Ask the Doctors: Difficulty Reaching Orgasm

Dear Doctors:

I am a 50 year old female in good health and shape with a healthy libido.  My problem is difficulty achieving an orgasm with my new husband.  I have had this problem for years now since coming out of a poor marriage with a husband that was not interested in satisfying me.  I can easily have an orgasm by myself and especially when using a vibrator.  I cannot reach orgasm through regular intercourse or even with prolonged oral stimulation.  I have cut back on using my vibrator in the last couple of weeks to once a week. I need help!!!

Hopefully I can offer some useful information for you.

First I want to make sure you know that your situation is not even remotely unusual. It’s not just that many women do not orgasm through partnered intercourse — most may not, at least much of the time, according to most surveys. While more women are generally able to come with oral stimulation, this is by no means a guaranteed method of climax either. But let’s consider some ways to make it more likely.

You don’t say how long you have been with your husband, how long your primary orgasm companion has been your vibrator, or how often you use it. It is true that if you have only come with a vibrator for a long time, it might take you some time to readjust to a different sort of stimulation. This is certainly do-able, but please be patient and ask your husband to be, too. The technique I think might make the most sense for you two to try is called “bridging,” and involves you bringing your vibrator to bed — have all the fun you want with your partner, get as close to orgasm as you can, use the vibrator for a bit and get even closer, and go back to other stimulation. This may well not work right away, but it uses the stimulation and neural response your body already recognizes to add new sources of high arousal response. It’s certainly worth a try.

Also, you might want to switch to manual stimulation — your hand — when you would ordinarily use your vibrator. The great efficiency of the vibrator is wonderful, but you want to dial your response back a little. Your own hand is possibly a good compromise for a while, and may add to the kinds of stimulation you like. This way, too, you can use your hand during intercourse — or he can use his — for clitoral stimulation that will help get you to orgasm. And that in turn may help with the clitoral response you have to oral sex.

It is conceivable that at 50 you’re well into perimenopause, and this sometimes significantly affects your sexual patterns. You may want to talk to your gynecologist if you have noticed yourself taking longer than you used to even with the vibrator. I never recommend hormone replacement therapy, but occasionally women find it makes a big difference to them; talk to a doc if that is of any interest, and make sure you know there are plant-based hormones available now, not just animal-based ones like Premarin.

You don’t say anything about your health, and I hope it’s fabulous. There are a couple of relevant points to make about health, though. First, if you do not get lots of exercise at midlife, a sedentary lifestyle begins to take its toll on your sexual response by affecting your pelvic blood flow. It’s a very good idea to take walks even if you don’t do anything more athletic than that. Also, if you have any pharmaceutical meds in your life, or if you have more than a couple of drinks before having sex, these can affect your ability to orgasm. Especially notorious culprits in women: antidepressants. If by chance you are on them, talk to your doctor; but don’t just go off them yourself, because withdrawal can be very harsh.

Please don’t expect overnight change after a long period of only vibrator response, but if you’re patient and stay tuned in to your body’s responses, you may find you have more erotic flexibility than you do now. Good luck, and enjoy the path wherever it leads you!

We’re dedicated to getting you the information you need about sex, pleasure and your health. If you have any questions, please email our staff experts, Dr. Carol Queen and Dr. Charlie Glickman, at! For product-related questions, please email or call our customer service staff at

Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at

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