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Difficulty Orgasming

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ANORGASMIA

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Difficulty Orgasming / Anorgasmia

How to Orgasm with Freedom

We often think that it’s more likely for men to orgasm prematurely and for women to struggle to reach orgasm at all. Although there is some truth to those ideas, the reality is far different.

The reality is that it’s possible for anyone, of any gender, to struggle not only with timing orgasms, but sometimes also to orgasm at all.

Especially when having sex with a partner (particularly a new partner), we often feel a great deal of pressure to perform. And, perhaps an even greater feeling of shame, when we didn’t live up to our expectations.

Anorgasmia or Delayed Orgasms can have a plethora of causes. Some might be physiological; however, there is always a psychosexual component that needs to be addressed to heal past harm and to prevent further harm from being done.

Anorgasmia/Difficulty Orgasming is never something to be ashamed of. With the correct therapy, information, and treatment, Anorgasmia or Difficulty Orgasming can always be treated effectively.

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Psychosexual therapy is the cornerstone of any treatment for Anorgasmia/Delayed Orgasm. It should serve as the foundation and starting point for other treatments – if they prove necessary.

Please note that this entry is provided to inform you of potential treatment options – for psychosexual and physiological medical treatment. This information is not provided to advise you regarding your individual medical situation. If you would like to schedule a free initial telephone consultation with me, please click here.

How Can I Help You?

I work as an experienced central agent in your treatment. In therapy, we’ll work through the psychological causes and effects of Anorgasmia/Difficulty Orgasming together, and continue counselling until you reach the point of confidence and reduced anxiety.

We’ll also investigate any physiological causes together. I’ll refer you to private or NHS medical professionals I know and trust in the way of identifying and treating the physiological aspects. Together, we’ll provide you with a range of options available to you, while eliminating any harm the condition may have done to that point.

Anorgasmia/Difficulty Orgasming is often best treated through a process of education, counselling, and exploration. The keys are in understanding the sexual response cycle, your own body, realistic expectations (as opposed to what the media or porn tells us), and a process of exploring and discovering your own sexuality in a positive way. In counselling, you’ll have a safe space to discuss your concerns, and gain the information and confidence you need to flourish.

What is Anorgasmia/Difficulty Orgasming?

Anorgasmia/Difficulty Orgasming is technically sub-divided into a primary and secondary type.

The medical definition for Anorgasmia is the frequent difficulty of reaching orgasm following ample stimulation, causing personal distress.

Primary Anorgasmia is where the person has never experienced an orgasm. Secondary Anorgasmia occurs when the person has previously been orgasmic, but now has frequent difficulty doing so.

Who Are Affected by Anorgasmia/Difficulty Orgasming?

Any person of any age or gender can suffer from Difficulty Orgasming/Anorgasmia.

Even when we’ve had adequate control and normal sexual response for the entirety of our lives, there is always a risk that we can enter periods of A/DE without warning.

What Causes Anorgasmia/Difficulty Orgasming?

Anorgasmia/Difficulty Orgasming is caused by either psychosexual or physiological reasons. Even when physiological factors contribute to the cause, there is always an element of psychological distress that must be addressed to treat and cure the condition successfully.

An orgasm is essentially a mind-altering and explosive event during which we lose a sense of control. Several psychological and physiological elements contribute to making that possible. It’s a common misconception that orgasms happen in the genitals. Rather, it’s entirely possible to experience an orgasm purely through a psychological and mental state, without any genital contact whatsoever.

Physiological causes of Anorgasmia/Difficulty Orgasming may include (but are certainly not limited to) endocrine disorders (e.g. hypopituitarism, diabetes, hypothyroidism, Addison’s or Cushing’s disease), neurological conditions (e.g. epilepsy or spinal cord injuries), malignant diseases (e.g. cancer or following radical pelvic surgeries), dermatological disorders (e.g. candidiasis, herpes, vaginitis, or lichen sclerosus), medications (e.g. cardiac medicines, anti-depressants, anti-epileptic drugs, or contraceptives), obesity, chronic fatigue, alcohol or drug abuse, prostate abnormalities, nicotine, physical trauma or injuries, and sleep disorders.

Psychosexual causes of Anorgasmia/Difficulty Orgasming are often incredibly complex to decode. Anxiety and stress lead the pack, but pinpointing the exact factors that trigger the specific anxiety or stress can only happen through a process of reflection and counselling. Other causes can include relationship problems, depression, fatigue, feeling inadequate, sexual fears, rejection, sexual/emotional trauma, performance anxiety, low self-esteem, guilt, pornography, and a range of other factors. It takes time and skill to reveal the different layers of the psyche that are affected.

An experienced psychosexual therapist can guide you successfully in the journey to renewed confidence, as the reasons one thinks are the cause, very rarely actually are.

Only through a balanced approach that addresses all causal factors, can you achieve true healing and freedom.

How is Anorgasmia/Difficulty Orgasming Treated?

It is vital to heal the psychological damage already caused as well as to safeguard against any future psychological damage that would have been done.

During the counselling process, we’ll discover underlying causes in your past and present, and devise practical strategies to resolve them together. This process may not be instant, but it is certain to work.

Simultaneously, through a process of careful elimination, physiological causes must either be identified or ruled out and treated in parallel with psychosexual issues.

Dopamine is a neurotransmitter in the brain that plays a vital role in the regulation of orgasm. Should the patient have reduced dopamine levels, some doctors opt to prescribe medication that increases the amount of Dopamine in the brain. However, it’s important to note that this treatment is provided ‘off-license’ and should be considered with care.

Currently, no medication is licensed for the treatment of Anorgasmia/Difficulty Orgasming. Instead, the physiological focus should be to identify any underlying physical conditions or causes (if any exist) and to treat those causes effectively.

What to Expect From Treatment?

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Anorgasmia/Delayed Orgasm always encompasses a psychosexual element that must be addressed to ensure successful and permanent treatment.

Simultaneously, we must identify whether any physiological factors contribute to the condition and, if so, treat them in parallel to psychosexual counselling.

It’s vital to address both aspects to give you the confidence, control, and pride that you deserve.

Psychosexual Counselling

Free Initial Consultation

Our initial consultation should last around 30 – 45 minutes. We’ll have the opportunity to discuss your primary concerns and reasons for seeking treatment, and what the outcomes are that you’d like to achieve.

I’ll explain more about myself, my professional experience, and how we’ll work to achieve your goals. We’ll go over the costs of treatment and make sure that an option is available to you that is affordable and sustainable. I’ll also explain a little more regarding the technical aspects of online counselling and explain the best ways to set up the software options available.

Assessment Sessions

1. &nbspPhysiological Assessment Session

We’ll consider your full medical history. Below is a sample of the types of questions that we’ll be exploring:

How long has the erectile dysfunction been occurring?
Describe what happens when you have intercourse?
What happens when you try to masturbate?
Do you have morning erections?
Do you have equal difficulty achieving and maintaining your erection?
At which point do you lose your erection?
What is the level of your libido like at the moment?
How rigid are your erections?
Does your penis have a bend, twist, or curve when it’s rigid?
Have you ever had any serious testicular trauma?
What medications are you currently taking?
When last did you have your hormone levels examined?
How regularly do you check your blood pressure?
Do you often have palpitations?
Have you tried any erectile medications before (e.g. Viagra, Cialis, Levitra, Alprostadil, etc.)?
If so, to what extent were they helpful?
Have you before, or are you currently using any drugs (including cannabis)?
Do you take any opiate pain killers (or have you before)?
How much alcohol do you consume?
Do you smoke?
How regularly do you attend a prostate examination?
Are you currently overweight?
How would you describe your level of fitness?

2. &nbspPsychosexual Assessment Session

We’ll discuss your history and background, along with questions that relate more specifically to ED. A sample of the questions we’ll focus on are:

How much stress are you currently experiencing?
Do you have difficulty maintaining a relationship?
How would you describe your current relationship?
When did the erectile dysfunction begin?
How frequently do you have unsatisfactory erections?
Do you feel your chest tightening when you think of sex?
How has your relationship(s) been going?
Are you worried about performing sexually?
How would your partner respond if they knew you had erectile dysfunction?
How often do you wake up with an erection?
Do you have spontaneous erections throughout the day?
How would you describe the quality of your sleep?
Do you struggle to achieve or maintain an erection when you are alone?
How much pornography do you consume?
Do you have difficulty achieving/maintaining an erection when watching pornography?
Do you have difficulty orgasming?
Do you often orgasm prematurely?
In your opinion, what is causing the erectile dysfunction?
How would you describe your self-esteem?
Have you experienced any sexual or emotional trauma in the past?
Are you worried your partner might find you inadequate?
How worried are you about rejection in general?
Would you describe yourself as being depressed?
How difficult is it to focus during masturbation?
What are the thoughts/worries that your mind drifts to while masturbating?
When you are able to orgasm, how would you describe the quality of the orgasm?

Treatment Plan

We’ll work together to formulate a practical therapy plan for counselling sessions. You’ll very quickly begin to feel better and see a rapid improvement in the quality of your sex life and emotional health in general.

Sexual function is almost always affected by the level of happiness we experience in the rest of our lives. As such, we’ll focus not only on the sexual hurdles you’re facing, but also on improving the rest of your quality of life.

Depending on your circumstances, I may also ask you to conduct a blood test. This test is very affordable, can be done from the privacy of your home, and will remain entirely confidential. The results will show us a starting point for your general physical health. We’ll also find out whether your body is producing a sufficient amount of the correct hormones needed for sexual function.

Counselling Sessions

Our ongoing counselling sessions will continue working on improving the underlying issues that are the true psychological causes or reasons for distress. Our work will also ensure a vast improvement to your life in general, not just restricted to sexual function. There is no limit to the number of sessions we can have, but the process typically takes 12 – 16 sessions. We’ll work to overcome the obstacles you were facing, and explore the goals you’d like to achieve.

If a physiological component was an additional cause to the ED, I’ll continue working with you throughout the counselling process to find the correct medical support, and guide you through any treatment that you may require.

Debriefing Session

At the end of the counselling process, we’ll review the work we’ve done and the progress you’ve made. We’ll revisit any outstanding issues and discuss methods to ensure that your confidence and success remain in place.

Follow Up

3 – 6 months following the conclusion of your therapy, we’ll schedule a follow-up session to make sure that everything has been going well. We’ll take this opportunity to discuss any new concerns you might have, or conclude our work together.

Physiological Treatment

No primary physiological treatments currently exist to treat Anorgasmia/Delayed Orgasm.

Where an underlying physiological cause does exist, the focus is on treating the primary condition of which the orgasmic disorder is a symptom.

Oral Medication

Due to the role that Dopamine plays in sexual response and it’s regulating effect on orgasm, some physicians may opt to prescribe medication that increases the Dopamine levels in the blood.

An example of such medication is Bupropion Hydrochloride–a medicine that is otherwise used as an anti-depressant or smoking cessation aid.

Bupropion should only be used under the supervision of a skilled doctor, and should never be used by individuals prone to seizures.

(Men) Testosterone Replacement Therapy - TRT

Hypogonadism, or Testosterone Deficiency Syndrome, is a condition that affects many men of all ages. Most aren’t aware that they have the condition or what the cause is, but all who suffer from it are undoubtedly aware of the symptoms.

In the case of Primary Hypogonadism, a problem exists directly within the testicles, rendering them unable to produce the hormone in sufficient quantities. An example might be men who have suffered from testicular cancer.

With Secondary Hypogonadism, the cause lies outside of the testicles, usually in the hypothalamus or pituitary gland in the brain–the parts of the brain that signal the testes to increase production.

Symptoms of Low Testosterone

Patients who suffer from a Testosterone Deficiency usually present several, if not all, of the following symptoms:

Erectile dysfunction (obtaining OR maintaining an erection)
Desire Disorders (Low Libido)
Orgasmic Disorders (Premature Ejaculation/Delayed Orgasm/Anorgasmia)
Difficulty making decisions or concentrating
Increase in body fat
No results from exercise regimens
Loss of lean body muscle
Loss of bone density
Depression
Extreme fatigue
Poor work performance
Changes in the cholesterol profile
Mood swings

How is Testosterone Deficiency Diagnosed?

The sad fact is that testosterone deficiency is very seldom diagnosed correctly. Most doctors receive little to no training on optimal hormone levels for men unless they specifically opt to specialise in that field.

A common concern I hear from my patients is that their GPs tested their Testosterone (Total) levels, only to find a “normal” result.

A “normal” testosterone reading means nearly nothing. When I suspect that a client may suffer from a testosterone deficiency, I request that they have the following lab work done:

Testosterone, Total
Testosterone, Free
Testosterone, Bioavailable
Estradiol
Steroid Hormone Binding Globulin (SHBG)
Dihydrotestosterone (DHT)
Full/Complete Blood Count (FBC/CBC)
Follicle Stimulating Hormone (FSH)
Luteinising Hormone (LH)
Prostate Specific Antigen (PSA)
Metabolic panel

If your GP is hesitant to prescribe the correct tests on the NHS, or if you prefer to handle the testing privately, I work with a reputable laboratory that will conduct the tests for you. Please contact me to order a finger-prick test kit (circa £150) that can be done from the comfort of your own home. Based on the results, I can refer you to a network of physicians I know, trust, and have experience working with.

Even if you aren’t suffering from a testosterone deficiency at the moment, knowing your healthy baseline may be extremely helpful in the future.

Unfortunately, testosterone testing is littered with inconsistencies. Testosterone levels vary throughout the day. The most accurate method would be to collect urine for testing over a 24-hour period, or to hand in blood samples at 3 different times during the day, for multiple days.

However, even if you did that, the information might still not be valuable. The results might indicate that you have ‘normal’ testosterone levels. Except that what’s ‘normal’, might not be normal for YOU.

Very few men had doctors that were conscientious enough to do the correct tests during their twenties to establish what their individual, healthy, baseline levels were. As such, we should focus on providing treatment based on the symptoms, rather than obsessing about a particular blood level.

What Treatments are Available?

Testosterone injections provide the most effective treatment against the effects of hypogonadism. However, some men prefer other methods of application, such as testosterone cream, gel, pellets, or supplements.

Testosterone Replacement Therapy (TRT) causes very few side effects when taken in the correct dosages. TRT is contraindicated for men who currently suffer from prostate cancer. However, TRT will not cause cancer. In rare cases, TRT can also cause a condition that results in the thickening of the blood. Although this poses an increased risk, the condition is very easily detected and even more easily treated.

What are the Benefits of TRT?

TRT will reverse almost all of the effects of hypogonadism. However, it is no magic bullet. Only men who genuinely suffered from a Testosterone Deficiency will see results. Although some results will become evident within a few weeks, others may take months or even years to correct.

Men who suffer from hypogonadism and have ED as a symptom usually begin to see results within 3 months, with the benefits gradually incrementing over time afterwards.

(Women) Hormone Replacement Therapy (HRT)

A clear link exists between hormone levels and a healthy libido, arousal, orgasmic control, and a general sense of wellness. Women who are suffering from hormone imbalances may benefit significantly from HRT in addition to corrective psychosexual therapy.

Oestrogen

Oestrogen therapy is usually the hormone referred to when speaking of Hormone Replacement Therapy for women. Oestrogen supplementation can be beneficial for women suffering severe menopausal symptoms or had a hysterectomy. In HRT for menopause, a combination of Oestrogen and Progesterone is likely to be prescribed. Women who had their uterus removed may use Oestrogen alone. However, women who still have a uterus will need to take a combination of Oestrogen and Progesterone.

Testosterone

Fortunately, medical science is placing more emphasis on the sexual wellness of women. In so doing, testosterone has finally come more to the forefront in the diagnosis and treatment of female sexual dysfunction. Where testosterone is usually considered as the male hormone, in small quantities, it’s vital to women’s health and sexual wellbeing. Testosterone for women is available in several formulations, including gels and pellets that can be placed in the subdermal layers of fat in the buttocks. I work with a handful of physicians at the forefront of this research and can refer you as part of our sessions.

Menopause

All women go through menopause as they age. This is characterised by an array of symptoms such as insomnia, fatigue, hot flushes, low libido, painful sex, depression, and memory loss. It is crucial not to assume that feeling that way is just part of life. Endocrine sciences have progressed a long way and finding a competent physician who can treat the symptoms, and correct hormonal imbalances is pivotal.

Other Underlying Causes

During our assessment sessions, we’ll discuss any risk factors that may indicate a physiological cause to the Anorgasmia/Delayed Orgasm. It’s vital to ensure that if a physiological cause exists, we identify and treat that cause in parallel to your psychosexual therapy.

Because the potential array of physiological causes is relatively wide, I can help you to prioritise the order and types of specialists to approach for diagnosis and treatment, as well as to refer you to physicians I know and trust (both on the NHS and privately).

Preliminary bloodwork is always a good starting point and I can either write to your GP on your behalf to request this, or assist you in getting an affordable home test kit through a reputable laboratory that I regularly use. This is useful if you’d prefer to get the tests done with greater expediency and privacy.

If you’d like more information on the successful treatment of Difficulty Orgasming / Anorgasmia, please contact me to schedule a Free Initial Consultation.

Client Feedback:

“I’ve always struggled having orgasms since I began masturbating. I’d listen to all my girlfriends talk about how wonderful their sex lives are and feel pressured to pretend that mine was great too.

Ryan and I have been together for nearly 3 years and he’s always been very loving and supportive, trying everything to make sure that have as much pleasure as possible. He came nearly every time we had sex while I was lucky to climax once a month.

Then things got even worst. No matter what positions we tried or for how long, Ryan couldn’t come either. I felt like it was my fault and that he had lost interest in having a girlfriend who’s broken. Ryan felt emasculated and like he was letting me down by making me feel unattractive.

We went online to try and find a sex therapist that might be able to help. That’s when we called James. He has been absolutely fantastic!! He’s helped us to work through the buried issues that were causing our problems. We saw him for individual and couples sessions by webcam and what really helped was that he understood exactly what we were going through and had a very practical way of helping us deal with the issues.

We just got engaged!!! We’re madly in love, our relationship is going really well, and we’re having the best sex of our lives.

Thank you James!”