Q. I have a friend who does not live in the area who has never been able to orgasm with a partner — she can only achieve an orgasm thru masturbation (by “grinding” on a pillow) — but wants to be able to orgasm with her partner. Since my friend does not live nearby, I was hoping you might be able to suggest a book or two that might help her.

A. I walk a tricky slope when addressing orgasms issues. On the one hand, I advocate for individuals to experience mind-blowing orgasms. But I also know that partners can get very caught up in the “goal” of orgasm (which in part may inhibit it from happening) and miss the glorious pleasures along the way. So, while I will offer some feedback on the female orgasm, which I do think is important information, I caution partners to not make this the “end goal” of sex.

Your friend is not alone since 70-80% of women do not experience orgasms during intercourse. Orgasm difficulties are also known as inhibited orgasmic disorder or anorgasmia. This is further classified by whether or not this is lifelong or acquired, generalized (meaning all the time) or situational.

Extensive research on inhibited orgasms is lacking so I can only offer you what the current research shows. There are many variables that influence her ability to achieve orgasm, including energy level, mindset, thought processes, masturbation patterns, negative sexual attitudes (including those on orientation and gender), previous sexual abuse, adolescent sexual experiences, inhibition, to name a few.

However, one of the most important factors that influence orgasm is the communication pattern within the couple. She and her partner must be able to effectively listen to each other while talking about their sex life, verbalize needs, feelings, authentic desires and assert themselves during sex.

Since she has only achieved orgasm via grinding against a pillow, she is obviously achieving orgasm via clitoral stimulation. She may have also inadvertently trained her sexual response cycle to orgasm only during that scenario. She may need to abandon that technique and find how to bring herself to orgasm by masturbating in other positions first before trying to achieve orgasms with her partner. Once she knows her sweet spots better, she can communicate this to her partner.

Coital sexual alignment may also be a factor. She may need the right physical position that allows for the stimulation of her clitoris in order to achieve orgasm during intercourse.

There are some good books to read. I recommend “For Yourself: The Fulfillment of Female Sexuality” and “For Each Other: Sharing Sexual Intimacy” both by Lonnie Barbach. These are classic texts that many sex therapists recommend. Another text is Becoming Orgasmic: A Sexual And Personal Growth Program for Women by Julia Heiman and Joseph LoPiccolo, Ph.D.  Betty Dodson is a leading advocate for the female orgasm. For a fun and informative visit, go to her site at www.dodsonandross.com.

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