Improve Sexual Wellbeing & Intimacy

Understand Orgasm Concerns

Difficulty reaching orgasm, taking much longer than wanted, or reaching it sooner than you or a partner would like are common concerns, and most have causes that can be understood and worked on. This page is about orgasm and ejaculation concerns only; desire, arousal, pain, performance worry and communication have their own pages.

General information, not medical advice. Last updated November 1, 2026. Written by the AlternativeMed editorial team. Not medically reviewed.

Start here

Treat it as a common, workable concern, not a personal failing. Large surveys show these difficulties are widespread, and many people who have them do not find them a problem.
Notice the pattern: always or only sometimes, with a partner or alone, since when, and whether it began after a new medicine, illness, surgery or stressful time.
If it is distressing or has lasted a while, book a visit with a doctor, gynecologist or urologist; if it began after starting a medicine, speak to the prescriber before changing anything.

Be careful with

Do not stop or change a prescribed medicine on your own because of sexual side effects; talk to the prescriber, who may have other options.
Products sold online or in stores as sexual enhancers can contain hidden drug ingredients. The FDA says they can lead to severe health problems and hospitalization.
Do not use alcohol or recreational drugs to cope; the sources read list heavy alcohol and drug use among the possible causes.

Get help when

Orgasm or ejaculation difficulty that is distressing, lasts for weeks or months, or affects your relationship or wellbeing.
A change that began after starting or changing a medicine, after surgery, or alongside a new illness such as diabetes or a nerve condition.
Pain during sex, low desire, low mood or anxiety that comes with the orgasm problem: these are worth treating together.
Blood in semen (the NHS says it is usually not serious but a GP should decide whether tests are needed), or little or no semen with cloudy urine after sex.
Any link to past abuse or assault: a trained, non-judgemental clinician or counsellor can help, at your own pace.

About Understand Orgasm Concerns

What this goal means

Orgasm concerns cover a range of experiences. In women, MedlinePlus describes difficulty or inability to reach orgasm, taking longer than wanted to reach it, or orgasms that feel unsatisfying. In men, the NHS describes three main ejaculation problems: ejaculating sooner than you or a partner would like (premature), a significant delay or inability to ejaculate despite wanting to and having a normal erection (delayed), and semen flowing backwards into the bladder (retrograde).

This page is for adults of any gender, orientation or relationship status. It is about understanding the concern and the options, not about what is 'normal' to aim for.

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How common it is

MedlinePlus says about 10% to 15% of women have never had an orgasm, and up to half are dissatisfied with how often they reach orgasm. In a national Australian survey of 20,091 people aged 16 to 69, 21% of men reported coming to orgasm 'too quickly' and 25% of women reported being unable to reach orgasm, in each case for at least a month in the past year. Many people did not see these difficulties as problems, so how much it matters is personal.

The NHS notes that occasional episodes of ejaculating sooner than wanted are common and not a cause for concern.

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What can contribute

MedlinePlus lists psychological and relationship factors for women (stress, fatigue, depression, past sexual abuse, boredom with sex or the relationship, lack of knowledge about sexual response, negative attitudes about sex, shyness about asking for effective stimulation, and partner issues), medicines such as SSRI antidepressants, and medical factors such as menopause, chronic illness, pelvic pain, nerve damage from conditions like diabetes or multiple sclerosis, vaginismus and vaginal dryness.

For men, the NHS lists prostate problems, overactive or underactive thyroid, recreational drug use, depression, stress, relationship problems and performance anxiety for early ejaculation; and diabetes, spinal cord injury, multiple sclerosis, bladder or prostate surgery, older age and some medicines (SSRIs, beta-blockers and antipsychotics) for delayed ejaculation.

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Medicines as a cause

A meta-analysis of antidepressant studies found higher rates of sexual problems, including orgasm problems, than placebo for most antidepressants studied, ranging from about 26% to 80% of patients depending on the medicine, while a few showed no significant difference from placebo. A Cochrane review of strategies for these side effects found 23 trials (1,886 people) and noted that most strategies were tested in only single studies. This is why the medicines goal is linked below, and why the prescriber is the right person to talk to.

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Realistic expectations

Progress is usually gradual and often needs practice, communication and sometimes professional help. A systematic review of behavioral therapies for early ejaculation found limited evidence that physical techniques improve ejaculation latency over no treatment, with gains of 7 to 9 minutes in two of four waitlist trials. A 2026 review of treatments for women found that mindfulness-based cognitive behavioral therapy improved orgasm scores. Neither is a guarantee, and results differ from person to person.

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Who this applies to

Adults with concerns about reaching orgasm, delayed or absent ejaculation, or ejaculating sooner than wanted, whether alone or with a partner. For desire, arousal, painful sex, performance anxiety, communication, intimacy and medicine effects, see the linked goals. Concerns in children and teenagers are outside this page.

Related conditions and symptoms

Erectile dysfunction → Vaginal dryness and sexual wellness → Prostatitis → Pelvic floor & pelvic pain → Anxiety disorders → Trauma and PTSD →

A manageable starting plan

An educational starting point, not a personal prescription. Adjust it to your own situation and any advice from your clinician.

Your first actions

Write down the pattern: when it started, what changed (medicines, illness, stress, relationship) and what you would like to be different.
Choose one calm conversation with a partner, or one private exploration session, with no pass-or-fail goal.
Book a visit with a doctor, gynecologist or urologist, bringing your medicine list, if the concern is distressing or began suddenly.
Cut back on alcohol and recreational drugs and protect sleep for a few weeks to see what changes.

Optional additions

Try a short course of sex therapy or counselling, alone or as a couple.
Ask about pelvic floor physiotherapy.
Practise squeeze or stop-go techniques with a counsellor's guidance, if early ejaculation is the concern.
Explore stimulation options such as a vibrator, if comfortable.

What to track

Notes (not scores) on stress, sleep, alcohol and how you felt about intimacy.
The date any new medicine started and any change in sexual response afterwards.
What you found helpful or unhelpful, to share with a clinician.

When to reassess

Give lifestyle and communication steps a few weeks. If the concern persists, is distressing, or started after a medicine or illness, see a clinician rather than trying products.

When to seek professional support

See a doctor if the concern is distressing, has lasted for weeks or months, or comes with pain, low mood or other symptoms.
Ask for a referral to a sex therapist or psychosexual counsellor if talk-based help would suit you.
If a past assault or abuse is part of this, a trained professional or a local support service can help; we did not read a source naming a helpline for this page.

What helps

Ordered by how well the research supports each step. Evidence strength is shown on every card; precautions sit next to the advice.

Start here

Learn how your own body responds

Low certainty

Addresses: May make orgasm easier to reach and understand

Why it may help: MedlinePlus says treatment goals include a healthy attitude toward sex, education about sexual stimulation and response, and clear communication of needs and desires. It notes that most women need clitoral stimulation, which may be enough on its own, and that learning what produces arousal through masturbation can help.

How to apply it: Take unhurried private time to explore what feels good, without a goal of reaching orgasm. Mindful attention to sensation (rather than watching your performance) is the idea behind many therapy programs.

Who it may suit: Women who have not reached orgasm, or only rarely; also anyone who wants to understand their response better.

Precautions: If touch brings pain, distress or memories of abuse, go slowly and consider a trained therapist.

Address Arousal Difficulties →

Talk openly with a partner about what helps

Low certainty

Addresses: Improves stimulation and reduces pressure

Why it may help: MedlinePlus lists shyness about asking for effective stimulation and partner issues among causes, and lists couples' sexual counselling to improve communication and stimulation among treatments. The NHS says treatment for ejaculation problems usually works best when a partner is involved.

How to apply it: Choose a relaxed moment outside the bedroom. Describe what feels good rather than what is wrong, and agree there is no pass or fail.

Who it may suit: People in a relationship, including couples of any gender.

Precautions: If conversations become tense or painful, a counsellor can help.

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Communicate More Comfortably About Intimacy →

Widen the focus beyond intercourse

Low certainty

Addresses: Reduces pressure and adds ways to be close

Why it may help: MedlinePlus lists focusing on sexual activities beyond intercourse as a self-help step. Behavioral approaches such as sensate focus (touch exercises without a performance goal) were part of the trials in a systematic review of early ejaculation.

How to apply it: Spend time on touch, kissing and other shared activity without a set end point. Agree beforehand on contraception if pregnancy worry is a distraction.

Who it may suit: Couples where intercourse feels like a test.

Precautions: Agree what is comfortable and stop whenever either person wants to.

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Build Emotional & Physical Connection →

Ease stress, tiredness and low mood

Low certainty

Addresses: Removes common blockers

Why it may help: MedlinePlus lists stress, fatigue and depression among causes in women, and the NHS lists depression and stress for early ejaculation and for delayed ejaculation. MedlinePlus lists adequate rest and good nutrition as lifestyle steps.

How to apply it: Protect sleep, build in rest, and use stress tools you already trust. If mood has been low for two weeks or more, or you have any thoughts of self-harm, speak to a doctor or local crisis service today.

Who it may suit: Anyone whose orgasm change began during a stressful or low period.

Precautions: Low mood is a health matter in its own right and needs care, not just better sex.

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Manage Everyday Stress → Support a More Balanced Mood →

Limit alcohol, recreational drugs and smoking

Low certainty

Addresses: Removes a possible cause

Why it may help: MedlinePlus lists limiting alcohol, drugs and smoking as lifestyle steps for women's orgasm problems, and the NHS lists recreational drug use and alcohol or drug misuse among causes for ejaculation problems.

How to apply it: Cut back and notice whether anything changes. If cutting down is hard, ask a doctor or pharmacist for support.

Who it may suit: Anyone drinking heavily or using recreational drugs.

Precautions: Do not stop heavy alcohol use suddenly without medical advice if you drink every day.

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Get checked for medical and medicine causes

Moderate certainty

Addresses: Finds treatable causes

Why it may help: MedlinePlus and the NHS list diabetes, nerve conditions, thyroid disease, prostate problems, menopause, pelvic pain and medicines among causes. A medical history and exam are the usual starting point and, for women, MedlinePlus says results are almost always normal, so the history matters most.

How to apply it: Write down when it began, other health changes and every medicine or supplement you take, then raise it with your doctor.

Who it may suit: Anyone with a new change, or a long-standing concern that bothers them.

Precautions: Bring the full list of medicines, including supplements.

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Understand How Medicines Affect Sexual Wellbeing →

Additional options

Use of a vibrator or other stimulation aid

Low certainty

Addresses: May help women reach orgasm

Why it may help: MedlinePlus says a vibrator may help with learning to reach orgasm during masturbation. The NHS names thicker condoms and having a partner on top as self-help steps for early ejaculation, which are about slowing sensation, not about treatment.

How to apply it: Introduce it slowly, alone or together, and keep it as one tool among others.

Who it may suit: Women learning what stimulation works for them; couples.

Precautions: Wash devices as the maker advises; stop if there is pain or irritation.

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Squeeze and stop-go techniques (for ejaculating sooner than wanted)

Low certainty

Addresses: Can improve ejaculatory control with practice

Why it may help: The NHS describes the squeeze technique (stop before ejaculation, squeeze the head of the penis for 10 to 20 seconds, wait about 30 seconds, repeat) and the stop-go technique (the same without squeezing). The NHS says they need considerable practice. A systematic review of 10 randomized trials (521 participants) found limited evidence of benefit, with unclear risk of bias.

How to apply it: Practise alone first, then with a partner, using a psychosexual counsellor's guidance if available.

Who it may suit: Men and couples where ejaculation comes sooner than wanted.

Precautions: Evidence is limited and the studies are small; progress takes regular practice.

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Pelvic floor muscle training

Low certainty

Addresses: May help ejaculatory control and orgasm sensation

Why it may help: Kegel exercises are listed by MedlinePlus as a self-help step for women. A systematic review of 10 trials in men found pelvic floor muscle training appeared effective for early ejaculation, but the studies were low to moderate quality and no best protocol was identified.

How to apply it: A pelvic floor physiotherapist can teach correct technique, which is often not what people expect.

Who it may suit: Adults with pelvic floor weakness or ejaculation concerns.

Precautions: Doing it incorrectly or too hard can add tension; ask a trained clinician.

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Pelvic Floor & Pelvic Pain →

Still being studied

Mindfulness-based cognitive behavioral therapy

Moderate certainty

Addresses: Improved orgasm scores in women in trials

Why it may help: A 2026 systematic review and meta-analysis of 36 studies of women with desire, arousal or orgasm difficulties found mindfulness-based CBT significantly improved total sexual function scores and the desire, arousal and orgasm subscales. No studies compared CBT directly with medicines.

How to apply it: Delivered by a trained therapist in a structured program.

Who it may suit: Women with orgasm difficulty, especially if worry or distraction during sex is part of it.

Precautions: Studies often grouped different sexual difficulties together, so results for orgasm alone are less clear.

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Manage Sexual Performance Anxiety →

Sexual counselling and education programs

Moderate certainty

Addresses: Improved sexual function scores in postmenopausal women

Why it may help: A meta-analysis of 8 studies (619 women, in menopause under 5 years) found sexual education and counselling programs raised total sexual function scores compared with routine care, including the orgasm domain.

How to apply it: Programs ran 4 to 10 sessions of 45 to 60 minutes and covered anatomy, sexual response, menopause, methods of stimulation and myths.

Who it may suit: Women in or after the menopause transition.

Precautions: Studies were small and results may differ outside this age group.

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Perimenopause and menopause →

Combining behavioral therapy with medicine for ejaculating sooner than wanted

Low certainty

Addresses: Small extra gains over medicine alone

Why it may help: In the systematic review, three trials favored combining behavioral therapy with drug treatment over drug treatment alone, with small differences in ejaculation latency (0.5 to 1 minute) and better satisfaction and control scores. Whether to use a medicine is a decision for a doctor.

How to apply it: Discuss options with a clinician experienced in sexual medicine.

Who it may suit: Men who want a combined approach.

Precautions: Safety data were limited. Medicines are not recommended here; talk to a doctor.

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Food & nutrition

Eating, drinking and general health

We did not find a food or diet in the sources read that has been shown to improve orgasm or ejaculation directly. MedlinePlus lists good nutrition and adequate rest among general lifestyle steps for women with orgasm difficulty, and the NHS and MedlinePlus both point to limiting alcohol and recreational drugs.

Because diabetes and other long-term conditions can affect orgasm and ejaculation, steady everyday eating that supports overall health is a sensible background step, but it is not a treatment for this concern.

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What to be careful with

Sexual-enhancement foods, drinks and powders sold online can contain hidden drug ingredients according to the FDA. Ask a pharmacist before using any of them, particularly if you take medicines or have heart disease.

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Remedies & supplements

Traditional use, laboratory findings and human trials are kept apart. "Natural" does not mean safe.

Tribulus

Not enough evidence

Studied form and route: Herbal supplement

Intended outcome: Marketed for sexual function and stamina

Human evidence: We did not find a human trial or review in the sources read that shows it improves orgasm or ejaculation.

Traditional use: Used traditionally in several regions for vitality; this is not evidence of effect.

Limits: Product content and strength vary, and the FDA warns about hidden ingredients in sexual-enhancement products.

Interactions and precautions: Check with a pharmacist if you take medicines or have heart, liver or hormone-sensitive conditions. Avoid in pregnancy and breastfeeding unless a clinician agrees.

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Tribulus →

Yohimbe

Not enough evidence

Studied form and route: Herbal extract

Intended outcome: Marketed for sexual function

Human evidence: We did not find a human trial or review in the sources read that supports it for orgasm concerns.

Limits: Strength varies widely between products.

Interactions and precautions: We did not read a safety source for yohimbe, so be cautious: speak to a doctor or pharmacist first, especially with heart disease, high blood pressure or other medicines, and avoid it in pregnancy and breastfeeding unless a clinician agrees.

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Yohimbe →

Horny goat weed and fenugreek

Not enough evidence

Studied form and route: Herbal supplements

Intended outcome: Marketed for libido and performance

Human evidence: We did not find human trials in the sources read showing a reliable benefit for orgasm or ejaculation.

Traditional use: Used traditionally for sexual vitality; this is not evidence of benefit.

Limits: Small or no trials for orgasm itself; quality of products varies.

Interactions and precautions: Possible interactions with medicines, blood sugar and blood thinners; avoid in pregnancy and breastfeeding unless a clinician agrees. Ask a pharmacist.

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Horny goat weed → Fenugreek →

Hormone supplements for women's orgasm problems

Low certainty

Studied form and route: Hormones prescribed by a clinician

Intended outcome: Hoped-for improvement in orgasm

Human evidence: MedlinePlus says female hormone supplements are unproven for orgasm problems and that long-term risks are unclear.

Limits: Hormones are a clinician's decision; this page does not recommend or dose them.

Interactions and precautions: Hormone treatment has risks and depends on history, such as hormone-sensitive cancers. Do not use over-the-counter 'hormone balance' products on your own.

Evaluate hormone balance products and claims →

Therapies & care

Established care starts with a medical history and review of medicines, then education, communication work and sometimes sex therapy. A prescriber may sometimes adjust a medicine that is causing a problem. This page does not recommend medicines or doses, and you should not stop a prescribed medicine on your own.

Sex therapy and psychosexual counselling

Moderate certainty

Talking therapy The NHS describes psychosexual counselling for early ejaculation (including the squeeze and stop-go techniques) and sex therapy for delayed ejaculation, a form of counselling that combines psychotherapy with structured changes to your sex life. MedlinePlus lists couples' sexual counselling for women to improve communication and stimulation and notes that some women do better with treatments that teach sexual techniques or use desensitization.

Who it may suit: Adults and couples with long-standing or distressing concerns, or when worry, relationship tension or past experiences play a part.

Precautions: Choose a trained, regulated professional. Availability on public health services varies by area.

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Cognitive behavioral and mindfulness-based therapy

Moderate certainty

Psychological therapy A state-of-the-art review concluded that cognitive behavioral and mindfulness-based therapies arguably have the most support for female sexual dysfunction. The 2026 meta-analysis found mindfulness-based CBT improved orgasm scores.

Who it may suit: Women, and others, whose difficulty involves worry, self-monitoring or distraction.

Precautions: Studies often grouped different difficulties; results for orgasm alone are less certain.

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Pelvic floor physiotherapy

Low certainty

Physical therapy A systematic review of 10 trials in men concluded pelvic floor muscle training appears effective for early ejaculation, though quality was low to moderate and no best protocol was found. Kegel exercises are also listed by MedlinePlus for women.

Who it may suit: People with pelvic floor weakness, pelvic pain or ejaculation concerns.

Precautions: Learn technique from a trained physiotherapist; overly tight muscles may need different care.

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Pelvic floor & pelvic pain →

Medical review and treatment of underlying causes

Moderate certainty

Medical care Doctors look for treatable causes such as diabetes, thyroid disease, prostate problems, nerve conditions and menopause, and review medicines. The NHS says treating a physical cause should help, and that the right approach depends on the type of ejaculation problem. The ISSM guideline gives evidence-based recommendations for early ejaculation for clinicians; prescription options are a clinician's decision.

Who it may suit: Anyone with a new change, a long-standing problem, or other symptoms.

Precautions: Some treatments are not suitable with heart, kidney or liver problems; the NHS says a doctor should decide.

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Men's health: when to get help → Women's health: when to get help →

Reviewing a medicine that may be involved

Low certainty

Prescriber conversation The Cochrane review looked at strategies for antidepressant-related sexual problems, including adding or switching treatment, and found most were tested in only single studies. The prescriber can weigh options such as timing, changes or alternatives.

Who it may suit: People whose problem began after starting a medicine.

Precautions: Never stop or change a medicine alone; talk to the prescriber.

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Understand How Medicines Affect Sexual Wellbeing →

What to avoid

Habits, products and claims that can get in the way. Never stop a prescribed medicine without talking to the professional who prescribed it.

Risks that apply to most people

Self-blame and pressure to perform

Low certainty

Why: Worry about whether orgasm will happen is described by the NHS as a cause of early ejaculation and by MedlinePlus as a barrier through anxiety. Desensitization, which gradually reduces anxiety-driven responses, is described as helpful for women with significant sexual anxiety.

Who it applies to: Anyone, especially people who track results.

Try instead: Aim for comfort and connection first; treat orgasm as one possible part of the experience.

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Manage Sexual Performance Anxiety →

Comparing yourself with films, pornography or what friends say

Low certainty

Why: The Australian survey found many people did not regard these difficulties as problems, so there is no single right pattern. We did not find a source that supports a standard timing or frequency target for orgasm in everyone.

Who it applies to: Anyone.

Try instead: Judge by your own satisfaction and distress, not by others.

Ignoring a sudden change

Moderate certainty

Why: A change that begins with a new medicine, illness or surgery is worth checking. MedlinePlus advises raising a medication-related change with the prescriber.

Who it applies to: Anyone with a recent change.

Try instead: Book a visit and bring a list of medicines.

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Personal triggers to check

Heavy alcohol and recreational drugs

Low certainty

Why: Both are listed by the NHS as possible contributors to early or delayed ejaculation, and MedlinePlus lists limiting alcohol, drugs and smoking as a lifestyle step.

Who it applies to: People who drink heavily or use recreational drugs.

Try instead: Cut down and notice the effect; ask for support if needed.

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Stress, tiredness and rushed settings

Low certainty

Why: Stress and fatigue are listed causes in women, and the NHS lists stress for ejaculation problems.

Who it applies to: People under pressure; new parents; shift workers.

Try instead: Make time and privacy; reduce what you can control.

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Unresolved relationship tension or past trauma

Low certainty

Why: MedlinePlus lists past sexual abuse or rape and partner issues, and the NHS lists relationship problems and past traumatic sexual experiences.

Who it applies to: Anyone with relationship strain or a trauma history.

Try instead: A trained, non-judgemental counsellor or sex therapist can help at your pace.

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Trauma and PTSD →

Products that need caution

'Male-enhancement' and sexual-performance products sold online

High certainty

Why: The FDA says many products marketed for sexual enhancement are contaminated with dangerous hidden ingredients, may be falsely advertised as dietary supplements or all-natural, pose serious health risks and are not guaranteed to work. A product not on the FDA's list is not necessarily safe.

Who it applies to: Anyone buying online or in stores.

Try instead: Speak to a doctor or pharmacist before trying any product; report a serious reaction to the FDA or your national regulator.

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Testosterone boosters claim check →

Herbal 'orgasm' or 'stamina' supplements

Not enough evidence

Why: We did not find human trials in the sources read showing these improve orgasm or ejaculation, and herbal products can interact with medicines or contain undeclared ingredients.

Who it applies to: Anyone considering herbs such as tribulus, yohimbe or horny goat weed.

Try instead: Raise it with a pharmacist or doctor first; see the remedies tab.

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Numbing sprays and creams without understanding the trade-offs

Low certainty

Why: The NHS says numbing creams containing local anesthetics can help early ejaculation but may transfer to a partner and reduce their sensation; thick condoms can also reduce sensation.

Who it applies to: Men using products to delay ejaculation.

Try instead: Discuss with a pharmacist or doctor; agree choices with your partner.

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Unsupported claims

'Hormones fix orgasm problems'

Moderate certainty

Why: MedlinePlus says female hormone supplements are unproven for orgasm problems and their long-term risks are unclear.

Who it applies to: Women, especially in midlife.

Try instead: Ask a clinician to assess menopause symptoms and other causes before any hormone choice.

'One simple trick or pill works for everyone'

Moderate certainty

Why: The reviews read found limited evidence for behavioral techniques, a mix of small studies for medicines, and no head-to-head trials of CBT with medicine for women.

Who it applies to: Online ads and videos.

Try instead: Look for an individual assessment of causes and a step-by-step plan.

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'Natural means safe'

High certainty

Why: The FDA warns that some products sold as all-natural contain hidden drugs.

Who it applies to: Supplement shoppers.

Try instead: Check ingredients with a pharmacist; avoid anything promising instant sexual results.

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Common mistakes

Stopping a prescribed medicine without advice

High certainty

Why: Sexual side effects are common with some antidepressants and other medicines, but stopping can harm mental or physical health. The Cochrane review notes sexual side effects can lead people to stop treatment.

Who it applies to: People on medicines for depression, blood pressure or other conditions.

Try instead: Talk to the prescriber, who may adjust the plan; do not change it yourself.

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Understand How Medicines Affect Sexual Wellbeing →

Keeping it secret from a partner

Low certainty

Why: The NHS says treatment usually works best when a partner is involved and open communication helps; your partner may have their own factors.

Who it applies to: People in relationships.

Try instead: Share it gently and without blame.

Waiting a long time before getting help

Low certainty

Why: Both MedlinePlus and the NHS say a clinician can look for medical causes and refer for therapy; many causes are treatable.

Who it applies to: Anyone distressed by the concern.

Try instead: Book a visit sooner rather than later.

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Evidence & safety

What the research shows

Agency sources (MedlinePlus, NHS) agree that orgasm and ejaculation concerns have many possible causes (psychological, relational, medical, medicine-related) and that assessment, education, communication and counselling are the usual starting points. Evidence for specific treatments is mixed: behavioral techniques and pelvic floor training have limited, low-to-moderate quality support for early ejaculation, and mindfulness-based CBT and counselling have moderate support for women. We did not find reliable human trials for herbs or supplements for this goal.

Limits of the evidence

Many trials were small, short, and at unclear or high risk of bias.
Studies of women often group desire, arousal and orgasm problems together.
Most behavioral and herbal research has focused on men with early ejaculation or erectile problems, not delayed orgasm.
Surveys depend on self-report and different definitions.
We read agency pages and study abstracts, not full texts.

Precautions and interactions

Do not stop or change prescribed medicines on your own because of sexual side effects.
Avoid sexual-enhancement products with unknown ingredients; the FDA warns they can contain hidden drugs.
Ask a pharmacist before any herb or supplement if you take medicines, especially for the heart, blood pressure or blood sugar.
Prescription treatments are decided by a clinician; this page gives no drug names or doses.

Life-stage considerations

Pregnancy and breastfeeding: avoid herbal sexual-enhancement products unless a clinician agrees; speak to a midwife or doctor about changes after birth.
Menopause: hormonal change is a recognised contributor; sexual counselling programs helped in a meta-analysis. See the menopause page.
Older adults: more medicines and health conditions can affect orgasm; review them with a clinician.
Young adults and people new to a relationship: performance anxiety is a common contributor to early ejaculation, per the NHS.

Warning signs

Blood in semen that does not clear within a few days, or with pain or fever.
Orgasm or ejaculation change with new numbness, weakness or bladder problems.
Sudden change after starting a medicine, surgery or injury.
Low mood lasting two weeks or more, or thoughts of self-harm: seek a doctor or crisis service today.
Signs of abuse or coercion in a relationship: seek support from a trusted professional.

Claim checks

Natural supplements can fix orgasm or ejaculation problems

Not enough evidence

We did not find reliable human trials for specific herbs in the sources read, and the FDA warns about hidden drugs in some products sold as natural.

¹³

Hormone supplements improve women's orgasm

Low certainty

MedlinePlus says female hormone supplements are unproven for this and long-term risks are unclear.

Squeeze and stop-go techniques help men last longer

Low certainty

A systematic review found limited evidence, with 7 to 9 minute gains in two of four waitlist trials; the NHS says the techniques need considerable practice.

^7,4

Pelvic floor training helps with early ejaculation

Low certainty

A systematic review of 10 trials found it appears effective, but trials were low to moderate quality and varied widely.

⁹

Antidepressants can cause orgasm problems

Moderate certainty

A meta-analysis found higher rates of treatment-emergent sexual dysfunction than placebo for most antidepressants studied, with large differences between medicines.

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Questions people ask

Is it normal to have trouble reaching orgasm?

It is common. MedlinePlus says about 10% to 15% of women have never had an orgasm and up to half are dissatisfied with how often they reach one. In a national Australian survey, 25% of women reported being unable to reach orgasm and 21% of men reported coming 'too quickly'.

Is ejaculating sooner than I want a medical problem?

Occasional episodes are common. The NHS says treatment may help if it happens often and causes distress. Causes can be psychological (stress, performance anxiety, relationship problems) or physical (prostate or thyroid problems, drug use).

Can a medicine cause delayed or absent orgasm?

Yes. MedlinePlus lists SSRI antidepressants for women, and the NHS lists SSRIs, beta-blockers and antipsychotics for delayed ejaculation. Do not stop a prescribed medicine on your own; ask the prescriber.

Do I need a partner to work on this?

No. Learning what you enjoy alone can help, and MedlinePlus lists masturbation and a vibrator as options. The NHS says that when you do have a partner, treatment usually works best when they are involved.

Can stress or anxiety affect orgasm?

Yes. Both MedlinePlus and the NHS list stress, depression, fatigue and performance anxiety as contributors. Stress tools and, where needed, therapy can help.

What does a doctor do?

They take a history, may examine you, review medicines and look for conditions such as diabetes, thyroid or nerve problems. MedlinePlus notes the exam is almost always normal for women, so the history matters most. They may refer you to a sex therapist or specialist.

Do herbal pills like tribulus or yohimbe work?

We did not find human trials in the sources read showing they help orgasm or ejaculation, and the FDA warns about hidden drug ingredients in sexual-enhancement products. Talk to a pharmacist or doctor first.

Does therapy really help?

A 2026 meta-analysis found mindfulness-based CBT improved orgasm scores in women, and a meta-analysis found sexual counselling helped postmenopausal women. For early ejaculation, behavioral techniques have limited support. Results vary.

What is retrograde ejaculation?

The NHS describes it as semen flowing backwards into the bladder. Orgasm is still felt, little or no semen is produced and urine may look cloudy afterwards. It does not harm health, but a GP should be consulted, particularly if you want to have children.

Is blood in semen serious?

The NHS says it is alarming but usually not serious and typically clears within a few days. See a GP so they can decide whether tests or treatment are needed.

References

MedlinePlus Medical Encyclopedia. Orgasmic dysfunction in women. Read 2026-11-01. source
NHS. Ejaculation problems. Read 2026-11-01. source
Richters J, et al. Sexual Difficulties, Problems, and Help-Seeking in a National Representative Sample: The Second Australian Study of Health and Relationships. Arch Sex Behav 2022. PMID 35142971. source
NHS. Can premature ejaculation be controlled? Read 2026-11-01. source
Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol 2009. PMID 19440080. source
Taylor MJ, et al. Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database Syst Rev 2013. PMID 23728643. source
Cooper K, et al. Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. Sex Med 2015. PMID 26468381. source
Toledo RG, et al. Female Sexual Desire, Arousal, and Orgasmic Dysfunctions: A Systematic Review and Meta-Analysis of Treatment Options. J Minim Invasive Gynecol 2026. PMID 40543759. source
Myers C, Smith M. Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiotherapy 2019. PMID 30979506. source
Mestre-Bach G, et al. Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review. J Clin Med 2022. PMID 35628920. source
Santos Silva IM, et al. Educational Programs and Sexual Counselling for Postmenopausal Sexual Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2022. PMID 34758929. source
Althof SE, et al. International Society for Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med 2010. PMID 21050394. source
US Food and Drug Administration. Sexual enhancement and energy product notifications. Read 2026-11-01. source

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