Causes & Treatment for Lack of Sexual Pleasure

WE USUALLY THINK of sex as something that feels good; it’s one of the major reasons we do it in the first place. But sex and pleasure don’t always go together.

Some people experience a condition called sexual anhedonia, or the inability to experience pleasure through sexual activity. Someone with this condition may experience the usual signs of arousal and even orgasm, but for a variety of reasons, they’re unable to enjoy these experiences.

Read on to learn more about sexual anhedonia, how to know if you have it, and how it’s treated.


preview for Men's Health US Section - All Sections & Videos

What it’s like to experience sexual anhedonia

“The term ‘anhedonia’ literally means ‘a lack of pleasure,’” says James Giordano, professor of neurology and biochemistry at Georgetown University Medical Center. People with depression may experience general anhedonia, which means they are unable to take pleasure in day-to-day activities that used to make them happy. Sexual anhedonia may accompany depression and general anhedonia, or stem from something else.

Someone with sexual anhedonia may also suffer from orgasmic anhedonia or ejaculatory anhedonia, where they are able to experience the physiological signs of orgasm or ejaculation but not the subjective feeling, Giordano explains. However, sexual anhedonia is not the same as having difficulties with arousal, erection, or orgasm. Many people with sexual anhedonia do experience those things; they just don’t gain pleasure from them.

That’s how it was for Tina Fey, a 35-year-old in Vienna who founded the love and dating website Love Connection. Tina experienced sexual anhedonia when she suffered from depression in her mid-20s. “I was able to orgasm and get aroused, but I didn’t feel the physical sensations associated with it,” she says. “It was as if I was going through the motions but not experiencing the pleasure that should come with it.”

“Sex is more than simply arousal and orgasm, and often involves the pleasure of interpersonal connection, intimacy, touch, bodily sensations of various kinds, desire, and more,” says Good Vibrations staff sexologist Carol Queen. “A person can have issues or challenges with various elements of sex but still have some ways that they feel pleasure.”

However, many people with anhedonia do have issues with other aspects of sexual functioning because they lose their motivation to have sex. “Sexual anhedonia can sometimes be accompanied by low desire because without the ‘reward’ of pleasure or orgasm, it can be easy to lose interest,” says clinical sexologist Sarah Melancon.

Experiencing sexual anhedonia can also be very psychologically challenging. “I felt like I was letting my partner down, and I worried that our relationship was suffering as a result,” Tina recalls. “I tried a variety of different approaches to address the issue: everything from therapy to experimenting with new sexual experiences. But nothing seemed to work.”

depressed man lying in his bed and feeling bad

EmirMemedovski//Getty Images

What causes sexual anhedonia?

“Various factors, including medical conditions, medication side effects, psychological issues, and trauma can cause it,” says Lisa Lawless, a psychotherapist specializing in sexual health.

Some people may experience anhedonia in the bedroom because they have had negative sexual experiences in the past. “Many people with sexual anhedonia report a history of trauma or abuse,” Lawless explains. “This can create psychological barriers that prevent them from fully engaging in sexual activity.”

These barriers may be created not just from an acute trauma but from living in a sex-negative culture. “Being shamed can be a source of trauma, which might certainly be relevant for some who deal with sexual anhedonia,” Queen says.

Self-esteem and body image issues can have a similar impact, as can performance anxiety. “Concerns about sexual performance can be associated with having sex in general, which can affect sexual desire and can make sexual encounters stressful or even bothersome,” says Giordano. “As well, sexual anhedonia can occur with sexual boredom and/or frustration.”

Or, the cause may be more physical. “Certain medications, such as antidepressants and antipsychotics, have been linked to sexual dysfunction, including anhedonia,” Lawless explains. In some cases, hormonal birth control may lead to anhedonia, Melancon adds. Steroids used to enhance athletic performance can have a similar effect, Giordano says, adding that hormonal imbalances, like low testosterone or high cortisol (a stress hormone), may also factor in.

Other physical conditions like neurological issues and poorly toned pelvic floor muscles may also cause sexual anhedonia, Melancon adds. “Drugs and/or alcohol may play a role; remember, alcohol is a central nervous system depressant,” says Queen. Lastly, she adds that pain during sex can prevent someone from experiencing pleasure.

How is sexual anhedonia treated?

If you have lost the ability to experience pleasure through sex, Lawless recommends seeing a doctor as well as a therapist so that you can explore both physical and psychological causes. Sometimes, the solution may be as straightforward as switching a medication. For others, treatment will entail a deep exploration of your past and your emotions.

“Once the underlying issues are identified, we may incorporate techniques like cognitive behavioral therapy or mindfulness-based interventions to help individuals reframe their thoughts and emotions around sex,” Lawless says. “Other treatment options may include medication, sex therapy, sexual products, or alternative therapies like acupuncture or yoga.” Someone might even use a vibrator to increase blood flow to the genital area.

“Trauma, addiction, or mental health-related cases may benefit from working with a therapist trained in modalities such as somatic experiencing, sensorimotor psychotherapy, or the neuroaffective relational model, which help individuals process past events, create healthier relationships, and connect more deeply to the body,” Melancon says. “Pelvic stretching, massage, or pelvic floor therapy may be helpful. Generally, the research suggests that addressing the underlying cause may help, though in some cases, combining with sex therapy may be more effective.” One case study describes a man who experienced ejaculatory anhedonia related to a feeling that he needed to control his sexual desire; he was treated primarily with sex therapy.

Fey was able to experience sexual pleasure once again after improving her mental health through methods like meditation, exercise, and dietary changes. “I began to focus on improving my overall well-being—not just my sexual health,” she says. “And over time, I began to notice a shift. As my mental and physical health improved, I began to feel more connected to my partner, both emotionally and sexually. I was able to experience pleasure and intimacy in a way that I hadn’t been able to before.”

While not being able to feel sexual pleasure may be very distressing, it usually is treatable, and Queen recommends accepting it for the time being rather than putting pressure on yourself to perform sexually. “This might help associated distress or anxiety about it be more manageable,” she says, “and allow the person dealing with it to experience fewer negative emotions and be more open to understanding potential causes—and changes that might help them.”

Headshot of Suzannah Weiss

Suzannah Weiss is a freelance writer, certified sex educator, and sex/love coach whose work has appeared in The New York Times, The Washington Post, New York Magazine, and more

This article was originally posted here.

Comments are closed.