The elusive female big O

Rose walked into the consultation room at the Sexology Clinic, and before I could greet and usher her to a seat she blurted out: “All my life I have been searching for an elusive orgasm. Is it normal for a woman my size not to have orgasm?”

I smiled, noting that her size was above the average Nairobian woman. It also crossed my mind that she could have been suffering from low self-esteem due to her body size.

“What exactly do you mean?” I asked. “My friends say that when one has orgasm, you lose control and feel like you have been pleasantly electrocuted. Some say you lose consciousness and go to heaven for a while, and others say it feels like being struck by lightning when you are already in the clouds. Who on earth would not want such an experience?” she replied and burst out laughing.

Rose, 42, was in her second marriage, the first one having ended in divorce. She had three children (the first two with the first husband).

Her current husband was 49 years old. The two had been married for seven years. “I have tried lots of stuff to make orgasm come through — pornography, herbs and two extramarital affairs but nothing worked,” she said staring at the horizon, possibly expecting me to judge her harshly.

But that really is the nature of sex problems. People feel shy to talk about them and to seek help, and thus they end up trying many things, both socially acceptable and unacceptable ones.

Sexual health doctors understand how stressful life is for people facing sexual challenges, and so, as a rule, they do not judge them but offer a safe space for them to talk freely and get solutions.

I took to explaining to Rose all about orgasm. Is it normal for a woman to engage in sex and not experience orgasm? Well, the world over, many women actually fail to get orgasm.

Lack of orgasm is also referred to as anorgasmia. There are two types of anorgasmia: primary and secondary.

Primary anorgasmia is a state where a woman has never had orgasm in her life. Secondary anorgasmia is where one has had orgasm at one point or another, either with a partner or while masturbating, but stopped having it thereafter.

There are many causes of anorgasmia. Primary anorgasmia commonly results from lack of sexual experience in younger women.

The fear of conceiving as well as guilt resulting from engraved social values are also known causes of primary anorgasmia. Survivors of sexual abuse similarly find it hard to relax during sex and are unlikely to have orgasm.

Secondary anorgasmia commonly results from relationship problems. If you have been getting orgasm with your partner then it suddenly stops, there is need to examine your intimacy; possibly your relationship is sliding down south.

It’s common for couples to have disagreements as the marriage matures. Eventually, they engage in a power struggle and one spouse is left feeling overpowered.

Consequently, self-esteem and confidence wane, and thus engaging in sexual intercourse becomes a duty rather than a show of love. Anorgasmia naturally follows.

In a few cases, anorgasmia could be due to a disease that affects a spouse’s sexual functioning. Further, some medicines can cause anorgasmia.

Rarely, it could result from derangement of hormones. “So, it appears that mine is primary anorgasmia because I have never really had orgasm,” Rose quipped, “but I have come a bit late, at my age maybe I will never have orgasm!”

“Well, age is just but a number,” I answered, “the last I heard was that a woman aged 104 years had orgasm.”

I interrogated Rose, examined her and did a number of tests. The diagnosis boiled down to primary anorgasmia resulting from traumatic experiences while growing up.

Rose was sexually molested several times by a cousin, which left her with a deep emotional and psychological wound.

She had subconsciously struggled to overcome the experiences but failed, and it manifested as dampened sexual response and anorgasmia.

“Actually, I divorced my first husband because he wanted sex all the time and I really never had the desire for it,” she explained. “I am similarly struggling in my current marriage.”

Rose underwent sex therapy, counselling and sex coaching. It was not until eight months that she had her first orgasm.

“After going through this treatment, I have come to one conclusion,” Rose said on her last visit to the clinic, “lack of orgasm is a symptom of a deeper problem that should not be ignored.”

I nodded in affirmation. So, if your orgasm is elusive, do not take it lightly, seek help to unearth the deep-seated problem.