Causes

Orgasm is a complex reaction to various physical, emotional and psychological factors. Difficulties in any of these areas can affect your ability to orgasm.

Physical causes

A wide range of illnesses, physical changes and medications can interfere with orgasm:

• Diseases. Serious illnesses, such as multiple sclerosis and Parkinson's disease, and their associated affects on psychological well-being can hamper orgasm.
• Gynecological issues. Gynecologic surgeries, such as hysterectomy or cancer surgeries, can affect orgasm. Also, lack of orgasm often goes with other sexual concerns, such as uncomfortable or painful intercourse.
• Medications. Many prescription and over-the-counter medications can inhibit orgasm, including blood pressure medications, antipsychotic drugs, antihistamines and antidepressants — particularly selective serotonin reuptake inhibitors (SSRIs).
• Alcohol and smoking. Too much alcohol can hamper your ability to climax. Smoking can limit blood flow to your sexual organs.
• Aging. As you age, normal changes in your anatomy, hormones, neurological system and circulatory system can affect your sexuality. Waning estrogen levels as you transition to menopause and menopausal symptoms, such as night sweats and mood changes, can have an impact on sexuality.

Psychological causes

Many psychological factors play a role in your ability to orgasm, including:

• Mental health problems, such as anxiety or depression
• Poor body image
• Stress and financial pressures
• Cultural and religious beliefs
• Embarrassment
• Guilt about enjoying sex
• Past sexual or emotional abuse

Relationship issues

Couples' problems outside of the bedroom can affect their sexual relationship. Issues might include:

• Lack of connection with your partner
• Unresolved conflicts
• Poor communication of sexual needs and preferences
• Infidelity or breach of trust
• Intimate partner violence