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Some women need a little more to reach orgasm.
By Michael Bates — Written on Jul 19, 2019
Achieving the female orgasm seems like a mystery to most, even for women, but why do some have a harder time with it while others experience no problems during sex?
When I was a young doctor just starting in my OB/GYN practice, I had an equally young patient come to me with a question about orgasms. She wanted to know if she had ever had one. And I didn’t know what to say!
Believe it or not, during OB/GYN residency training there was little or no time dedicated to sexuality and the female orgasm. How could I help this patient?
After the interview, the nurse — who was older and experienced in the office practice of OB/GYN — and I left the room so the patient could prepare for the examination. The nurse looked at me kindly, put her hand on my arm and said, "Doctor, if she wonders if she has had an orgasm, she hasn’t had one."
So began my learning on female sexuality.
So just what is an orgasm and what does it feel like?
I like to define orgasm as an explosion of incredible pleasure that travels from your toes to the top of your head. It’s a delicious and warm sensation that is the result of sexual stimulation, arousal, and climax.
This wonderful explosion releases a cocktail of hormones and brain pleasure-center neurotransmitters that are responsible for feelings of trust, caring and closeness, euphoria, good mood and well-being, relaxation and sleepiness.
Is achieving orgasm during sexual intercourse the same for women and men?
Women and men have the same four stages of sexual arousal: excitement, plateau, orgasm, and resolution. Now, begin the differences.
Men, in general, are more easily aroused. A sexy thought or the sight of a desirable person and the wheels begin to turn. Women generally have a much more variable sex drive and need context to become aroused.
That’s not all. The plateau phase of sexual response is shorter in men than women. The plateau phase is the advanced stage of arousal that precedes orgasm. All men have a point during this stage when they can’t hold back an orgasm.
Women don’t have this inevitability — they can lose an orgasm even as it’s happening.
This shorter plateau phase for men — sometimes too short — can result in an orgasm occurring sooner than they and their partners would like. As men age, this becomes less of a problem.
The time interval to reach orgasm is quite variable for women and men. That said, the average time for women receiving adequate clitoral stimulation is about 20 minutes, while for men the average time from receiving penile stimulation to orgasm is nearer 5–6 minutes.
For most women, adequate stimulation is not penetration alone, while for men, it is.
Although the plateau phase is longer in women — meaning it takes longer to reach climax — there’s a benefit in the ability to enjoy multiple orgasms.
Good sex takes practice and men can learn to control and slow down their plateau phase, allowing their partner to enjoy this phase and reach orgasm at her own pace, even before he ejaculates.
Enhancing sexual satisfaction for both takes a willingness to accommodate differences in the journey to orgasm. But, why do some women still have difficulty reaching an orgasm?
Orgasm for women is complicated and can be affected by physical, emotional, or psychological factors — or a mixture of all of these.
Physical factors:
- Pain during sex is a major distractor from sexual pleasure and can be caused by vaginal or pelvic infection, pelvic surgery or radiation, and menopause.
- Chronic disease like diabetes, high blood pressure, multiple sclerosis, depression, and anxiety.
- Medications used to treat chronic illness like antidepressants, high blood pressure medication.
- Overuse of alcohol.
- Smoking.
Relationship factors:
- Not enough time spent in foreplay and subsequent lack of arousal.
- Unresolved couple conflicts.
- Infidelity and loss of trust.
- Violence.
- Poor communication.
Psychological factors:
- Anxiety and depression.
- Poor body image.
- Stress of raising children, at work, or both.
- Cultural and religious beliefs.
- Past sexual abuse.
If you have a chronic illness that requires medication, ask your doctor if it could be affecting your sexuality. If so, talk about a lower dose or a change. Moderate your alcohol intake and stop smoking.
If you are menopausal or beyond, talk to your doctor about estrogen therapy. It helps a lot with lubrication and vaginal wall pliability.
So, you've seen your doctor but none of the factors discussed above apply to you. Yet, orgasm isn’t happening during penetrative sex. In this case, a lack of the right kind of stimulation could be the issue.
Most women do reach orgasm without difficulty ... just not during penetration. They require clitoral stimulation and don’t climax from penetration alone. This goes against what we see in movies or read about in erotic books, where intercourse is often portrayed as the be-all-and-end-all of orgasmic pleasure.
There’s great diversity in preferred stimulation and techniques, including manual stimulation (fingers), oral stimulation, vibrators, and clitoral suction cups.
Research and various studies support these conclusions:
- Elisabeth Lloyd, faculty member of the Kinsey Institute at the University of Indiana-Bloomington, found that only 25 percent of women reach orgasm with penetration alone.
- The Journal of Sex and Marital Therapy states that 18.4 percent of women reported intercourse alone was insufficient for orgasm.
If you don’t orgasm from penetration alone, don't worry — most women don’t. That’s normal female sexuality. The key is to add clitoral stimulation.
Now that you know why orgasm seems to evade you, here are 4 things you can do about it.
1. Communicate with your partner
Make sure your partner knows that women rarely orgasm during penetration and that if you don’t, it’s no reflection on him or his performance.
Understand that the journey to orgasm has a different velocity for men and women and despite what is shown in movies or described in books, it rarely happens simultaneously.
Share things that feel good or don’t feel good without fear of criticism or judgment.
2. Experiment with new positions that create friction against your clitoris
The standard missionary position can be very intimate, but it doesn’t often provide enough clitoral stimulation without a little adjustment.
A pillow or positioning wedge under your hips may help provide indirect stimulation by putting the clitoral area in contact with your partner’s pubic bone. Woman-on-top also allows this.
3. Incorporate manual clitoral stimulation into intercourse
Ask your partner to slip a hand between you or reach up or around to provide manual stimulation during intercourse.
You can also do this for yourself — many people find this extremely sexy!
4. Try sex toys
Use a clitoral vibrator beforehand or as part of foreplay. Think of it as a warmup to help move you further along the arousal path, so you and your quicker-to-arouse male partner will start sexual intimacy closer to the same point. You might want to try a non-gender bullet vibrator that you both can enjoy!
Many women find that using a clitoral pump before stimulation helps them reach orgasm. Clitoral pumps create suction that draws blood into the clitoris, making it more sensitive.
There are also vibrators that are specifically designed to provide extra clitoral stimulation during intercourse. So what about my patient who asked if she had ever had an orgasm?
I learned that her husband had sent her to the doctor because he didn’t think he was pleasing her. He thought there must something wrong because he couldn’t get her to reach orgasm during sex.
She shyly admitted that she knew she could orgasm with masturbation, but she had been afraid to admit that to her husband.
So, another case of not being able to reach orgasm with penetration alone, unrealistic expectations, and lack of communication.
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Michael Bates was an OB/GYN for 34 years until his retirement from private practice in 2011 and co-founded X’s and O’s, an online sexual wellness resource center for adults over 50 years old.