Dear Dr. Kate,
I have a big issue. I have been sexually active for about 4 years now and I have had my share of partners, but for some reason I just cannot seem to be able to have an orgasm. I have never had one, whether it was through intercourse, oral sex, or masturbation. I have tried everything I possibly could but nothing seems to work. At times I get so close but then I just lose it. Most of the time I think the problem is that I cannot seem to relax, I always have a million things running through my head. It's gotten to the point where I don't even want to have sex anymore. My sex drive is way off because I want to be able to enjoy sex fully instead of just being disappointed every time. I have also heard that there are women that never get an orgasm, is that true? Do you have any suggestions on what I can do?
Even though sex is about more than orgasms, I can understand why not having an orgasm is affecting how you feel about sex in general. But I've never had a patient who is simply not able to have an orgasm - in my experience, EVERYONE can have them, it just may take more time to figure out how to get there. So don't lose hope!
For my patients who are having difficulty with orgasms, I recommend starting with masturbation - I think you'll find that it's going to be easiest to come by yourself, before trying to come with someone else. Yes, part of having an orgasm is being able to "let go" - so you'll want to be in a place where you won't be bothered or interrupted, where you'll have plenty of time and won't be rushed. This is how you'll be able to figure out what kind of touch feels best for you, and follow the sensations where they lead. My other recommendation is a vibrator - it can pull an orgasm out of you almost against your will. There's lots to choose from on sites like Good Vibrations or Babeland.
When you try a vibrator, don't start out with it directly on your clitoris - that's often too intense. Try it on your labia, then on the sides of your clit. Vary the amount of pressure you use, and try alternating leaving it in place and moving away. See what feels good, and don't be afraid to give into the sensations if they get intense.
Once you can figure out what feels good, you can then teach your partner how to touch you like that. Fingers and tongue often work best - climaxing during intercourse can take a long time to figure out, so don't try for that right away. If you're with a considerate, caring partner, he'll be eager to try different things to make you feel good.
Best of luck (and let me know how things go),