Unlocking Pleasure by Exploring the Reasons Why Women Struggle to Achieve Orgasm

Written by Sam Mishra, The Medical Massage Lady

Sam Mishra (The Medical Massage Lady) is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology and lymphatic practitioner, trauma practitioner, breathwork facilitator, reiki and intuitive energy healer, transformational and spiritual coach, and hypnotherapist.

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The conversations I have with clients cover a wide range of topics, often including those that may be embarrassing or taboo. There is an assumption that every woman out there is achieving mind-blowing orgasms, and if you are, then congratulations, but I hear from so many women that they’ve actually never achieved an orgasm or really struggle to do so.

From my own experience, I went through long-term relationships and marriages, not ever reaching my orgasmic potential. I thought it was just youth and inexperience at first, but during my first marriage, I blamed it on chronic endometriosis pain, an abusive relationship, or lack of attraction. However, as I got older and more experienced, I had sexual encounters with some incredibly attractive men, who were respectful and caring and who were giving me great sex, but, while I sometimes got close, I still wasn’t quite getting there. I then had a few dates with somebody in his early 40s, and yes, he was very attractive, he made me laugh, and he was a perfect gentleman, but when things became intimate, I didn’t know what had hit me! I have to applaud him for sheer perseverance, and I guess I was lucky that he was someone who was genuinely more focused on my experience than his own. That was when, aside from realizing that I was actually capable of achieving an orgasm, I experienced postcoital dysphoria, becoming completely emotionally overwhelmed with tears pouring down my face.

Post coital dysphoria is thought to be due to return of hormone levels to baseline after a surge of oxytocin and dopamine, but I came to realise when I did more work on myself in the years that followed, that this had been a release of not only physical tension, but years of trauma related anger and sadness. I then had two yoni massage sessions, which again resulted in not only orgasm, but also changes in the way I viewed myself as a woman, my trauma, and my sexuality.

All women have the capacity to achieve orgasm, yet for so many it has remained elusive, so what are the reasons for this? Menopause? Trauma? A lack of understanding of our anatomy by men? A lack of awareness about our own bodies? In reality, it’s probably due to all of these and more. Often it isn’t deemed acceptable, at least in UK culture, to talk about our vaginas or our sexual experiences, and so as women we don’t understand ourselves well enough intimately to know exactly what we need to fulfil our potential. We also get very good as women, as the carers, at looking after everyone else’s needs but forgetting about our own, and our sexual needs are just one more thing that we just think we weren’t supposed to have.

There are misconceptions about what turns a woman on, not helped by images created by social media or pornography, and often, the things that men believe will turn a woman on actually aren’t correct. So we become dissatisfied, often shutting down and appearing disinterested, limiting our sexual experiences. So many women worry that there is something wrong with them because they can’t achieve an orgasm, so sex loses its appeal, and feelings of not being good enough creep in.

I talk in my transformation workshops about looking within ourselves rather than to our external environment, and this applies to sex, too. How often do we take time to simply feel the sensations in our body, or even look at our body without any judgement? How often do we masturbate simply to gain information about what we are feeling and how our body is responding? Without this self-awareness, we often become invisible as our male counterparts relentlessly pursue us for a few minutes, seemingly completing the task before we even begin. Even when men take the time to stimulate the clitoris, it’s often too hard or not quite at the right angle, or it’s just really painful because you’re in menopause and everything is dry. I’m honestly not bashing men, as they are probably doing their best with what they have been told or learnt from films, but my point is if we don’t know what works for us, how are we going to educate our partners?

We must start realising that orgasm is not about arriving at a destination but a natural emotional and spiritual state of relaxation and acceptance, where we are truly present. We must look at our social conditioning when we were growing up to identify where our view of sexuality comes from. Were we taught that surrendering meant being submissive? Or that free expression was somehow detrimental to our femininity? Or our external appearance? The perceived ‘normal’ view of sexuality that many of us take into adulthood is very much compliant with a male version of sexuality, dictated by a patriarchal society that essentially wipes out the softer, more emotional, and energetically focused qualities.

We make choices, and by continuing to support the notion that a man achieving his sexual goal is more important, perhaps unconsciously, because we want to satisfy our partner, so we just become passive and let them carry on even though we may not be ready, we also perpetuate the cycle of painful sex, penetration before we are ready, maybe aggressive sex or just an overall lack of fulfilment. Furthermore, the goal for men is often perceived to be the moment of ejaculation, which often happens too quickly after penetration, meaning there is not enough time for a woman to reasonably be able to even approach orgasm when foreplay is lacking. If we can express ourselves better in terms of those softer, more feminine qualities, being who we truly are, rather than who we have been conditioned to believe that we should be, maybe we can naturally transform our experience.

At the root of the sexual experience is a woman

Sexual re-education will not happen without the input of women finding their voice, expressing their needs, educating their children, and overcoming the misconceptions that have been imposed by society. We are so used to being judged on our outer appearance by the external environment that we lose our self-worth and don’t feel like our true selves. When we don’t care for ourselves, we deny ourselves an essential part of our femininity. We must remember that we actually hold a lot of power in sex because we are the host that receives the man. Therefore, by creating a receptive internal environment, we can transform the male sexual experience as well as our own. The problem is we generally don’t know how, and other factors often get in the way.

The first step is really understanding the female anatomy, and research has shown that many women don’t even know the correct anatomical terms for parts of their genitals, yet this is an essential aspect of feminine healing. We also have reflex points in the genitals corresponding to other areas of the body which may hold physical and emotional blockages due to karmic transgenerational memories in women.

In Chinese medicine, the uterus is considered the second heart, holding feminine vital energy and responsible for creation; balance is characterised by regular, pain-free menstrual cycles and peak fertility, while issues such as endometriosis, fibroids, and infertility symbolise imbalance. This reflects emotional blockages or unresolved trauma. Through targeted energy treatments to release trauma, energy flow, and optimal functioning can resume.

The kidneys secrete menstrual hormones and are a vessel for sexual creativity, so any imbalance encourages issues such as polycystic ovary syndrome (PCOS) and early menopause. The vagina is so much more than a birth canal; it is the gateway to femininity, intimately connected with the root chakra, which promotes grounding and bodily confidence. A healthy vagina is demonstrated by balanced secretions, tissue elasticity, and sensitivity, but imbalance brings recurrent yeast infections, painful sex, dryness and shameful taboos, making it difficult for women to connect with intimacy. Techniques such as pelvic rocking, vaginal breathing, orgasmic meditation and yoni massage can facilitate the release of profound blocks, empowering women to reclaim their sexuality. Immersing oneself in such healing practices requires delicacy and in-depth knowledge of female energy anatomy, creating a sacred space where the woman can safely reconnect with this intimate part of herself. This often carries painful memories and limiting conditions, but can bring true reconciliation with their sacred femininity.

Understanding the menstrual cycle and its four phases (menstrual, pre-ovulatory, ovulatory, and premenstrual) and the accompanying hormonal issues enables women to meet the specific needs of each stage. For example, ovulation is accompanied by an energy peak where expressing one’s full potential should be easier. Changes related to female reproductive life ie. puberty, pregnancy, and menopause can also impact on vaginal mucosa, for example, which can make sex more difficult.

Puberty and motherhood

As women, we shouldn’t underestimate how the hormonal fluctuations that accompany our childbearing capacity can affect our sexual expression. The menarche, childbirth, and menopause are significant life stages accompanied by substantial physical, emotional, and energy changes. With puberty and menstruation comes the awakening of sexual energy, but standing in the way of us fully diving into liberating sex is the fear of becoming pregnant. The internal conflict over contraception and pregnancy can prevent women from opening up, and even a slight underlying resistance can block the flow of energy. When clear physical signs of sexual development show, barriers associated with social conditioning and generational traumas may become stagnant in the body, increasing vulnerability.

When a woman begins her sexual journey and is enjoying new exciting feelings, it is easy to go into sex quickly and with less awareness due to that level of excitement, but the aim to reach orgasm can create quicker ejaculation, which can either increase the fear of, and risk of, pregnancy as well as penetration before she is physically ready. This in itself can create an unconscious cycle of fear which will be detrimental to a woman’s orgasmic potential.

Motherhood is a time of deep connection to feminine essence, but also of re-evaluation of priorities and roles, confronting women with their deepest fears, and where there has been a previous traumatic childbirth, this will also subconsciously play a part in sexual openness, and possibly pain.

During pregnancy comes a reluctance to be sexual, because suddenly the protective instincts kick in and sex seems aggressive, so the woman withdraws, which in turn can change the partner dynamic. Women who breastfed may feel unattractive due to stretch marks, c-section overhang, and breast shape changes. Prolactin, which is required for milk production, is also thought to reduce libido, having a calming effect.

Reluctance to engage in sex can be a consequence of the physical demands of childbirth, and perineal tearing will almost certainly impact a woman openly embracing sexual encounters. Softer penetration will be needed. For many women after motherhood, sex also becomes more of a spiritual experience, requiring as much energy as bringing a child into the world, but for many men, it is often still a purely physical exchange. Tantric sex may generally be a better option, as it is less animalistic, so it can help build a connection without pain, without the embarrassment of children witnessing the sexual exchange, and work at a more spiritual and energetic level.

Finally, menopause is another key transition that marks the end of the reproductive period, characterised by existential enquiries over life's meaning and individual purpose, in addition to vaginal atrophy and dryness, disrupted sleep and hot flushes. Women will reflect on their experiences, relinquish what doesn’t serve them any longer, and re-establish a connection with their profound aspirations. For menopausal women, this may be perceived as the loss of their femininity and attractiveness. However, the transition is also a stage of life where the realisation comes that femininity and sexual attraction are not about external appearance, so confidence becomes separated from the physical ageing process. Whether at puberty, during motherhood, or at menopause, women must exercise self-compassion, limit conditioning, and embrace their essence as a free, wildly alive woman to connect to the innate wisdom of their bodies and turn these transitions into opportunities for growth and unfolding of their full feminine potential.

The effect of trauma on sexuality

Trauma may be type I trauma, referred to as shock trauma, or type II or complex trauma. Type I traumas result from sudden, unexpected events, such as a car accident or rape, and may involve reliving the event, avoidance of triggers, and hypervigilance. Type II traumas result from repeated or prolonged exposure to traumagenic situations, such as sexual abuse, severe neglect, or domestic violence, often involving dependency on the perpetrator. Type II traumas often bring feelings of betrayal, shame, and guilt, leading to profound alterations in emotional regulation, self-image, interpersonal relationships, and belief systems. Early traumatic childhood experiences, particularly where an attachment figure is the perpetrator, will significantly affect the development of an internal sense of security, trust, the formation of healthy relationships, and the ability to emotionally regulate.

Women are particularly devastated by traumas such as sexual abuse, abortions, and miscarriages, which significantly affect psychological wellbeing and deeply impact their connection with the body, femininity, and sexuality. It is quite possible that such experiences will cause women to devalue and defile themselves, and disconnect with their own body sensations.'

On an emotional level, traumatised individuals frequently transition between phases of intrusion, such as flashbacks, and phases of avoidance and emotional numbness. They may be overwhelmed by feelings of fear, shame, guilt, or anger without being able to regulate them, and this emotional dysregulation often creates co-dependent relationships and trust issues.

In addition to validating feelings of unworthiness, trauma, particularly domestic and sexual abuse, can create cognitive distortions, such as “every man will hurt me” or "it's my fault I was abused”. The body becomes an object of shame, disgust, or even hatred, and we numb ourselves to bodily sensations, avoid connecting with our needs and feelings. Sexuality and intimacy reactivate traumatic memories, increasing anxiety and resulting in reduced confidence in one's value as a woman and diminishing one’s femininity.

Unfortunately, women make up the majority of victims of sexual abuse, domestic abuse, harassment, forced abortion, miscarriage, and female genital mutilation due to gender inequalities in society. The objectification of women and the deprivation of their dignity exemplify the male dominance that so often characterises these traumas. The abuser takes advantage of physical, economic, or emotional fragility by gaining control through violence. Blaming the victim and social stigma exacerbate any feelings of shame. They generate feelings of betrayal and confusion. The resulting depression, anxiety, sleep and eating disorders, addictions, and self-destructive behaviours, can be devastating to a woman’s identity, self-esteem, feelings of legitimacy, and the ability to assert and respect oneself.

These effects can cause somatic and sexual scarring, creating dissociation and even disgust towards the body. Women might develop unhealthy coping mechanisms such as striving to reclaim control or transferring from engaging in hazardous sexual conduct to phobic aversion to physical closeness. Chronic pelvic pain, gynaecological conditions, and sexual dysfunction are common.

Why women aren’t having orgasms

There are various complex factors contributing to a woman’s ability to reach orgasm, and these can be physical, psychological, or relational. Medical conditions, such as an underactive thyroid, may inhibit sexual responses; fluctuating hormone levels can affect sexual function; and medications like antidepressants may impact sexual desire. There may also be gynaecological issues, such as multiple pelvic surgeries and resulting scarring, vaginismus and uncontrolled tightening, or endometriosis, which causes chronic pain; all of these issues can really interfere with experiencing pleasure.

But we also know that for women, sex can really be a psychological experience, and so stress or suppressed trauma, whether having had multiple partners cheat or having been sexually assaulted, might alter orgasmic potential. Our social conditioning or cultural beliefs may have taught us that sexual expression is something dirty; we may consequently have little knowledge about how to be stimulated sexually and find it difficult to express our needs. Certainly, there can be a lot of shame associated with our culture or previous sexual abuse, and this can cause us to have poor body image, which will stand in the way of our sexual pleasure.

Any of these physical or psychological factors can create a lack of connection and intimacy, or mean that women struggle to communicate their needs and how they want to be stimulated. Perhaps the most common reason, however, is that a woman’s partner is so focused on his own satisfaction that she has barely even started to become aroused. This can happen due to premature ejaculation, a lack of foreplay, or a lack of knowledge about where to stimulate. Often, sexual experiences for women are too short, and there is very little understanding about the different types of orgasm or the energy exchange that takes place during a sexual connection.

Both the male and female energies, known as yin and yang, are equal and essential for the creation of life. The two forces are opposites but complementary. The relationship between sexuality and spirituality is often underestimated, and what is good for a man during sex may not be good for a woman. The male and female genitals are polarised; positive and negative, active and receptive, creating a whole unit. The vagina is the negative, receptive pole, and the penis, the positive, active one. Female breasts are positive, as opposed to the negatively polarised chest of a man. Tantra teaches that there is a magnetic rod running between the upper and lower poles within the body, where energy flows. Orgasm is thought to be an interplay of these opposing poles, which create a cycle of electromagnetic energy, hence why hugging can feel so good.

Different types of orgasm

Orgasms are rhythmic pelvic muscle contractions, due to the sudden discharge of accumulated sexual tension, but this definition is limited because the orgasm isn’t just physiological but also psychological, neurological, and energetic. We often overlook the fact that women experience various types of orgasms, which we can classify as either implosive or explosive. Vaginal, cervical and G-spot orgasms are implosive, while clitoral and nipple orgasms may be either. Implosive orgasms build up gradually, allowing the energy to be channelled in a positive way to the places where it’s needed, maybe toward the higher chakra to reach another state of consciousness or toward specific areas. The energy doesn’t dissipate, and sexual desire isn’t lost with this type of orgasm. The woman will experience an expanded state of consciousness if the energy is properly channelled, resulting in a longer and stronger orgasm that creates a feeling of bliss. Explosive orgasms, on the other hand, are similar to the male orgasm/ejaculation and dissipate energy. The energy increases, spreading across the whole body upon orgasm, but the energy is dissipated rather than channelled, resulting in a loss of energy and sexual desire.

There are six main erogenous zones that can trigger orgasms; the clitoris, nipples, vaginal entrance, G-spot, cervix and the anus, but how many of these are actually stimulated properly during sex? The clitoris and nipples can produce either implosive or explosive orgasms. Research has shown that nipple stimulation activates the genital sensory cortex in the brain, which is also activated by clitoral and vaginal stimulation. Nipple stimulation can, therefore, elicit an intense response in the vulva, triggering pelvic muscle contraction and inducing a warm, pleasurable feeling at the level of the heart. Clitoral orgasms involve rhythmic and involuntary contractions of the vaginal muscles resulting in a warm, tingling feeling that expands throughout the body, but it only lasts a few seconds, after which the clitoris may be too sensitive to touch. The problem is that at this point, many women will probably not feel like continuing sex and may not be satisfied at a deep level; hence, this may lead to reduced desire and connection with their partner. Given that many men stimulate the clitoris too hard, it is easy to see how desire and sexual satisfaction can drop. While clitoral orgasms can be implosive, in women who don’t practice tantra, and whose partners are overly enthusiastic with their technique, they are usually explosive.

The vaginal orgasm, resulting from stimulation of the lower vagina, is implosive, but women often believe they can only achieve clitoral orgasms because they don’t receive enough vaginal stimulation, i.e., 20 minutes plus. Intercourse often does not include this amount of foreplay or last long enough to reach this type of climax. Pelvic floor strength may also influence vaginal orgasm, potentially due to factors such as traumatic childbirth. G-spot orgasm also requires up to 30 minutes to build energy and results in expansive and intense pleasure, leading to deep satisfaction and relaxation. Intense contractions of the pelvic floor may even result in female ejaculation or emotional release. Again, the problem is that there is usually not enough time given to stimulate this area. Cervical orgasms build energy even more slowly than G-spot orgasms, but when they are achieved, a series of long vibrations channel energy upwards, creating a profoundly satisfying orgasm on physical, emotional, and spiritual levels.

The other type of orgasm is anal, but many women are reluctant to try this type of stimulation or find that their partners are too aggressive when it comes to penetration. The outer anus is full of nerve endings, but anal orgasm requires a lot of relaxation. Anal orgasms are also quite intense, usually convulsive, and hard to control.

Relaxation is the key

The more a woman can relax into her body, without any specific goal, the easier it is to experience what is happening in the body. Where possible, women should try to hold awareness in their breasts leading up to sex and during, because the breasts are energetically linked to the vagina. By bringing awareness to the vagina, not only will it be more receptive, but it will also reinforce the fullness of the penis upon penetration. With conscious awareness, everything slows down, and the vagina becomes less constricted and more sensitive. Pelvic floor exercises will also improve vaginal tone, but intentionally contracting against the penis during penetration will be counterproductive. Even thrusting movements will contract the vaginal walls, making them less receptive, so to increase sensitivity, it is advised to maintain a position and focus on receiving the penis, at least for the initial part of the sexual experience. Then once you want to introduce pelvic movement, you should isolate the vaginal muscles, keeping them relaxed while thrusting, but this level of awareness can take some practice.

Also, breathing slowly through the nose, down into the abdomen rather than the chest, helps expand the sensitivity in the genitals. Additionally, focusing on the breath helps maintain awareness, which keeps individuals relaxed.

Conclusion

As women, we are often dominated by male sexuality, but we are ultimately the ones responsible for creating our connections. By exploring our sexuality, we connect with ourselves on a deeper level, overriding social conditioning, but this can also create some contradictory feelings – empowerment as well as confusion and overwhelm. Maybe by bringing our awareness into our bodies and exploring with our partners without penetration, we can discover new ways to overcome convention and, in the process, find a new level of satisfaction and connection. So often we allow our doubts and fears to take over; fear of being naked, fear of the unknown, fear of losing control, but often these challenges can help us to grow and to know ourselves better, becoming more empowered rather than devalued. To grow, we must be willing to feel everything, and sometimes this may include painful or traumatic emotions, but by remaining true to our own femininity and consciously inviting our partner in, we can create a whole new experience.

I offer an intimacy guide for couples, which is also useful where either partner has experienced trauma. If interested in this, please contact me at sam@medicalmassagelady.com.

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Sam Mishra, The Medical Massage Lady

Sam Mishra (The Medical Massage Lady), is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology and lymphatic practitioner, trauma practitioner, breathwork facilitator, reiki and intuitive energy healer, transformational and spiritual coach and hypnotherapist. Her medical background as a nurse and a midwife, combined with her own experiences of childhood disability and abuse, have resulted in a diverse and specialised service, but she is mostly known for her trauma work. She is motivated by the adversity she has faced, using it as a driving force in her charity work and in offering the vulnerable a means of support. Her aim is to educate about medical conditions using easily understood language, to avoid inappropriate treatments being carried out, and for health promotion purposes in the general public. She is also becoming known for challenging the stigmas in our society and pushing through the boundaries that have been set by such stigmas within the massage industry.