SHOULD I HAVE AN ORGASM WHEN I HAVE SEX?

Many people are content not to have an orgasm; others find it disappointing not to climax. Sometimes a woman's partner may feel inadequate if she doesn't “come,” so some women fake having an orgasm. In general, though, if the sexual experience is pleasant, having an orgasm may not be important.

WHERE DOES THE ORGASM COME FROM?

An orgasm usually comes from your clitoris, an extremely sensitive area with thousands of nerve endings that feels like a small firm button just above the urethra (where the urine comes out). Only the tip is visible; the rest of the clitoris lies under the labia. The pelvic floor muscles are also involved in orgasm. These muscles include the bulbospongiosus muscle, the perineal muscles, and the pubococcygeus muscle. They extend from above the clitoris down past and around the entrance to the vagina. Using these muscles during sex can be pleasurable and also help with having an orgasm. Figure 1 shows the location of the clitoris and the pelvic floor muscles. You can strengthen the pelvic floor muscles by doing Kegel exercises: Try to hold the muscles that stop the flow of urine for 3 seconds and then relax. You can do this several times a day. No one can see you!

The traditional man-on-top position usually does not lead to orgasm for the woman unless the clitoris is stimulated at the same time. Women have other sensitive areas, including the skin, breasts, and nipples, and all can become aroused. The brain is also involved, as a woman's emotional feelings when making love are important to her enjoyment.

You might want to experiment with different positions, try oral sex, or stimulate your clitoris yourself while having sex.

IS MASTURBATION SAFE?

Knowing your own body and learning what kind of touch you like is helpful. Many women enjoy having an orgasm by themselves. There is no time pressure, and you don't need to please someone else. There is no physical harm in having sex with yourself. You will need a quiet place where you won't be interrupted.

SHOULD I WATCH PORNOGRAPHIC MOVIES WITH MY PARTNER?

Most pornography is designed to excite men, and many women find it boring. It is also usually not realistic. You might find it sexually stimulating, but if you do not enjoy it, you should explain to your partner that it is not helpful.

I'M AFRAID SOMETHING IS WRONG WITH ME

Women who have never had an orgasm usually do not have anything physically wrong with them. Your health care provider is trained to help you when you have questions. A careful, gentle physical exam should reassure you.

Some women are not able to fully enjoy sex because they have had a bad sexual experience in the past. Do not ignore this. A good counselor should be able to help you work through these problems.

WHAT ELSE PREVENTS ME FROM HAVING AN ORGASM?

Sometimes people are so anxious to have an orgasm that nothing happens! Trying to climax at the same time as your partner can put too much pressure on you. Alcohol, drugs, being angry or distracted, or rushing into sex can detract from the pleasurable sensations that lead to orgasm. Worry that someone will hear you or come into the room will not help either—you might need a lock on the door.

THE BOTTOM LINE

The best way to find out more about having an orgasm is probably to talk with your partner. Your health care provider can help you find a way to do this.

Sex is not just about having an orgasm. For many people, making love or just being close is a wonderful caring way to spend time together. JAAPA