The Pill Might Be Preventing Pleasure

On the Pill—sex is pleasurable, but never any orgasm. What’s causing this inability to orgasm?

Case #: 475

Concern：

Every time my boyfriend and I have sex, I never seem to have an orgasm. I was just wondering if there was anything that we could do to ensure that I do have an orgasm.

I am 20. Yes, I am on the pill and my urethral nerve occasionally is stimulated well. Most of the time that we have sex I enjoy it (although no orgasm), but there has been once or twice where I didn't enjoy it. It didn't hurt or anything, I just didn't get any type of pleasure.

Discussion：

Many people consider stimulation of the genitals to be the most important aspect of reaching orgasm, but here I feel that’s not entirely correct. You mention that sex is pleasurable, but that you’ve never had an orgasm. I wonder if you’ve been taking birth control for the entirety of your sexual exploration.

If so, that might explain why you’re experiencing such a block when it comes to orgasm. Oral contraceptives traditionally contain two hormones—estrogen and progesterone. Now, estrogen should be keeping you happy and healthy when it comes to sex: keeping your vagina well lubricated, and giving you a good sexual response to vaginal stimulation. However, contraceptives have also been shown to also impact levels of oxytocin and prolactin—decreasing the former and increasing the latter.

Oxytocin has specific effects on your physiological sensations of what arouses you. Prolactin is not a great hormone to have more of unless you’re breastfeeding, otherwise it messes with your body in ways you didn’t anticipate and probably wouldn’t want.

The Battle of the Sex Hormones

In an uninfluenced hormonal system—by that I mean one not being affected by outside hormone sources such as birth control, antidepressants, etc.—estrogen levels are high when prolactin levels are low. Estrogen, as mentioned above, keeps you sexually responsive to vaginal stimulation and also creates a healthy environment for sex in general: springy interior walls, moist membranes, the works.

Prolactin is generally only in production after childbirth, as it turns down a woman’s desire for intercourse, decreases clitoral and vaginal sensitivity, and causes her to be more focused on nesting behaviors—have you noticed an increased interest in decorating lately? With the birth control creating more prolactin, estrogen levels are going down, and this situation is probably creating lack of sensation and orgasm block you’re experiencing now.

The Breasts Have It

Luckily, although prolactin causes decreased vaginal and clitoral sensation, it also increases sensitivity of the breast area. The nipples in particular become a great source of erotic sensation, and beginning sex with breast manipulation can greatly increase enjoyment of sex overall.

Nipple stimulation produces oxytocin, which is considered the most important hormone for orgasm. Oxytocin increases your body’s sensitiveness to all erotic sensation, as well as stimulates the uterine contractions that occur during orgasm. I would suggest having your lover play with your breasts and nipples prior to beginning intercourse, and see if continuing stimulation brings you a better sensation of pleasure when you do begin having sex. Hopefully the oxytocin production from the breast handling results in an orgasm for you!

Contraceptive Cleanse

Birth control is a smart decision for a woman in a monogamous relationship who doesn’t currently want children, but sometimes the side effects have a greater effect than you bargained on.

If you want to stabilize your hormone levels without stopping birth control or introducing a new hormonal agent, you might consider trying some time-tested herbs with cleansing properties to help remove the excess prolactin, herbs that aid blood-flow to areas of arousal, and herbs that increase the body’s production of oxytocin, to aid in orgasmic response. Good luck with your orgasm!