Why Women in Committed Relationships Still Struggle with Orgasm

Holly Wood
Jul 8
5 min read

You’re Not Alone if you are a woman and orgasm Feels Out of Reach

If you're in a committed relationship and still find yourself struggling to reach orgasm, you're not alone. Many women experience this challenge, even in relationships that feel emotionally safe and loving. As a certified sex and relationship therapist based in Orange County, I often hear from women who wonder, "What’s wrong with me?" The truth is: nothing. Achieving orgasm involves a nuanced mix of physical, psychological, and relational factors. In this post, we’ll break down the common reasons behind orgasmic difficulty and how you can begin to reconnect with your pleasure. And if you'd rather watch than read, feel free to check out my YouTube video on this topic!

A person lies under a white blanket beside a woman sitting up in bed with arms crossed, looking upset. She is thinking of going to couples therapy in Orange County. — If you're in a committed relationship and still find yourself struggling to reach orgasm, you're not alone. Many women experience this challenge, even in relationships that feel emotionally safe and loving.

The Complex Reality Behind Orgasmic Struggles

Orgasm isn’t just a physical response. It’s an embodied experience influenced by your body, mind, and the dynamics of your relationship. Let’s explore why even women in committed partnerships might still struggle.

1. Medical and Hormonal Factors

Certain medical conditions—such as thyroid dysfunction, hypertension, or neurological disorders like multiple sclerosis—can interfere with orgasmic response. Additionally, medications such as antidepressants (especially SSRIs) and some hormonal contraceptives may blunt sexual desire or make orgasm harder to achieve.

What you can do:

Talk to your doctor about side effects of medications.
Explore alternatives or adjustments if a prescription is impacting your libido.
Ask about hormonal shifts (e.g., pregnancy, menopause) that could be influencing your experience.

2. Performance Pressure

When either partner is hyper-focused on "achieving orgasm," it can inadvertently create a high-pressure environment. This pressure can lead to intrusive thoughts, anxiety, and a sense of "needing to perform"—none of which are conducive to relaxation or arousal.

Reframe: Pleasure is the goal—not performance. Creating space for exploration rather than outcome can shift the entire experience.

3. Psychological and Emotional Factors

Anxiety, depression, body image struggles, or a history of trauma can all interfere with a woman’s ability to feel safe enough in her body to access pleasure. Even in a loving relationship, unresolved personal wounds can surface during intimate moments.

Therapist Tip:

Practice grounding exercises before intimacy.
Therapy (including trauma-informed sex therapy) can help unpack emotional blocks.
Mindfulness-based sex therapy can be incredibly healing in reconnecting with bodily sensation.
Engaging in mindfulness-based therapy, a couple explores grounding exercises and emotional healing with a therapist to deepen intimacy and reconnect with bodily sensations.

4. Relationship Dynamics

Even in committed relationships, emotional disconnection, unresolved conflict, or a lack of emotional safety can hinder physical intimacy. If you feel emotionally distant from your partner, it can be difficult to let go and experience pleasure fully.

Ask yourself:

Do I feel emotionally supported in this relationship?
Are there unresolved tensions affecting our intimacy?

Open conversations, couples therapy, or intentional reconnection rituals can help restore emotional safety.

5. Cultural Focus on Penetration

Our society often centers vaginal penetration as "real sex," but research shows that the majority of women don’t orgasm from penetration alone. Clitoral stimulation is key for most women, and expanding your definition of intimacy can help improve satisfaction.

Try this:

Experiment with outercourse (everything other than penetration).
Include more clitoral stimulation, oral sex, mutual masturbation, or use of sex toys.
Learn about the full anatomy of the clitoris—it’s larger than you think!
Enhance intimate experiences with clitoral stimulation and toys for added pleasure and connection.

6. Hormonal Shifts Across Life Stages

From pregnancy to postpartum to menopause, hormonal changes affect sensitivity, arousal, and lubrication. For example:

Pregnancy can increase pelvic blood flow and arousal.
Postpartum hormones and fatigue may decrease libido.
Menopause often brings vaginal dryness and reduced elasticity due to declining estrogen.

Supportive tools:

Use high-quality lubricants and vaginal moisturizers.
Focus on extended foreplay and erogenous zones.
Consult a healthcare provider about hormone therapy or vaginal estrogen if needed.

7. Lack of Communication About Sex

If you’re not talking openly about sex with your partner, it’s easy for miscommunications and unmet needs to build up. Vulnerable conversations about what feels good, what doesn’t, and what you’d like to explore can be transformative.

Start small:

Bring up the topic during a calm, non-sexual moment.
Use “I” statements: “I love when you...” or “I’d like to try...”
Be open to feedback and cultivate mutual curiosity.

Gentle Strategies for Reconnecting with Pleasure

Let’s shift from why orgasm may be difficult to how you can begin to heal and reclaim your pleasure. Here are therapist-informed tips to try:

Practice Sensate Focus

This is a cornerstone technique in sex therapy that encourages touch without the goal of orgasm. It helps retrain the body to associate physical contact with safety and pleasure.

Explore Your Own Body

Solo exploration (masturbation) is a powerful tool for learning what you enjoy. Use mirrors, toys, or even erotic literature to help connect with your arousal patterns.

Prioritize Emotional Intimacy

Feeling emotionally seen and supported is a key component of physical intimacy. Consider weekly check-ins with your partner or writing letters to each other about your desires and needs.

Create a Safe and Erotic Environment

Lighting, music, scents, and setting all contribute to your ability to relax. Make your bedroom feel like a sanctuary.

Couple kissing on a couch with a laptop showing Netflix. They are having a romantic date at home after a wonderful therapy session with their couples therapist from Orange County — Create a cozy sanctuary in your bedroom with soft lighting, music, and scents for a romantic and relaxing evening.

Integration and Reflection

Struggling with orgasm in a relationship isn’t a personal failure—it’s a sign that something deeper may need attention. Whether it’s a medical concern, emotional residue, or relational disconnect, the path forward starts with curiosity and compassion.

Journal Prompts:

When do I feel most connected to my body?
What messages did I receive growing up about women’s pleasure?
What would I like to experience more of in my intimate life?

Remember: there’s no “right” way to experience pleasure—only the way that feels most true to you.

Smiling woman writes in a notebook, sitting on a bed with a laptop, writing down her reflections after her sex therapy in Orange County — Explore personal insights about your body and intimate experiences.

Support & Resources

You don’t have to figure this out alone. If you're ready to go deeper:

Work with me one-on-one: I offer therapy for individuals and couples navigating sexual concerns.
Watch more videos on my YouTube channel: I cover topics like desire, trauma, and communication.
Download my free guide to talking about sex with your partner
Visit AASECT to find certified sex therapists near you.

You Deserve Pleasure—In Every Stage of Life

Thank you for exploring this topic with me. If you’ve ever felt alone or broken because of sexual challenges in your relationship, I want you to know: you are neither. You are whole, worthy, and capable of experiencing deeply satisfying intimacy. It just takes support, exploration, and a willingness to understand yourself more fully.

Ready to take the next step? Book a consultation with me today and let’s explore how therapy can support your journey toward pleasure.

About the author

Dr. Holly is a leading expert in sexual health based in Orange County, certified as both a clinical sexologist and AASECT sex therapist. With extensive experience in sex therapy, sexual wellness, and relationship counseling, Holly provides evidence-based insights to clients in Orange County, the state of California and beyond. Recognized for expertise in sexual trauma recovery, sexual dysfunction, and intimacy, Holly is dedicated to empowering individuals with practical advice and research-backed strategies. For more, follow Holly for expert advice on sexual health and relationships.