Difficulty Reaching Orgasm

“Why can’t I orgasm?” “Why does it take me so long?” “Why are my orgasms less intense?” “Why can I orgasm alone but not with my partner?” These are some of the most common questions Dr. Bawa is asked by women who are struggling with orgasm.

The answer is seldom just one thing. Orgasm depends on blood flow, sensation, healthy tissue, hormones, the pelvic floor, the brain, adequate time and the right stimulation. In Dr. Bawa’s clinical experience, physical changes are almost always at least part of the picture, and they often overlap with sexual, hormonal and psychological factors. The Bawa Method looks at the entire sexual response rather than treating orgasm as one isolated problem.

The Orgasm Gap

Women orgasm less often than men during heterosexual sex. In a large U.S. study, 95% of heterosexual men said they usually or always orgasmed when sexually intimate, compared with 65% of heterosexual women. Lesbian women reported a much higher rate of 86%.[1]

That difference suggests the orgasm gap is not simply about female anatomy. Time, partner knowledge, communication and the type of stimulation a woman receives all matter. Only 18.4% of women said vaginal penetration alone was enough for orgasm, while 72.6% said clitoral stimulation was either necessary for orgasm or made their orgasms better.[2] In many cases, women are simply not getting enough of the stimulation they need, for long enough, to reach orgasm.

Time and Stimulation

Women often need more time and more sustained stimulation than men. In one multinational stopwatch study, the median time from vaginal penetration to ejaculation in men was 5.4 minutes.[4] In another multinational study, women took an average of 13.41 minutes to reach orgasm.[5] Women who already have difficulty reaching orgasm tend to take even longer during partnered sex.[6] The studies measured orgasm and ejaculation latency differently, but they make one point clear: time and sustained stimulation matter.

A partner may not know exactly what a woman needs. There may not be enough clitoral stimulation. The pressure, location or rhythm may change just as she is getting close. Penetration may begin too soon, or sex may end before she has had enough time. Pleasure and enjoyment—not just penetration—have to be part of the sexual experience.

Physical and Hormonal Changes

Women’s sexual anatomy changes over time. Perimenopause and menopause can affect blood flow, moisture, collagen, elasticity, sensation and the tissues of the vulva, vagina and clitoris. Genitourinary syndrome of menopause (GSM) can include clitoral atrophy, reduced moisture and changes in sexual function, including orgasm.[7]

When the clitoris becomes smaller or atrophic, there is less responsive tissue and less surface area available for stimulation and engorgement. That can make orgasm harder to reach or less intense. A pelvic MRI study also found that women with anorgasmia (the inability to achieve orgasm) had a significantly smaller clitoral glans than women with normal orgasmic function.[8]

This is why non-surgical vaginal rejuvenation is an important part of the Bawa Method. Improving blood flow, tissue health, sensitivity and responsiveness addresses physical changes that stimulation alone cannot correct.

Postpartum Changes

After having a baby, the body, hormones, pelvic floor and sexual experience can all change. Breastfeeding lowers estrogen for many women, while childbirth may leave pain, pelvic floor dysfunction or altered sensation.[10]

A woman may also not see herself as a sexual being at that point. Her body has changed, her attention is focused on her baby, and she is exhausted. Sleep deprivation, body-image concerns, hormonal changes and the physical and emotional demands of caring for an infant can all affect pleasure, arousal and orgasm.

Medical Conditions and Medications

Diabetes, neurologic disease, pelvic surgery, cancer treatment and other medical conditions can interfere with the nerves, blood flow, hormones or tissues needed for orgasm.

Certain medications can also make reaching orgasm much harder. SSRIs—selective serotonin reuptake inhibitors—are commonly prescribed for depression and anxiety. Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), Paxil (paroxetine) and Celexa (citalopram) can cause sexual side effects, including difficulty reaching orgasm.[9] Medication may be part of the problem, but it is rarely the only thing the Bawa Method considers.

Psychological and Emotional Factors

The mind is part of sexual response too. Stress, anxiety, distraction, body-image concerns, relationship issues, exhaustion and pressure to orgasm can all make it harder to stay aroused and reach orgasm.

That does not mean a woman can simply think herself into a better orgasm most of the time. Psychological factors can exist alongside very real changes in blood flow, hormones, sensation and tissue health. Treating only one part of the problem can leave the others untouched, and the problem unsolved.

How This Affects Both of You

Difficulty reaching orgasm can turn pleasure into pressure. A woman may begin worrying that she is taking too long, fake orgasms or avoid sex. Her partner may feel responsible, frustrated or assume she is no longer attracted to them.

Understanding what her body needs, what has physically changed and what makes sex pleasurable for her can take pressure off both partners and bring enjoyment back into the relationship.

There Is Always Something You Can Do About It.

At Bawa Medical in Boca Raton, Florida, the Bawa Method treats orgasm problems as the multifactorial problem they usually are. Non-surgical vaginal rejuvenation, improved blood flow and sensitivity, healthier tissue, hormonal support, pelvic floor treatment and nutritional support can all play a role in improving function, pleasure and orgasm.

Dr. Bawa often combines BawaWave® and BawaRF® as part of non-surgical vaginal rejuvenation because better blood flow, healthier tissue and improved responsiveness work together. The BawaShot®, BawaTone®, hormone replacement therapy (HRT) and pelvic floor treatment may also be used as part of the Bawa Method. DSF.me® supplements are an integral part of treatment and are used to support circulation, hormonal health, libido and overall sexual response.

• BawaShot®
• BawaRF®
• BawaWave®
• BawaTone®
• Hormone Replacement Therapy (HRT)
• DSF.me® Supplements

1. Frederick DA, St. John HK, Garcia JR, Lloyd EA. Differences in Orgasm Frequency Among Gay, Lesbian, Bisexual, and Heterosexual Men and Women in a U.S. National Sample. Archives of Sexual Behavior. 2018;47(1):273-288. doi:10.1007/s10508-017-0939-z.

2. Herbenick D, Fu TCJ, Arter J, Sanders SA, Dodge B. Women’s Experiences With Genital Touching, Sexual Pleasure, and Orgasm: Results From a U.S. Probability Sample of Women Ages 18 to 94. Journal of Sex & Marital Therapy. 2018;44(2):201-212. doi:10.1080/0092623X.2017.1346530.

3. Dunn KM, Cherkas LF, Spector TD. Genetic Influences on Variation in Female Orgasmic Function: A Twin Study. Biology Letters. 2005;1(3):260-263. doi:10.1098/rsbl.2005.0308.

4. Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M. A Multinational Population Survey of Intravaginal Ejaculation Latency Time. Journal of Sexual Medicine. 2005;2(4):492-497. doi:10.1111/j.1743-6109.2005.00070.x.

5. Bhat GS, Shastry A. Time to Orgasm in Women in a Monogamous Stable Heterosexual Relationship. Journal of Sexual Medicine. 2020;17(4):749-760.

6. Rowland DL, Sullivan SL, Hevesi K, Hevesi B. Orgasmic Latency and Related Parameters in Women During Partnered and Masturbatory Sex. Journal of Sexual Medicine. 2018;15(10):1463-1471. doi:10.1016/j.jsxm.2018.08.003.

7. Danan ER, Diem S, Sowerby C, et al. Genitourinary Syndrome of Menopause: A Systematic Review. Agency for Healthcare Research and Quality. 2024.

8. Oakley SH, Vaccaro CM, Crisp CC, et al. Clitoral Size and Location in Relation to Sexual Function Using Pelvic MRI. Journal of Sexual Medicine. 2014;11(4):1013-1022. doi:10.1111/jsm.12450.

9. Mayo Clinic. Selective Serotonin Reuptake Inhibitors (SSRIs).

10. American College of Obstetricians and Gynecologists. Experiencing Vaginal Dryness? Here’s What You Need to Know.