If you have never had an orgasm, or they have become harder to reach, several factors may be involved. Stress, medication, pain, the kind of touch, and the pressure to finish can all play a part. A useful first question is whether this has always been the case or whether something has changed.
Start with what feels comfortable
Many people with a clitoris find external touch important, whether that is a hand, a toy, a partner's mouth or pressure through fabric. Direct contact can also feel too intense, so there is no instruction to rub harder until something happens. Try varying pressure, pace or placement, and notice what is pleasant rather than judging each attempt by whether you climax.
Lubricant can reduce friction if you want it. It can help with friction, but pain is a reason to stop. If penetration is painful, stop and seek advice rather than trying to work through it.
The context matters
It can be difficult to focus on pleasure when you are tired, anxious, worried about your body, distracted or trying to meet someone else's expectations. You might want more time, more privacy, a different kind of touch, or a conversation with your partner outside the bedroom. Physical health and the circumstances around sex can both matter.
Some medicines, including certain antidepressants, can affect arousal and orgasm. Hormonal changes and health conditions may matter too. If a change followed a new medicine, tell the prescriber; do not stop it without medical advice.
When to ask for help
If the difficulty is bothering you, if you used to orgasm and now cannot, or if you have pain, a GP or sexual-health clinician is a sensible place to start. You can say plainly: “I'm having trouble orgasming, and I'd like to talk about possible reasons.” A professional can consider your health, medication and symptoms without assuming one answer fits everyone.
Make a note of changes in sensation, medication or health before the appointment. You can also explain which kinds of touch feel pleasurable and which feel uncomfortable.
