Treatment

Treatment for anorgasmia will depend on the cause of your symptoms. It might include lifestyle changes, therapy and medication.

Lifestyle changes and therapy

For most women, a key part of treatment includes addressing relationship issues and everyday stressors. Understanding your body and trying different types of sexual stimulation also can help.

• Understand your body better. Understanding your anatomy and how and where you like to be touched can lead to better sexual satisfaction. If you need a refresher course on your genital anatomy, ask your doctor for a diagram or explore your body in a mirror.

  Self-stimulation with your hand or a vibrator can help you discover what type of touch feels best to you and can provide information you can share with your partner. If you're uncomfortable with self-exploration, try exploring your body with your partner.

• Increase sexual stimulation. Women who've never had an orgasm might not be getting enough sexual stimulation. Most women need direct or indirect stimulation of the clitoris to orgasm.

  Switching sexual positions can produce more clitoral stimulation during vaginal penetration. Using a vibrator or fantasizing during sex also can help trigger an orgasm.

  For some women, a device called a clitoral vacuum can improve blood flow and increase stimulation. This device is battery operated and hand-held, with a cup that fits over the clitoris.

• Seek couples counseling. A counselor can help you work through conflicts in your relationship that can affect your ability to orgasm.
• Try sex therapy. Sex therapists specialize in treating sexual concerns. Therapy often includes sex education, help with communication skills and behavioral exercises that you and your partner try at home.

Medical treatments

• Treating underlying conditions. If a medical condition is hindering your ability to orgasm, treating the cause might resolve your problem. Changing or modifying medications known to inhibit orgasm also might eliminate your symptoms.

• Estrogen therapy for postmenopausal women. If anorgasmia is associated with menopausal symptoms, such as night sweats and hot flashes, systemic estrogen therapy — by pill, patch or gel — might relieve those symptoms and improve sexual response.

  Local estrogen therapy — in the form of a vaginal cream or a slow-releasing suppository or ring that you place in your vagina — can increase blood flow to the vagina and help improve sexual arousal.

• Testosterone therapy. Testosterone plays a role in female sexual function, but how big a role is uncertain. Replacing testosterone in women is controversial, and it's not approved by the Food and Drug Administration (FDA) for sexual dysfunction in women.

  Additionally, it can cause side effects, including acne, excess body hair (hirsutism) and male-pattern baldness. Testosterone seems most effective for women with low testosterone levels as a result of surgical removal of the ovaries (oophorectomy).

  If you choose to use this therapy, your doctor should monitor its effects on you.