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HOW-TO · SHELF IV

When Desire Is Absent or Orgasm Doesn't Come

  • Research
  • Experiential

If you are not interested in sex, should you push yourself? Can you be healthy without it? Does not reaching orgasm make you ill? And what do you do when you love him and are still not satisfied?

In brief

  • Not being interested in sex is not a lack; it is one way of being.
  • Neither sex nor orgasm is required for health, and no causal link to fibroids is known.
  • When you are not satisfied: say it, show it, check your body, see a professional together.

This manual is general information based on the sources available to us. It is not medical advice and has not been reviewed by a clinician. For your own body, health or medicines, talk to a doctor.

This manual is general information based on published research and the sources available to us. It is not medical advice and has not yet been reviewed by a clinician. For questions about your own body, health, medicines, pregnancy or contraception, talk to a doctor or pharmacist.

If you are not interested in sex

There is no need to push yourself. Asexuality, feeling little or no sexual attraction, is recognised as a sexual orientation; in one national survey it described about one person in a hundred. Not being interested is not a lack; it is how you are.

If a loss of interest is new and it troubles you, though, it is worth looking for a cause: hormonal change, medication (some antidepressants, for example), low mood, pain during sex, or something in the relationship. All of these can be talked through with a doctor.

Can you be healthy without sex?

Yes. Neither sex nor orgasm is a medical requirement for health. Some surveys link sexual activity with wellbeing, but which causes which is unclear, and many people live healthy lives without partnered sex. The World Health Organization defines sexual health as including the possibility of pleasurable and safe sexual experiences: a possibility, not an obligation.

Fibroids and orgasm

You may be told that "even if you have sex, not reaching orgasm puts you at risk of fibroids". We know of no research showing that an absence of orgasm causes fibroids. Fibroids become very common with age: one ultrasound study found them in most women by age fifty. The established risk factors are age in the thirties and forties, family history, an early first period, never having given birth, higher body weight and high blood pressure.

If a doctor has told you this, ask what exactly they meant and what it is based on. The symptoms worth checking are heavy periods, pressure or pain in the lower abdomen, and needing to pass urine often.

How important is orgasm?

It is not either/or. In a national US survey, fewer than one woman in five said intercourse alone was enough for orgasm; many needed clitoral stimulation. A night without climax, if it felt good and close, is not an incomplete night. Making the peak the goal can push it further away; when pleasure itself is the point, orgasm more often follows.

When you love him and are still not satisfied

  1. Put it into words: not blame, but a specific "I would like…". How to have that conversation is in Talking About Desire.
  2. Show him: draw your own map (Knowing Your Own Pleasure) and share it.
  3. Check your body: if there is pain or dryness, see a gynaecologist first.
  4. Bring in a professional together: sex therapy and couples counselling exist for exactly the things that are hard to say between two people.
  5. If you are considering help outside the relationship, read Seeking Help first: on guilt, secrecy and promises.

Sources, and what kind of guide this is

  • Research Backed by clinical or laboratory studies, cited at the end.
  • Experiential Works for some people and not others; offered to try, never as a promise.
  1. Bogaert, A. F. (2004). Asexuality: prevalence and associated factors in a national probability sample. Journal of Sex Research, 41(3), 279–287.
  2. World Health Organization (2006). Defining sexual health: report of a technical consultation on sexual health.
  3. Baird, D. D., Dunson, D. B., Hill, M. C., Cousins, D. & Schectman, J. M. (2003). High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. American Journal of Obstetrics and Gynecology, 188(1), 100–107.
  4. Herbenick, D., Fu, T.-C., Arter, J., Sanders, S. A. & Dodge, B. (2018). Women's experiences with genital touching, sexual pleasure, and orgasm: results from a U.S. probability sample of women ages 18 to 94. Journal of Sex & Marital Therapy, 44(2), 201–212.

This manual is general information based on the sources available to us. It is not medical advice and has not been reviewed by a clinician. For your own body, health or medicines, talk to a doctor.

Concepts in this manual

Responsive desireAsexuality

How these guides are madeGlossary of concepts

Read on

Talking About DesireIn a long relationship, the hardest part may be not sex itself but talking about it: sharing a fantasy, hearing "I want to be with other people," considering an open arrangement, feeling jealous. This manual is a set of tools for having those conversations honestly without breaking what you have.Knowing Your Own PleasureYour own pleasure is not something anyone can teach you; it is something you find. This manual covers how to draw your body's map, how to explore the G-spot and anal pleasure, how to live well with fantasy and desire, and what tends to change from your twenties to your fifties, step by step and in specific terms. There is no hurry. This is not an exam; it is a long journey.Seeking Help: Guilt, Privacy and PromisesShould you feel guilty for seeking professional help with your sexuality? And if it is outside your relationship, and you keep it to yourself, how do you think it through?Responsive Desire, and the Diagram That Made You Feel BrokenThe model everyone was taught puts wanting first, so a person who never feels it arrive on its own concludes the whole process is closed to her. There is a second order, at least as common, in which desire shows up after arousal rather than before it — and under that account she is ordinary, with a scheduling problem rather than a defect.生理的に無理: When the Body Has ClosedLow desire is an absence: you wait and nothing arrives. Aversion is a presence: something arrives, fast, before any thought, and it is an objection. Almost every resource treats the second as a severe case of the first, which is why the standard advice — schedule it, add novelty, do it anyway — reliably makes it worse. Adding stimulation to an absence sometimes helps. Adding stimulation to an alarm is turning up the volume.The Appointment You Have Been Putting OffVery few women are avoiding a diagnosis. They are avoiding a room they cannot picture, in which something undescribed will be done to them by a stranger while they cannot see what is happening. The chair moves by itself. There is usually a curtain. You may ask for it to stay open, you may say stop, and you may bring someone — and nobody ever wrote any of that down for you.How Much Is Normal? Thinking About SexThinking about sex all day, in and out: is it healthy, and is it only you? What the research measures, and the better question to ask instead, step by step.MANUALA Map of MassageMassage has its schools. Swedish glides long with oil; shiatsu presses straight down; Thai massage is like doing yoga together; hilot wraps you in warm coconut oil; myofascial release sinks in and waits. This manual shows how they differ, which techniques suit each part of the body, six more schools and a comparison of what helps fatigue, tension, sleep and stress, and a sequence that begins with letting go and builds towards shared arousal, with drawings throughout.MANUALThe Pelvic Floor ManualAt the base of the pelvis sits a layer of muscle slung like a hammock. It holds your organs up, controls the bladder and bowel, and during orgasm it contracts in waves: these are, quite literally, the muscles of pleasure. This manual shows you how to find them, strengthen them, release them and use them during sex, without euphemism.MANUAL
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