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Low sexual pleasure

I'm 23, and used to feel a lot of sexual pleasure but now it is extremely rare. Most of the time, there is no pleasure, sometimes a little bit and even rarer a medium amount. I see a sex therapist and it feels like I have tried everything to help... also, I am unsure if I have ever orgasmed and my sex therapist is unsure, too. It doesn't bother me but it bothers my friends and anyone I date.
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20620809 tn?1504362969
I assume your sex therapist explained how to masturbate to orgasm? I'd just continue to work on that in your own private moments.  Are you taking any medications? Are you anxious?  As to your friends, they don't need to know anything about this.  It's time, as an adult, to maybe keep that kind of info private. I have no idea how often my friends have orgasms.  For real, not a necessary conversation.  Boyfriends, well.  just keep working on it.  While there can be physical reasons for anorgasmia, it also can be related to emotional health and relationship things.  For the physical, I'd talk to your ob/gyn (you are a woman?).  There are different things they can do to help you.  https://www.mayoclinic.org/diseases-conditions/anorgasmia/symptoms-causes/syc-20369422
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She didn't, but I know the information on how to masturbate to orgasm although orgasm is not my goal, my goal is sexual pleasure, but I don't feel much or any sexual pleasure most of the time.
Tapering off of meds although I had this issue before then... Not anxious anymore.
My friends brought the sexual topics up themselves.
I heard that sex therapists know more than OB/GYNs know, and my sex therapist and GP haven't referred me to one.
I will have a look at the link.
Do you enjoy sex? The closeness with your partners, the touch, the intimacy?

Do you feel desire for it?

Do you dislike it or are you sort of meh about the whole thing?

Since you used to feel it, I'd rule out physical reasons - hormone (birth control, hormone imbalances), depression, medications, thyroid, etc. - and then look at other things. What changed? Was there trauma? A bad relationship or encounter? Has your body changed in some way?

Why won't your GP refer you?
Yeah, I enjoy it somewhat but not as much as I used to.
What would an OB/GYN be able to do that a sex therapist can't?
The difference is that an  OB/Gyn has been to medical school and their experience would be that they see countless women, understand any anatomy issues that could affect this, understand hormonal issues that could affect this, medical issues, etc. A sex therapist can have varying levels of education.  Most women transition their gynecological care to an ob/gyn when they become an adult. It's their sole specialty to treat that part of you.  Verses the 'general' knowledge that a gp has.  Sex therapist provides therapy. Ob/gyn provides medical care.  Hard question and one I do not need you to answer here but were you sexually abused, assaulted or have any past trauma?  
Thanks for the advice. I'll ask my GP about seeing an OB/GYN. Yes, I have been sexually abused but I have had this problem before then and I also have PTSD from when I was a baby.
Trauma can impact what you in the way you describe.  I'm very sorry about things that have happened to you.  A therapist that isn't a sex therapist but regular may be able to help release your trauma. We carry it in our bodies and it is challenging. Again, I'm sorry you've had experiences that have caused trauma.
I used to see a psychologist for my trauma, but I don't think I have PTSD. But thank you.
I'm just trying to think of things that could be contributing. Sometimes what we've done, if we revisit, we get a different outcome based on circumstances. This has to be a frustrating problem for you.
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