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TODAY contributor
updated 11/26/2008 1:45:45 PM ET 2008-11-26T18:45:45

Q. My partner and I have great sex, but I have a problem having an orgasm, so he thinks he’s not doing his job. He is awesome. It’s me, not him. I have ignored this in the past but I can’t ignore it any more. I need some help. What do I do?

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A. I agree that it is you, not him, in as much as no guy can help you have great sex if you don’t help him help you.

You say he thinks he isn’t doing his job, but this doesn’t bother you. Except that it does, but until now it hasn’t been important enough to do something about it.

Part of what’s fun, enjoyable and intimate for him is watching you be excited enough to achieve orgasm. But I would hope you would want to achieve orgasm for yourself, as well. Otherwise, you are both missing an exciting element of the sexual experience.

You are not alone. Nearly 10 percent of women haven’t figured out how to have an orgasm. This is called anorgasmia. It’s primary anorgasmia if you have never had an orgasm and secondary anorgasmia if you have in the past but don’t any longer.

Some medications can make having an orgasm more difficult. Antidepressants are known to do this. So if you are taking one, speak to your doctor.

In the case of secondary anorgasmia, you need to look at what is happening presently, either within you or with this particular partner at this particular time. Are you angry at him or fearful he will leave you? Are you worried about outside things, like work or finances?

If you don’t feel comfortable and relaxed, it is tough to have an orgasm. Men can often be angry or anxious and still perform sexually, whereas women need a greater comfort level.

If you have primary anorgasmia, chances are you haven’t discovered what works for you when it comes to stimulation. You might also have discomfort about being sexually excited or losing control.

Many women have a tough time achieving orgasm through intercourse alone. They need more direct clitoral stimulation, so vaginal intercourse without this doesn’t work. Often, a couple must try many different things to figure out what is successful.

Often, women are better in the women-on-top position, because they can control pressure on the pelvic bone. Many women also need plenty of foreplay.

It is best to start by experimenting on your own, either with your hand or with a vibrator. So spend some time alone, without the pressure of performance, to become well-versed in what works for you. Once you have figured that out, you can convey it to your partner.

A good resource is a book called “For Yourself” by Lonnie Barbach, a guide to self-stimulation. If you use a vibrator, there is a popular, heavy-duty version called the Magic Wand. Once you know what it feels like to have an orgasm, you can refine your technique.

Two good Internet shops are Eve’s Garden and Toys in Babeland. They have a good selection of vibrators and other sex toys.

Dr. Gail’s Bottom Line: You can learn to have an orgasm. It helps to experiment and practice on yourself before sharing this information with your partner.

More on sex | relationships

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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