Orgasm eludes many women; upwards of 10 percent have never sexually climaxed, and many others do so erratically. Often, women just need some education about how their bodies work or professional counseling to address anxiety or inhibitions, says Sheryl Kingsberg, a psychologist at University Hospitals Case Medical Center in Cleveland. "You have to kick out every nun, rabbi, parent, and grandmother that's in your head," she explains. "Get them all out of the bedroom first."
Banner, whose experience isn't atypical, pins the root of her "anorgasmia" on a jumble of "goofy" ideas—like rigid notions that sex is for keeping men satisfied and that women shouldn't touch their nether regions. Things finally clicked for the Californian when she learned to grant herself license to relax, explore, and enjoy her sensuality.
Of course, medical factors can mute or kill orgasms in women who once felt them, and such cases may require treatment. Medications are big offenders, especially antidepressants that boost serotonin in the brain. Diabetes, neurological diseases like Parkinson's, and conditions that cause clitoral scarring or numbing can also affect orgasm. So, too, can sexual pain problems or anything that may lower libido, such as a hormonal imbalance. But medicine might fix what medicine has caused: The Journal of the American Medical Association recently reported that Viagra may counteract antidepressant-related orgasm problems.
Research suggests that women can learn to intensify their orgasms, giving hope to those who don't normally experience them. By studying the brains of those who can climax just by thinking about it, behavioral neuroscientist Barry Komisaruk and his Rutgers University team found that both physical stimulation and thoughts of physical stimulation activate many of the same brain areas. He is now showing anorgasmic women real-time scans of their brain activity as they self-stimulate, aiming to see if they can teach themselves to climax.
Even some women who can orgasm don't experience all three known types: vaginal, cervical, and clitoral. In fact, only a minority of women can reliably orgasm through penetration alone; most require clitoral stimulation, as by oral sex or touching. A long-standing theory suggests that if a woman's clitoris is more than an inch from her vagina, penetrative sex is less likely to produce a climax, says Kim Wallen, a neuroscientist in Emory University's psychology department. No matter, he says. "For many women, a helping hand works just fine."
When Sex Drive Dries Up
For years, Kate Johnson didn't know she had a sex drive. On the birth control pill since age 17, she participated without desire. Now, she uses a different contraceptive—and often makes the first advance with her husband. Ironic as it may seem, suppressed libido is a known side effect of the pill. "It was a relief to figure out that I was normal," says Johnson, 39, of Littleton, Colo., "as opposed to some sort of undersexed person."
Many women find themselves stalled by sluggish sex drives, and the pill isn't always the culprit. Hypoactive sexual desire disorder, the medical term, is recognized as the most prevalent sexual complaint among females. It can affect young and old alike, stemming from a complicated stew of factors from partner problems to medical issues, like depression (and some of its treatments) and waning hormones. Although no drug has been approved by the FDA, medical solutions do exist. "Something can be done," says Goldstein of Alvarado Hospital, though it usually requires a thorough medical and psychological evaluation.
For some women, especially those who are aging, low testosterone is the trouble. That hormone is linked to libido in both sexes, not just men. While deficiencies won't always create problems, specialists like Goldstein may use testosterone products that are approved for men to rekindle female desire. Of course, doses are scaled way back: Too much of the hormone can cause a collection of effects, like voice deepening, acne, and excessive hair growth. Testosterone replacement appears safe, says Goldstein, although some experts worry that its use in breast cancer survivors might trigger recurrence. Some also warn against using it in women who could become pregnant.
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