It’s quite natural for a woman to have experienced orgasms many times before, only to go through periods of time where orgasms are less frequent or absent.

Masturbation

If you are concerned about not reaching an orgasm, you may want to try some self-stimulation. You should learn how your genitals feel and what feels good. When you know how to please yourself, you can start to share your knowledge with your partner.

Masturbation is completely normal and healthy. Society’s views on masturbation have changed a lot over the years and it is understood as being part of a healthy lifestyle — there is much less taboo and sense of shame about masturbation.

Some women like to use objects, such as sex toys, to masturbate with. Everyone is different and will find that different things stimulate the genitals in different ways. Discovering what is pleasurable for you may take time and practice, but it is an important part of getting to know your body and finding out what pleases you.

Factors that may affect orgasm

Difficulty reaching an orgasm when you’ve managed to before can be a result of several things. Common causes may include:

• hormone changes, for example after childbirth or during menopause
• diseases
• gynaecological issues including painful intercourse
• not being stimulated enough
• medicines (such as antidepressants)
• worries or fears about having sex
• lack of self confidence
• use of recreational drugs, alcohol or smoking
• vaginal dryness
• relationship worries
• stress or emotional distress
• ageing

Getting advice

You should visit your doctor if you have any concerns about your sexual performance, especially if it has changed for no apparent reason.

Your doctor may ask you questions about your sex life, relationships and medical history. They may also perform some tests if they think your medicine or a health condition may be the underlying cause of your concerns.

Your doctor may also refer you to a therapist who deals with sexual issues, as well as advising you on the best steps to take to resolve the issue.

Lifestyle changes

Your doctor will treat any underlying medical conditions and may recommend hormone therapy if you have been through menopause. You could try couples counselling or sex therapy.

Leading a healthy life may improve your chances of having a healthy sex life. You could try:

• losing weight (if you are overweight)
• reducing the amount of alcohol you drink
• not using illegal drugs
• taking regular exercise
• if you smoke, try to cut down or quit
• don’t stop any prescribed medication until you have spoken to your doctor