Orgasm and sexual satisfaction

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Orgasm and sexual satisfaction

Women do not have to reach orgasm in order to have satisfying sex, but if orgasm is your goal and it’s not being reached or you feel less satisfied sexually it can be frustrating and upsetting, especially if this is a result of your diagnosis and treatment. You may find that you can still orgasm alone but not with a partner, or that all your orgasms have been affected. In our sex and relationship survey a quarter of women (one in four) felt their orgasms were less satisfactory or difficult to achieve than before their diagnosis and treatment. Also one in three women expressed feeling less sexual pleasure or satisfaction.
Feeling depressed, stressed, fatigued/tired or having low self-esteem/-confidence can influence your ability to orgasm or experience sexual satisfaction. Some medications may also hinder orgasm and some of the physical changes can have an impact. How your body works may have been affected by treatment, making the steps to orgasm slower or reducing the number you experience.

It may help to know what an orgasm actually is so you understand the changes you may experience during masturbation or intercourse. Everyone experiences orgasms differently, but in essence it is the climax and release of sexual excitement or tension. Your breathing, pulse and blood pressure increase, you body muscles tense, and the uterus, outer third of vagina and pelvic floor muscles contract or pulsate. Some women may ejaculate; however, unlike men, if stimulation is continued women can orgasm more than once. Chemicals (oxytocin, norepinephrine and serotonin) are released into the brain giving it a message of pleasure and joy.

Orgasm(s) are followed by your body returning to how it was before you became aroused. Blood flows back into normal circulation, muscles relax and the cervix remains open for a while. This stage is known as the ‘resolution phase’ of sexual response. If this is felt positively the experience should leave you with a sense of wellbeing and, in coupled sex, enhanced intimacy; therefore, delays or problems here can affect your sexual pleasure and satisfaction.

Changes in sexual satisfaction after treatment

Some women feel their orgasms are different following a hysterectomy, possibly due to not experiencing the pulsation of the uterus or movement of the cervix. However, the majority of women orgasm through clitoral stimulation rather than penetration, the pudendal nerve that supplies sensation to your clitoris should not have been affected during surgery so clitoral orgasm should still be possible.

Radiotherapy can cause changes in the vagina that lead to pain either during penetration or discomfort following sex, and this can impact on your ability to reach orgasm or feel pleasure. It can also cause the vagina to bleed more easily and some women find they bleed during or after sex. Hormonal changes can slow down your sexual responses, meaning that it will take longer and you will need more stimulation than you did before to reach orgasm. Alterations in blood drainage can affect the resolution stage, leaving you feeling uncomfortable and ‘full’ in your pelvis for longer than you used to.

Psychological and emotional factors may have the biggest impact. Your attitude towards sex, your body and your relationships may all have changed. You may not be able to relax and enjoy sexual activity like you used to or it could be difficult for you to stay engaged in the pleasurable sensations during sexual activity. Your mind may be focused on the expectation of a negative experience, distracted by life events or concentrating on how you feel/think as if you're watching yourself from a distance, all of which can stop you enjoying the sexual experience.

Ways to manage changes to sexual satisfaction

You need to give yourself some time and try to enjoy sex, focusing on pleasure and avoiding putting pressure on yourself to have an orgasm. Spend time building your self-confidence and positive body image. Exploring your own body will help you understand what feels good and, if you’re in a relationship, talking to your partner and working together could lead to better sexual pleasure for both of you. Other things that can help include using a vibrator to increase stimulation and pelvic floor exercises to help strengthen the pelvic muscles, which help orgasm. Mindfulness can also help you stay in the moment. You may need extra help and support from psychosexual therapy to reclaim or adapt your sex life so you find pleasure and satisfaction, don’t be afraid to ask.

You may like to visit our useful links page on sex and relationships.

Date last updated: 
25 May 2017
Date due for review: 
25 May 2020

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