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TODAY contributor
updated 4/30/2008 5:05:18 PM ET 2008-04-30T21:05:18

If you don’t think you’ve ever had an orgasm, then I’d say you are right — and this is called primary anorgasmia.

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Ten to 15 percent of women have never had an orgasm. The causes for this range from feeling sexually inhibited so that you are unable to really explore what is most exciting for you and subsequently can’t tell your partner what would work either, to having suffered from some sexual trauma earlier in life making you afraid of being sexual, to the use of a medication (like antidepressants) or too much alcohol, which can make having an orgasm more difficult.

Usually, however, it is just that you haven’t yet figured out what works for you. This is why taking time to stimulate yourself in privacy so that you can figure out which parts are the most sensitive and what exactly feels best is so important.

Really, it’s hard to underestimate the value of good old-fashioned masturbation. Most women cannot climax from intercourse alone (only 20 percent can) and really need direct clitoral stimulation (with a hand, a tongue or whatever else seems handy).

Try being on top during intercourse, where you will get more pressure from his pubic bone and pressure you can control, in addition to both of you having better access to stimulating your clitoris.

It takes the average woman 20 minutes to reach climax. That’s a lot of foreplay! So, if you are getting the quick once-over and on to intercourse, it just may not be enough. Try to relax and expect that you are going to allow for a full half-hour of foreplay.

Many women worry — “It’s taking too long,” “My God, he must be bored” or “This is never going to work” — and as a result, their anxiety, speed to intercourse and inability to drift with sexual fantasy make coming impossible.

When you have never had an orgasm, it can feel like looking for a “widget,” that thing you have never seen so you don’t know what it looks like. In this case it is really helpful to just HAVE ONE so you can then know where you are trying to go. Here, a vibrator can really do the job. For example, “the magic wand,” a handheld vibrator that is also a body massager in general, has a lot of power. It will allow you to power your way to an orgasm.

For some women, it is actually too stimulating, in which case you can use it on top of your panties to diminish the sensation but still have it work.

Once you’ve had an orgasm, you will know it and it will be easier for you to work toward it without a vibrator (though you may like to keep the vibrator around for extra fun).

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her latest book is “Anatomy of a Secret Life: The Psychology of Living a Lie.” She is also the author of “Amazing You! Getting Smart About Your Private Parts,” which helps parents deal with preschoolers’ questions about sex and reproduction. Her first book, “Becoming Real: Overcoming the Stories We Tell Ourselves That Hold Us Back,” was published in 2004 by Riverhead Books. It is now available in a paperback version. For more information, you can visit her Web site, www.drgailsaltz.com.

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