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Failure to reach orgasm, the peak of sexual excitement, is called anorgasmia. The causes are usually psychological.Anorgasmia is the most frequently reported sexual problem in women and affects up to half of all women at some time in their lives. Fewer than 1 in 10 men report failure to reach orgasm. Phases of sexual arousal In men, sexual arousal rises rapidly to reach a plateau; in women, arousal is more gradual. In both sexes, arousal peaks at orgasm, which may not occur simultaneously, and wanes in the resolution phase. What are the causes? What might be done? Self-help: Communicating your sexual needs What are the causes? Psychological factors that can inhibit orgasm include anxiety about sexual performance, fear of pregnancy, a previous unpleasant sexual experience, physical or mental abuse during childhood, and sexual inhibitions as a result of a strict upbringing regarding sex. Poor sexual technique on the part of one or both partners may lead to failure of orgasm. Most often, insufficient time is allowed for the woman to become fully aroused. Poor sexual technique is common between new partners who know little about each other's sexual responses. The problem may also be due to inexperience or a lack of communication between partners. Some long-term disorders that result in damage to nerves, including diabetes mellitus, may lead to failure of orgasm. Certain drugs, such as particular antidepressants and some antihypertensive drugs, including beta-blockers, can cause a decreased sex drive that may result in anorgasmia. Heavy drinking may also cause failure of orgasm. What might be done? If you or your partner repeatedly fail to reach orgasm, it is important to discuss the matter together. Your doctor should be consulted if the situation does not improve. If the problem is psychological or due to poor sexual technique, you will probably be referred to a sex therapist. If the problem is caused by drug treatment, the doctor may change your medication. However, if you have nerve damage, the problem is usually permanent and cannot be treated. Sex therapy is effective in most cases, but, if you or your partner have deep-rooted problems such as difficulties due to abuse in childhood, some form of psychological therapy may be needed. Failure of orgasm can be treated successfully in many people. Self-help: Communicating your sexual needs Many people feel that the sexual side of their relationship could be better. The key to improving your sex life is communication with your partner and mutual understanding. Bear the following points in mind when you discuss your problems with your partner: Think carefully about your words and timing to avoid sounding hostile or critical. Talk about the positive aspects of your sex life. Suggest things that you would like to do or would like to spend more time on; watch your partner's reaction carefully. Keep your comments open and your suggestions positive. Listen to what your partner says. Create an action plan together, and include the points that you would both like to work on.