Intimate Wellness Institute

The Intimate Wellness Institute is the foremost center in the region for treatment of sexual dysfunction including orgasmic dysfunction and arousal disorders. IWI has the most comprehensive and most advanced treatments available to overcome all aspects of orgasmic dysfunction and arousal disorders. AT IWI we understand how sensitive these issues can be and how often they are ignored and mistreated. We provide expert care in a comfortable and understanding environment so you can achieve success.

What is anorgasmia?

Anorgasmia is when a person has difficulty or can’t orgasm even if they’re enjoying sex and it feels good to them. It also describes orgasms that aren’t as strong or don’t happen as frequently as you’d like. It’s a form of sexual dysfunction that affects both genders. It can take a toll on your mental health, causing distress and anxiety, and can even interfere your relationships. Anorgasmia is also called orgasmic dysfunction.

Orgasms (also called sexual climaxing) are feelings of pleasure or sexual excitement that occur after being aroused. It may feel like a release and involve bodily movements beyond your control. They can vary in duration and intensity. Some people need more sexual stimulation to have an orgasm, while others need less.

With anorgasmia, you can still have a desire for sex and feel pleasure. However, you may feel anguish or emotional distress because you can’t have an orgasm. Your IWI team member can help determine the cause of anorgasmia and recommend treatment.

Anorgasmia in women

Anorgasmia in women (also called female orgasmic disorder) is classified into four types:

  • Primary (or lifelong): You’ve never had an orgasm.
  • Secondary (or acquired): You were once able to have an orgasm but can’t now. This is common with menopause.
  • Situational: You can only reach orgasm in specific situations like with masturbation (self-stimulation).
  • General: You don’t reach orgasm in any situation, even when you feel aroused or excited.
  • Problems with orgasm increase as you age, but it can affect people of any age. Up to 15% of women never have an orgasm.

Who does it affect?

Anorgasmia can affect anyone but it’s most common after menopause.


What are the symptoms of anorgasmia?

The main symptom of anorgasmia is not reaching sexual climax (orgasm). Other symptoms are delayed climaxing (it takes a long time to orgasm) or not feeling fulfillment from sexual climax.

What causes anorgasmia?

Many factors can make reaching orgasm difficult. These factors can be physical, mental, emotional or medical (related to a disease or condition). In many cases, a combination of factors make orgasm difficult.

Medical and physical causes

  • Age (especially women in menopause).
  • Medical conditions like multiple sclerosis (MS).
  • Medications, especially selective serotonin reuptake inhibitors (SSRIs).
  • Surgeries on your genitals and organs near or connected to your reproductive system.
  • Complications from cancer or radiation therapy.
  • Pelvic floor dysfunction or pelvic trauma.
  • Hormonal conditions.
  • Congenital disorders (conditions you’re born with) of the vagina.
  • Psychological causes
  • Depression, stress or anxiety.
  • Previous sexual abuse or assault.
  • Cultural or religious factors.
  • Being shy or unable to express yourself through sex.
  • Lack of confidence.
  • Relationship, trust or intimacy issues with your partner.

Can low testosterone cause anorgasmia?

Even in women testosterone is the main hormone needed to have a good libido. Low testosterone is often overlooked in women and can affect the ability to orgasm due to lack of interest and sexual response. Low testosterone can also cause the clitoris to shrink making it less sensitive. IWI has the most comprehensive Hormone Optimization Program in the region. We can help you improve testosterone levels and other hormone imbalances with advanced bioidentical hormones and get you feeling the way you want to feel.

Do SSRIs cause anorgasmia?

Yes, many SSRIs (selective serotonin reuptake inhibitors), often used to treat depression or anxiety, can affect sexual function. If you’re taking this kind of medication, talk to us about your symptoms and discuss alternative medications. Some SSRIs are less likely to cause anorgasmia, and there are other types of antidepressants that may help also.

In addition to SSRIs, other medications may affect your ability to orgasm. Some examples of these are:

  • Tricyclic antidepressants (TCAs).
  • Monoamine oxidase inhibitors (MAOIs).
  • Antipsychotic medications.
  • Anti-mania medications.

Medications used to treat high blood pressure can also cause sexual dysfunction in women just as they cause erectile dysfunction in men. Some antihistamines and decongestants can also similar issues.


How is anorgasmia diagnosed?

Dr. Guerette and the IWI team can diagnose anorgasmia based on your symptoms and a discussion about your sexual history. This discussion could shed light on reasons or underlying causes for sexual dysfunction. We also will perform an exam and tests like ultrasound or blood tests to check for underlying hormonal or medical conditions that could be part of the problem. Physical issues are often missed as the cause of orgasmic dysfunction. IWI specializes in identifying and correcting these physical issues and will not ignore them.

Once an underlying cause is determined, many options are available to treat anorgasmia.


How is anorgasmia treated?

It depends on the underlying cause. There’s no one method that fits all cases, and treatment usually involves a combination of approaches. Some treatments for anorgasmia include:

Basic Strategies:

  • Changing medications.
  • Treating any underlying health issues.
  • Introducing new stimuli to the relationship such as new techniques, sex toys and devices or erotic media.

Behavioral Management:

  • Learning self-stimulation (masturbation) techniques.
  • Counseling or psychotherapy to address relationship issues, mental health conditions or past sexual trauma.
  • Sex therapy to address sexual needs or underlying factors preventing climax.

Hormone Optimization:

Using hormone therapy to enhance libido, sexual response, blood flow and increase sensitivity. IWI has the most advanced hormone optimization program in the region.

Advanced IWI Treatments: IWI has the most experience and the most comprehensive suite of treatments for orgasmic dysfunction in the region.

Platelet-rich Plasma: IntimatePRPTM is a nonsurgical procedure that uses your own Platelet Rich Plasma (PRP), cells separated from your own blood, from a simple blood draw, to rejuvenate vaginal tissues and enhance sexual pleasure. Using FDA approved equipment the PRP treatment immediately activates the body’s localized stem cells and begins rejuvenating and revitalizing vaginal and clitoral function helping women experience orgasms with increased intensity. Dr. Guerette is one of the few physicians trained to perform this breakthrough procedure.

How Does PRP Work?

The in-office procedure starts with a simple blood draw from the your arm. Using an FDA approved centrifuge, platelets and growth factors are separated to create PRP. After applying a numbing cream to the vagina, a very thin needle is used to inject the PRP near the clitoris and the upper area of the vagina that is most important for sexual pleasure (the G-spot). The entire process takes about 20 minutes and women experience little to no discomfort. Patients experience the benefit almost immediately with full benefit after about 3 months.

Treatment Results include:

  • Greater arousal from clitoral stimulation
  • Rejuvenated skin of the vulva
  • Stronger orgasm
  • Increased sexual desire
  • Increased ability to have vaginal orgasms
  • Increased lubrication

Laser Vaginal Rejuvenation: Dr. Guerette is one of the pioneers in developing the use of gentle rejuvenating lasers for improving vaginal issue including orgasmic function. The laser treatment is a simple 5-minute office treatment with no preparation or recovery and minimal to no discomfort. The procedure works with the laser going in slow circles around the vaginal canal to deliver the energy to the tissue. This stimulates the body to form new collagen, nerves and blood vessels to improve sexual response, sensitivity and lubrication. The effect of the laser lasts 12-18 months and then needs a simple touch-up treatment.

Radio-frequency (RF) Vaginal Rejuvenation: RF is another energy type that works similarly to a laser to remodel the tissue and improve nerve function, blood vessels and lubrication. The treatments are very similar. Dr. Guerette has also pioneered many RF technologies for vaginal treatments.

Extra-corporeal Shock Wave Therapy (ESWT): ESWT has been used to safely and effectively improve male sexual dysfunction as well as other medical conditions for many years. Dr. Guerette has been a leader in research and clinical care to bring this revolutionary, non-invasive treatment to women for orgasmic dysfunction. ESWT is a treatment where low intensity focused shock waves can reach deep into the tissue which will stimulate the body’s healing process. The treatment involves placing the energy on the clitoris and vulva (area outside of the vagina) for about 6 minutes per session. During the healing process, new blood vessels and nerves are formed, which increase blood flow to the clitoris. There is no preparation or downtime with the procedure and the equipment used for the procedure is FDA cleared. The treatment is simple and painless, performed in our office twice a week during the treatment time. Many women report a noticeable improvement of their ability to orgasm within a few weeks.


  • Non-invasive treatment
  • No downtime
  • Virtually painless application
  • Improvement in orgasm
  • More spontaneous sexual response
  • Almost no risks or adverse effects
  • Well-tolerated treatment method
  • Development of new blood vessels and nerves

Emsella Therapy: EmsellaTM Advanced Pelvic Floor Therapy: Emsella is a FDA-approved revolutionary treatment for pelvic muscle and nerve issues. Orgasmic function is often improved with improvement in nerve, muscles and vascular function. The BTL EMSELLA treatment uses High Intensity Focused Electromagnetic Energy (HIFEM) to treat ALL the pelvic floor muscles, nerves and blood vessels. The improved pelvic floor muscles restore function and eliminate pain and enjoy normal daily activities. During each 28-minute session you sit comfortably on the Emsella chair while it generates thousands of supramaximal pelvic floor muscle contractions.  Each session is equivalent to doing 11000 pelvic floor exercises. The procedure is non-invasive, and you remain fully clothed throughout. No drugs are required and the most you will feel is a slight tingling during the treatment. With no recovery time needed you can leave immediately after each session and resume normal daily activity. The majority of people need a course of six sessions over a period of three weeks to see optimum results, with most people seeing and feeling results after just two or three treatment sessions

IWI Combination Therapy: The advanced IWI treatments work in different ways to improve orgasmic dysfunction. They are the most effective when used in combination to treat all aspects of the physical issue. Talk to an IWI team member about treatment packages to get the best results.

How long does it take to cure anorgasmia?

It depends on the cause. It may take several months to reach a point of significant, lasting improvement. The good news is that almost all women can orgasm again with proper treatment by the IWI team.


What’s the outlook if I have anorgasmia?

Anorgasmia can be upsetting and frustrating. It can impact intimacy with your partner and affect your self-esteem. It’s also extremely unlikely that you can solve this problem without proper medical care or guidance. This issue is embarrassing to discuss and often ignored and mistreated by physicians and other medical professionals. At IWI we understand how seriously this affects you and how difficult it is to discuss. We strive to create a comfortable environment to talk about these issues and will work with you to achieve satisfaction and get you feeling the way you want to feel.