If you’ve wanted to experience an orgasm but struggled in the quest to reach your peak, it can be frustrating to hear the same old advice to minimize stress, relax, and let go of expectations. While stress and anxiety can certainly get in the way of orgasms (and sex in general), if you’ve been unable to orgasm for years, you probably want more specific advice. Read on for some things to try when you feel like you’ve tried everything.‍

So, why can’t I come?!‍

Struggling to orgasm is very common. There are many reasons why someone might struggle to orgasm. Emotional, psychological, and medical factors — beyond stress — can all play a part.

1. Medical issues

Painful sex caused by medical issues such as such as vaginismus, and other conditions that impact nerves like Parkinson’s, multiple sclerosis, or local trauma as a result of childbirth or certain surgeries, can make orgasming difficult. 

2. Medications

Some medications may impact your ability to orgasm. This can include antidepressants, anti-anxiety medications, and drugs used to treat high blood pressure and heartburn. 

3. Substance use

Some recreational drugs can make having orgasms harder. The nicotine found in tobacco products diminishes blood flow to the sexual organs, reducing sensation; alcohol can also make it harder to come.  ‍

4. Gender dysphoria

If your gender doesn’t correspond to your body’s appearance or the sex you were assigned at birth, feelings of discomfort, shame, or being disconnected from your physical body can detract from your pleasure and inhibit orgasm.

5. Shame

If you grew up thinking sex or masturbation was a sin, it can be difficult to separate your sexual desires from the message that pleasure is somehow dirty or shameful. Unrealistic beauty standards that are prevalent in many cultures can often lead to shame or poor self-image. If you’re uncomfortable with your body, it can be very difficult to completely surrender to feelings of pleasure. There are a few techniques you can try to build sexual confidence, though. 

6. Trauma

A history of abuse or trauma can contribute to an inability to reach orgasm. If you have associations — even subconscious ones — between sex and violence or abuse, your body’s stress response can kick in during a sexual encounter, even when it’s consensual and desired. Similarly, past trauma — even if it wasn’t associated with sex — can lead to dissociation or a sense of being disconnected from your body. ‍

Tips to orgasm when you feel like you’ve tried it all.‍

If you’ve already explored information and tips about how to have an orgasm, but still haven’t experienced the big O, it can be worthwhile to explore some alternatives. O.school talked to sex educator, sensual massage practitioner, and professional dominant Mistress Amy for some in-depth advice.

1. Get in touch with your body.

“Feeling comfortable with self-pleasure and masturbation,” is a great first step, says Amy. She recommends setting the stage and using specific techniques to help you connect deeply with your sensory experience: “Being in a warm, comfortable environment, such as a hot bath or shower [can be helpful].” She also suggests “using light strokes on your inner thigh around your [genitals]” and getting comfortable with gentle, low-stakes touch. In addition to helping you relax, Amy explains that this type of touch “can increase circulation and encourage blood flow to help the tissues swell; the nerve-endings have more oxygenated blood so they’re fully ready to feel the sensations.”

2. Give your communication a boost. 

On the surface, talking about sex and having an orgasm can seem totally separate. In fact, being able to openly communicate your wants, needs, and what feels good to you—as well as when you’re feeling uncomfortable or uncertain—is essential for partnered sex. If you’re not comfortable communicating your needs to your partner, there are a few tools that can help do the talking for you. Try filling out an orgasm order form to get crystal-clear about what feels good to you. Simply listing the things you like and don’t like can be a good reference point for approaching the conversation with a partner. 

3. Try more intense sensation. 

Using a vibrator or sex toy is a common recommendation for those who struggle to achieve orgasm — but not all vibrators are equal when it comes to delivering the specific sensations that some people need in order to climax. Amy tells O.school that, for some of her clients who were unable to orgasm for years, “the one vibrator they swear by is the Magic Wand. You can plug it in, so it has a much higher amplitude of vibration, as opposed to other vibrators which are not quite as intense.”

4. Experiment with edging. 

Although it’s often touted as a trick for intensifying orgasm, Amy tells O.school that the practice of alternating intense stimulation with periods of rest can (aka edging) can help people to have their first orgasm: “Some people can get overstimulated if they keep trying. I call it the ‘glass ceiling:’ You feel like you are on the verge of getting to a climactic feeling but you just can’t cross through into it. If you take a little break and focus on your partner, or do some other touch on other parts of the body, and then come back to it that can help you break through.”

5. Give cannabis a try. 

Amy tells O.school that, while “alcohol can actually make it more challenging to have an orgasm some folks do well with cannabis. [It] can actually enhance their experience with touch, and, in some people, can help bring them to orgasm or even enhance the orgasm experience. There are also products you can apply topically — lubes, gels, ointments.” Note that certain cannabis strains work better for sex than others. Cannabis isn’t right for everyone, so if you’ve never tried it before, take something with low potency to start. And of course, it’s not legal in all countries or States.

6. Double up on toys. 

For people with clits, Amy offers this suggestion: “If you’re having intercourse or masturbating, you can use a dildo or toy internally and then add a vibrator externally. Having a solid base to push the vibrator against can make the vibration go a little bit deeper through all the clitoral tissue as it vibrates through the dildo; for some people [the extra sensation] can be very helpful.”

7. Try a different kind of orgasm. 

Many people assume that, in order to have an orgasm, the clit or the penis needs to be the focus. If you’ve been unable to have an orgasm from direct stimulation of the vulva or penis, though, it might be worthwhile to try something different: an anal or blended orgasm (which combines stimulation to multiple erogenous zones at once) might be just what you need to take you over the edge.

8. Talk to a pro.

For people who struggle with body image, gender, or a history of trauma, Amy recommends talking it out with a therapist. She adds that, if you suspect the issue might be medical, “It’s a great idea to talk to a physician and actually have a pelvic exam to see if there are any problems anatomically.”‍

What if you still can’t orgasm after trying these techniques? ‍

If you’ve given it time, practiced different techniques, taken the pressure off and still can’t orgasm, there’s no need to give up. Our bodies change (sometimes dramatically) throughout our lives and some people experience their first orgasm years — or decades — after their sexual debut. And if you never have an orgasm? Amy tells O.school that taking orgasms off the menu can have a silver lining: “Orgasm is not necessarily the end goal of having sexual interactions. You can have a lot of pleasure and enjoy stimulation with each other and then if you reach a point where you say, ‘I’m done,’ [you can] move on and and the person who has struggles with orgasms doesn’t feel that they have to keep trying.” Especially for those who feel that their partner is frustrated or disappointed by their lack of orgasms, and may feel pressure to fake it, taking orgasms off the table “can be a way to take back power. Eliminating that pressure for both people in the sexual encounter, it helps you to be a little more true to yourself as well as to each other.”‍

The bottom line ‍

Orgasms can be a delightful aspect of sex. For those who have struggled to experience one, however, the quest can be frustrating. If you’d like to have your first orgasm after years of trying, try a variety of techniques, keep up on your self-care, and remember that orgasms, while fun, are not the point of sex. Intimacy, pleasure, connection, and a full and satisfying sex life can still be yours, whether or not you even encounter the big O.