A simple modification of this position, called the Coital Alignment Technique, is considered to be much more beneficial for both partners - which should be what sex is all about, right?

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