I can't orgasm

[JackHamilton]

So,first of all,I am Jack,23 years old,transgender (born female but live as a male).I haven't had any surgery yet.I discovered masturbation when I was about 19.I couldn't orgasm through vaginal masturbation,but could through clitoral stimulation.I had very intense orgasms.I am,and was on Testosterone injections.I had normal,even strong, orgasms until one day they just stopped.I am seeing a sexual therapist.He thought the reason why I can't achieve orgasm is because I have too much of a hormon called prolactin.But then he took me off some pills and my prolactin levels were normal but I STILL couldn't orgasm.Then I was taken off Zoloft because it is known to cause sexual issues.Again nothing.My therapist suggested sex toys.Used them and nothing.Then he suggested different types of mastubation. Tried and nothing.He then suggested "autogenic training exercises".Tried them - again no orgasms. Then I wasn't sure If I was getting clitoral erections so the doc prescribed me Viagra.Tried that,got erection but couldn't reach the climax.Even when I'm watching porn and masturbate I can't have an orgasm.I have just some tiny bit relaxing feeling,but that's not even close to orgasm.It's been 2 years and 4 months since I had an orgasm.

[JackHamilton]

What should I do? I think the reasons are psychological maybe....i have psychosis and mild depression.And I am under a lot of stress (mostly because of my gender dysphoria and anxiety).Could that be it?

[Sam W]

Hi Jack,

It sounds like you and your therapist have been experimenting with a lot of different approaches to this, and it's great that you're so open to trying stuff. In terms of figuring out underlying causes, I think you're best bet is to continue working with the therapist to see if you can identify them. You mention dealing with a lot of stress and some depression, both of which are things that can influence your sexual response cycle, so that could be something to explore. Too, depending on when you started testosterone, that could also be playing a role. Some trans guys find that starting testosterone influences their ability to orgasm, at least for a little while, because it's causing a bunch of changes to their system.

I also wonder if it would be beneficial to pull back from focusing on orgasm so much and instead focus on pleasure in general. A common thing that happens when people notice their orgasms are a no-show is that they get really focused on making those orgasms occur, and the pressure from focusing so hard on that one goal actually decrease the likelihood that an orgasm will happen. Something we recommend is that instead of focusing on orgasm when you masturbate, you focus on doing things that give you the most possible pleasure. If you orgasm as a bonus, awesome, but if you don't it's no big deal because you still did something that felt good. Does that feel like something you could try, if you haven't already done so?

[JackHamilton]

I started testosterone 4 years ago.After taking it for 2 years I made a 2-month-long pause.Then my Testosterone levels dropped and I got my period,for the first time after 2 years.And I could orgasm before I got my period but when I masturbated during and after period I couldn't orgasm anymore.Then I quickly got back on testosterone and nothing has changed.No more periods,but no more orgasms either.Recently,they drew my blood and found high levels of testosterone,but i still can't reach climax.

[Sam W]

So, it sounds like maybe some of the hormonal ups and downs could have influenced this, and that's an element you could bring up with your healthcare provider and therapist if you haven't already done so.

How do you feel about the suggestion to focus on overall pleasure rather than orgasm during masturbation? Does that sound like something you could try?

[JackHamilton]

My hormones are normal now...

i guess I could,but i always have this feeling of failure when I don't reach climax

[Sam W]

Okay, so let's talk about that a little bit more. Why do you think it feels like a failure when you don't orgasm? Does it feel like orgasm is supposed to be the goal of masturbation? Something else?

With the hormones, I was mostly wondering if you and your sex therapist had discussed the fact that your orgasms went away when you stopped testosterone but didn't come back when you restarted, just in case they needed to factor that in to how they approached their work with you.

[JackHamilton]

Yes,orgasm IS the goal of masturbation.


I think I told my therapist but I can say it again

[Siân]

Hi Jack,

Maybe this seems like a silly question, but do you have any idea why orgasm is the goal of masturbation for you? I'm asking because masturbation can be about plenty of other things - like pleasure, or feeling relaxed or getting in touch with your body - and orgasm doesn't have to be the goal. Have you ever masturbated just because it could feel good, whether you orgasm or not?

It's always a good idea to mention this to your therapist again too.

[JackHamilton]

I used to have strong orgasms but now I don't have any and it's making me REALLY frustrated.Because I have a lot of testosterone in blood and lots of testosterone causes lots of libido.I do masturbate,and I find some smallish pleasure but in the end I just lie there feeling disgusted (because every time I masturbate i pee a little so I have a towel on which I lay while I'm in bed masturbating) and because I masturbate to fetish videos and because my vagina gets very wet and that is uncomfortable to me

[Sam W]

Got it. I want to address two different elements of this, because it sounds like there are maybe two separate things that are kind of colliding with each other to create this situation.

To get at what both Sian and I were thinking about, something we know happens is that when people make orgasm the main goal of masturbation and keep all their focus on it, the pressure from doing that often makes is harder for an orgasm to happen. That's why we advise people who are struggling with orgasm to switch tactics to focus instead on getting as much pleasure from masturbation, regardless of if that pleasure results in an orgasm. Does that make sense?

It also sounds like there's some dsyphoria that might be flaring up, which can also inhibit orgasm. If you'd like we can talk about techniques that some people use to decrease those feelings during masturbation. Too, to make sure I'm understanding correctly, do both the videos you use and the way your body behaves cause those feelings of disgust?

[JackHamilton]

I'd be interested to hear the techniques.

Yes,the videos and the pee are causing me discomfort.Also,it is important to mention that the ONLY thing that arouses me is the fetish (not gonna say which but let's describe it as certain behavior that I imagine is happening to me.) And if I don't imagine that "behavior" happening to ME I can't find pleasure in masturbation.Two people having sex or someone else doing the thing I imagine is my situation - can't arouse me.I sometimes lets say walking down the street think "hey there is a hot guy,I'd like to have sex with him" but that only stays as a mental thought,physically I don't get wet,I don't have a clitoral erection and even mentally I don't get aroused,but I think I would If I had sex with a hot man.The only time in my life that I got sexually excited from a person was about 5 months ago,when I was hugging a guy I had a huge crush on.That happened about 3 times with him,when hugging him (I'd get wet and I received a very horny feeling).Never before.Just with my fetish,he was the first and only person that got me sexually excited. Although,this summer I saw a hot boy and I couldn't stop staring at him.I wanted sex with him.But I am not sure was I aroused.There are like these separate levels of attraction in my case (I can see a hot guy and want to have sex with him,but can't receive pleasure If i think about him during masturbation) and this hornyness I receive when thinking about the fetish - which gives pleasure.

[JackHamilton]

why don't i get an answer on this question?

[Heather]

Jack: we make clear in our user agreement and guidelines that we do our best to answer questions within 24 hours (but sometimes it can take even longer). A lot of the time we will answer more quickly than than that, but not always. You only posted this a couple hours ago.

[Heather]

Hey there. I'm looking at this, and to be honest, I'm not quite sure what we can really offer you with this.

It seems to me, if I have this right, that your choices right now are to take a break from masturbating -- and there are other ways you can potentially experience physical feelings of release besides sexual release, if you want to talk about those -- or to keep doing what does work for you and to work on getting more comfortable with what works for you.

How do you feel about those options? Do you see any others I'm not seeing?

[JackHamilton]

I'd like to know those other ways of release you mentioned

[Heather]

Sure.

Ultimately, what orgasm is -- in the simplest way of seeing it -- is a central nervous system event where our bodies have first built up a whole bunch of tension, reach a peak of that tension and then let it go, which sets off a few hormones that make us feel good, particularly endorphins.

Exercise is generally the easiest and cheapest (depending on the kind, obviously) way of getting something similar, particularly sustained exercise like, for example, running, hiking, swimming or biking or extended sessions of yoga, especially intense kinds of yoga like hot yoga or Kundalini.

Massage can also be another way of experiencing all of this in a milder way. Some people also have similar experiences with meditation.

[Heather]

I wanted to add that you might think about trying this with exercise that might also change your body in ways you like and might also help with your dysphoria, like bodybuilding, for instance, where you can choose to focus on muscle areas you may prefer be larger or smaller or more or less defined.

[JackHamilton]

thanx...yeah i planned doing bodybuilding but after my mastectomy (top surgery,breast removal) because I don't feel comfortable going to gym and guys there thinking I'm a woman

[Jacob]

I think plenty of people feel uncomfortable in a Gym, especially the weight training section...

That said, people I know who do train in the gym often find it easier if they can find someone to train with.

I also think it's worth saying that these things also don't automatically require a gym membership. Plenty of people get started at home.

It sounds like it could be a really good way to work of some of the tension your feeling!