Is Your Orgasm MIA?

Is your orgasm MIA? It happens to everyone: Despite your best efforts, you just... can’t... get there. Find out what’s holding you back, plus tips to get you going again...

Up to 80% of women

don’t climax through intercourse alone, but most of us find a way – with a helping hand – to cross the finish line. Maybe not every time, but more often than not. But some don’t – ever.

The official medical term for a permanently missing orgasm is “anorgasmia.” And although firm numbers are tough to come by – because women don’t like to admit the problem or talk to their doctors about it – sex experts guess that about 10% of women do the deed without fireworks.

That doesn’t mean sex isn’t enjoyable, but it’s like getting sidelined at a theme park while your pal rides roller coasters. After a while, you get tired of watching him scream with excitement.

So what’s up down there?

Sometimes it’s a medical problem. Diseases like diabetes and multiple sclerosis, which deaden nerve endings, and depression, which deflates desire, can derail orgasm. Other culprits are drugs, like birth

control pills, blood pressure drugs and antidepressants, such as selective serotonin reuptake inhibitors (SSRIs). You’ll need a doctor’s help to diagnose the problem and figure out the right remedies.

But for many women, the inability to orgasm is all in their heads, says psychiatrist Gail Saltz, M.D., author of The Ripple Effect: How Better Sex Makes for a Better Life (Rodale Books).

How does your brain get in the way? Read on to learn the obstacles and discover surefire strategies to reach the Big O.

Sex Obstacle #1: You think you’re not built right.Many women believe that they can’t have an orgasm because their genitals are “broken or damaged,” Saltz says. Of course, faulty wiring may have nothing to do it.

“Some women may just need more stimulation,” she says.

Sex Rx: If your partner gives out before you can get off, try a vibrator.

“It doesn’t get tired and it can move a lot faster and more consistently than any finger or tongue,” says licensed sex educator/counselor Ellen Barnard, co-owner of the erotic boutique A Woman’s Touch in Madison, Wisc.

Sometimes a little turbo power is all it takes to prove you can orgasm, which makes it easier to climax again the next time – even without a vibrator.

For a lot of women, once they use the vibrator to learn what feels good

, they can usually figure out how to make it happen without it.

Vibrators can help you practice having orgasms, so you’ll know what they feel like and what it takes to get there, Barnard explains. “And they’re helpful for women who have difficulty with orgasms because of medications or physical issues or because they just need very intense and prolonged stimulation.”

Getting a toy

helped one 25-year-old who participates in discussions on Leftos.com, a new online community for candid relationship discussions.

“Once I figured things out for myself, I found it easier to orgasm during sex,” she says. “Now I can direct my guy on what will help lead me there. Though, it’s still easier to climax with my toy.”

Sex Obstacle #2: You don’t know the territory down under.

Women who have trouble reaching orgasm just may not know their own terrain.

If you don’t know your body

well and your partner doesn’t either, it’s hard to figure out how to have orgasms, says Barnard.

Plus, you may have a mental block against masturbation. Maybe you’re shy about exploring your body or you were discouraged from letting your fingers roam as a kid.

“There’s a lot of guilt and shame about that part of our bodies,” says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University and author of Pleasure: A Woman’s Guide to Getting The Sex You Want, Need and Deserve (Perigee Trade). “It’s difficult to get that garbage out of our brains when we want to have a pleasurable sexual experience.”

Sex Rx: Spend quality Time doing a hands-on tutorial of your whole body, figuring out where and how you like to be touched. -

“For some women, stimulating the clitoris feels good.” Hutcherson explains. “For others, it’s the labia, around the cervix or G-spot. Or maybe it’s your nipples or behind your ear.”

Explore by yourself at first, because it’ll take time to figure it out. Besides, you don’t want to worry that you’re taking too long or that your partner is impatient for his own orgasm.

Self-stimulation was just the ticket for Heather, 22, of Ottawa, Canada. She says she regularly faked orgasms with her boyfriend until she heard an educational radio show about sex and followed its advice.

With a week or two, she says, “I became an expert on my own body and learned what I needed to think in my head, how to move my hips and what to ask my partner to do to get me off.”

Sex Obstacle #3: You’re focused on intercourse.Intercourse isn’t the only road to climax. In fact, only about 20% of women routinely reach orgasm that way, most sexperts say.

Those who do are using positions that stimulate the clitoris as well, Barnard says. “Anatomically, there’s not enough consistent, intense clitoral stimulation to lead to orgasm.”

Sex Rx: Ask your guy for a pre-game sensual massage to increase your arousal and nudge you closer to orgasm. Then experiment with positions that let him rub against your clitoris with every thrust, like missionary or legs-together style

You can also try positions that allow you to give yourself a hand, like woman-on-top, rear-entry or reverse-straddle. Erection rings equipped with tiny vibrators designed to hit the clitoris during intercourse help too, says Barnard.

Remember figuring out what you liked and where? Now clue your partner in with show and tell.

“The way we masturbate and have orgasms [solo] is what we want to incorporate into partner sex,” says sex expert Betty Dodson, Ph.D., author of Orgasms for Two (Harmony).

That’s what worked for Cecille, 50, of Seattle. She had given up on being able to orgasm with anyone else, though she could occasionally get there on her own.

“When I met my husband, he said ‘Show me what you do.’ He watched and then the next time he did those things, I was like, ‘Oooh, that works,’ and we moved on from there.”

Sex Obstacle #4: Distractions derail the mood.The brain is our main sexual organ. Our thoughts can enhance sexual pleasure or shut it down.

“It’s fabulous at turning off the things that make sex work for us,” says Barnard – especially if we’re fixated on how we look, whether we taste

OK down there or other unsexy thoughts like tomorrow’s dinner menu, errands to run or that the baby’s crying.

If you’re too busy, stressed or distracted, your brain says forget about it.

“There’s a funny balance between the relaxation part of our brain and the arousal/stimulation portion that allows us to have orgasms,” Barnard says.

Sex Rx: Just like you get ready

for work, you need to prep for sex.

If you have children, ask your husband to handle bedtime duties, so you can take 30 minutes alone to shift from mom mode to vivacious vixen. With less on your mind, you may be more likely to relax

and go with the flow.

Orgasm is “like a watched pot,”Barnard says. “If you feel ‘I gotta, gotta, gotta have an orgasm,’ you won’t.”

The best move for women? Surrender and give up on the goal, she says.

“Then they come back and say, ‘It worked!’” she says.

Another way to raise your orgasm odds: Start the party solo. Take a scented bath, light candles, have a glass of wine, read erotica or put on something that makes you feel sexy

and confident. Even do some “self-massage,” so your motor’s already running before your mate joins in.

Sex Obstacle #5: You think nice girls don’t. If you grew up in a buttoned-up family with sexual taboos – and negative messages about sex before marriage in particular – it’s a challenge

to shake them, even with a gold band on your left hand.

“The message is that there’s something wrong with women who express their sexuality,” says sex therapist Gina Ogden, Ph.D., author of Women Who Love Sex (Trumpeter).

Sex Rx: You may need an outside authority, such as a church-based sexuality seminar retreat, to say that sex is OK – that nice girls can and do.

Cecille of Seattle felt stymied sexually until she attended Christian women’s retreats and heard more a more positive view of sex.

“One leader said, ‘Masturbation is God’s gift to the single person,’” she recalls. “Another said ‘How are you going to teach a man if you don’t know what to do?’ It was like a light bulb went off.”

“Often women just need permission – from Mom, the church, from somebody,” Barnard says. “If they get that or give it to themselves, most women can redefine that [negative] message.”

If you still have trouble short-circuiting the only-bad-girls-do-it thinking, consider working with a sex therapist. You can find someone in your area through the American Association of Sex Educators, Counselors and Therapists (AASECT).

Sex Obstacle #6: Your fantasies freak you out. Fantasies can give sex that extra sizzle. But if yours are far from what you’d do in real life – making love to another woman, joining a threesome, having sex in public, being forced – they can also be scary.

For example, "for many women, the fantasy – not the reality – of rape is exciting,” Saltz explains. “Yet if they have any thoughts in that direction, they think ‘That’s horrible, I’m disgusting.’”

So they turn off any sexual thoughts because they might lead to the “shocking” fantasy.

“Instead, they think about making dinner or getting the dry cleaning,” she says.

The same kind of shut-down can happen if there has been a real sexual trauma in your past, such as sexual abuse, child molestation, assault, or rape.

Sex Rx: Fantasies are just made-up stuff in your head. They don’t mean you want to have that happen in real life, says Saltz.

With a sexual trauma, you may need professional help – a psychologist, psychiatrist or sex therapist – to uncover and work through your blocks.

“Some people have serious issues that they need to delve into,” says Michele Sugg, an AASECT-certified sex therapist in Branford, Conn. “They really do need to plumb the depths and look intensively at what’s going on in their lives.”

Sex Obstacle #7: You don’t recognize an orgasm when you have one. Seems impossible, right? But if your reference point is the movies – think actress Meg Ryan’s classic

imitation from "When Harry Met Sally" – you might miss an orgasm if it doesn’t match your imagination.

One reason your orgasms might not rock: Your pubococcygeus (PC) muscles, which hold up your vagina, uterus, bladder, urethra and anus, are weak.

“Orgasms are the spasming of your pelvic floor muscles

,” Barnard says. “If they aren’t very strong, you’re not going to feel much.”

Sex Rx: Strength-training exercises will build them up. Start with Kegel exercises, squeezing and releasing the muscles you use to prevent urine leakage when you sneeze or cough.

You’re doing them right if the area between your vagina and rectum pulls in as you squeeze, says Lauri Romanzi, M.D., a uro-gynecologist at New York Presbyterian Hospital-Weill Cornell Medical College.

Plus, pump up your Kegel workout with vagina weights – basically cone-shaped “dumbbells” in a slender

plastic holder inserted into the vagina and held there as you squeeze – or pelvic floor exercisers, which work the muscles using resistance instead of weight.

Regular core-focused workouts, such as yoga or Pilates, can also help strengthen the area.

“The more control you have of those muscles and the stronger they are, the easier the arousal process and orgasm,” says sex expert Laura Berman, Ph.D., author of The Book of Love (DK Adults).

How’s Your Sex Life?

For some of us, regular sex is as necessary as breathing; others don't mind an occasional dry spell. Where you fall on the nookie spectrum has a lot to do with just how passionate you are about making whoopee. Find out how much you really want it with this libido quiz.

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