When you see a therapist for anorgasmia, she will take a full history of your personal, health, social and psychological as well as sexual history, as all of these may have a bearing on why you feel you cannot have an orgasm.

The history will tell her whether or not there are likely to be any health reasons why you have not climaxed, and you may receive a physical examination if you are being seen by a nurse or doctor.

Many types of medication can interere with the orgasm, as well as physical conditions like Multiple Sclerosis, but the most likely factors are psychological. You will be asked if you are able to climax at all eg by masturbation or with a particular partner.

The therapist will then assist you in deciding what is the likely cause of your orgasm difficulty. It may be because of fear of letting go, or being too anxious, or having unsure feelings about sex at all, or being angry with somebody about sex.

If you are sexually active, you may be asked to abstain from intercourse while you relearn some of your sexual experiences. You and your partner may receive some guidance with Sex Therapy as well.

For yourself, you will be given some exercises in self-examination, and then self-stimulation, which are graded and which will be carried out alone in the privacy of your own room. The purpose of this graded programme is to give you a chance to learn about your own sexuality, and sexual response, and to give yourself permission to have pleasure before trying anything with your partner. It may help you build up your confidence, and begin to deal with whatever has been the cause of your resistance to orgasm.

You may be asked to keep a diary of your progress, both to act as a record for yourself, as well as for your therapist when you next meet. It is only when you have climaxed alone, that your partner will be involved, depending on whether your orgasm is primary -you have never had an orgasm under any circumstances, or Secondary- you have been able to in the past, or you can only under certain conditions.