Why are some women never able to orgasm? A gynaecologist explains

Despite modern society being able to openly discuss female sexuality, there remains a number of existing taboos.

One of the most glaring is female orgasms. Women are rarely taught about the intricate details of their anatomy and often work these things out through their own experimenting.

What is the best way to get an orgasm? How often should I have one? Should I be able to have one during penetrative intercourse? Why have I never had one? Questions not uncommon to hear among small friendship groups of women over a bottle of wine.

Dr Sherry A Ross, an LA-based gynaecologist with 25 years experience aims to educate with a complete guide to the vagina in her new book She-ology: The Definitive Guide to Women's Intimate Health. Period.

In the foreword of her book, Dr Sherry notes that “talking about the mighty V outside of doctor’s offices and bedrooms has remained a major taboo” and devoted an entire chapter to the female orgasm.

The Independent asked the gynaecologist and obstetrician all the questions about female orgasms that are rarely spoken about.

Why might some women never orgasm?

Attitudes regarding sex, sexuality and gender vary greatly between different cultures and religions. Certain sexual practices, traditions and taboos are passed down through generations, leaving little to the cause of female pleasure or imagination.

For some women, finding and/or enjoying sexual intimacy and sex is difficult, if not impossible. Research suggests that 43% of women report some degree of difficulty and 12% attribute their sexual difficulties to personal distress. Unfortunately, sexual problems worsen with age, peaking in women 45 to 64. For many of these women the problems of sexual dysfunction are treatable, which is why it is so important for women to share their feelings and concerns with a health care provider.

Unfortunately, there has been a history of “gender injustice” in the bedroom. Women have long been ignored when it comes to finding solutions to sexual dysfunction. In short, there are twenty-six approved medications for male erectile dysfunction and zero for women. Clearly, little attention has been paid to the sexual concerns of women, other than those concerns that involve procreation.

How many women might never orgasm?

During my 25 years in private practice, I’ve met a number of women in their 30s, 40s and 50s who have never even had an orgasm. In fact, 10 to 20% of all women have never experienced one.

Issues related to sex are not talked about enough even with a health care provider. Let’s just start by saying, 65 per cent of women are embarrassed to say the word vagina and 45 per cent of women never talk about their vagina with anyone, not even with their doctor.

Some patients say they have pain with sex, have problems with lubrication, don’t have a sex drive or don’t enjoy sex. My first question is “Are you having problems in your relationship?”, “Do you like you partner?” , “Are you able to have an orgasm?”, “ Do you masturbate?” These open-ended questions tend to bring out sexual dysfunction including the inability to have an orgasm.

There is a great deal of embarrassment and shame when a woman admits she has never experienced an orgasm.

Is the inability to not orgasm normal?

The inability not to have had an orgasm can reflect women’s inability to know they own anatomy and may not be a disorder at all. In a survey of women aged 16-25, half could not find the vagina on a medical diagram. A test group of university- aged women didn’t fare much better with one third being unable to find the clitoris on a diagram. Clearly, if you can’t find it, how are you going to seek enjoyment from it?

Women must first understand what brings them pleasure and in their pursuit of happiness they have to understand where their clitoris is and how to stimulate it. Masturbation is a skill. It has to be learned, just as walking, running, singing and brushing your teeth.

What is an orgasm disorder and how would you categorise one?

The inability to have an orgasm falls under the category of Female Sexual Dysfunction of which there are five main problems: low libido or hypoactive sexual desire disorder, painful sex, sexual arousal disorder, an aversion to sex and the inability to orgasm.

Hypoactive sexual disorder, the most common female sexual dysfunction, is characterised by a complete absence of sexual desire. For the 16 million women who suffer from this, the factors involved may vary since sexual desire in women is much more complicated than it is for men.

Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. The daily stresses of work, money, children, relationships and diminished energy are common issues contributing to low libido in women.

Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms or a history of physical or sexual abuse.

You are the person in charge of your vagina and clitoris. First and foremost, get to know your female parts intimately. Understanding your sexual response is a necessary health and wellness skill. Make mastery of that skill a priority.