Ailments, technique can be culprits

Dear Dr. Gott: I’m a happily married woman in my middle 40s. Why can’t I have an orgasm anymore when having sex? This has been going on for almost a year.

Dear Reader: Anorgasmia (lack of orgasm) has many causes, especially in women. Aside from the usual considerations — depression, distractions and fatigue — women may fail to achieve orgasm because of several physical causes, including pain and gynecological disorders.

In addition, technique plays a large role.

You may be interested in the recent reports showing that only a third of healthy women achieve orgasm through intercourse. This may come as an unwelcome surprise to most men, but it’s probably true because a woman’s sexual arousal depends less on her physiological cues than on environmental factors.

For example, women are much more likely to “screen” the situation before taking action; they may worry a lot about pregnancy, sexually transmitted diseases and so forth. Also, they may need more sexual stimulation than they receive.

Many women believe there is something wrong with them if they don’t have orgasm through intercourse alone. This is a culturally oriented misperception. The best sex therapist I ever knew used to state that the hand, mouth and penis all give sexual satisfaction — in descending order of importance.

Consequently you may need to analyze your family situation. Most crucial: Do you share the responsibility for sexual satisfaction? Do you dictate the terms of it or the pace of it? Basically, does your husband take the time to pleasure you?

I advise you to share your concerns with your gynecologist and have an examination to make sure that there is no physical cause for your anorgasmia. Also, consider involving your husband in learning ways to pleasure you during the sex act. Most men are more than willing to discover what “turns on” their wives. In fact, such an open communication can be extremely stimulating to both partners.

If you check out physically, you surely may begin again to have orgasm once you involve your partner in the exciting awareness of your needs.

To give you related information, I am sending you a copy of my Health Report “Where to Find Sex Information.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure mention the title.