Is this normal? When to call the doctor

Is not being able to orgasm during sex normal?

Believe it or not, you aren't alone. According to Dr. Diana Ramos, professor, OB/GYN and collaborator on 50 Years of the Pill, "Only about a third of women experience orgasm regularly during intercourse. A third can reach orgasm with intercourse but need extra stimulation. A third never achieve orgasm during intercourse but can by manual and oral stimulation."

If you haven't achieved orgasm yet, however, don't give up hope. Dr. Prudence Hall of the Hall Health and Longevity Center says:

"Like learning about anything new, having an orgasm can take a bit of practice. I tell my women patients that guys are very good at ejaculating because they practice so much. To have good orgasms, first identify the muscles involved in the process.

"These muscles are called the pubo-coccygeal (PC) muscles and are located deep in the pelvis underneath the vagina. If you squeeze your pelvic muscles to stop from urinating, those muscles are your PC muscles. It is important to exercise and build those muscles so they contract strongly when stimulated. An orgasm is simply a contraction of those muscles, and you need to have some good muscle tone to have an orgasm. Kegel exercises strengthen those muscles, as does the battery-operated Women's Liberty Machine, which gives a mild shock to those muscles and causes them to contract. Women need lots of time to have orgasms -- usually 45 minutes of continual stimulation."

Practice doesn't always make perfect, though. A hormonal imbalance may be the cause of the problem. If you have tried Kegel exercises, experimented with a vibrator, worked with your partner and are still unable to achieve orgasm, talk to your doctor.

"The birth control pill diminishes our hormones so dramatically that many of my patients complain of a low sex drive and poor orgasms while on the pill," explains Hall. "I advise them to come off it ASAP and to use condoms (crown condoms are best), a diaphragm, IUD or the new Ovu-Watch, which helps women predict and avoid their fertile times. When my peri-menopausal and menopausal patients begin to lose their orgasms due to declining hormones, I replace their hormones to youthful levels with bioidentical hormones. Testosterone, estrogen, DHEA and thyroid really help keep us vital and sexy, as well as prevent the diseases of aging that occur when our hormones decline."

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