Dear Sasha,
About two years ago my family doctor diagnosed me with anorgasmia. When I was diagnosed, I was with a steady boyfriend who was trying so hard to make me come, he even studied the physiology of the vagina and talked to me about it. I tried guiding him and I was comfortable with him in bed. We were both surprised why I wasn't able to come when often I came so close. I only became aroused with oral and I would feel like I was about to come and then it was so intense for my clit that it became irritating and I wanted to stop. It's like my brain didn't disarm that extra clitoral notch.

Our guess was the effects of my anti-depressants. I started on Celexa (and ended with Wellbutrin, a weaker medication) a few months before I was dating this boyfriend, and then ended medication one year into the relationship. My online research on anti-depressants says they are known to inhibit orgasm and libido. I have always had a strong libido, it's just the orgasm that I don't experience. I've been off meds for two-and-a-half years now and still am not able to orgasm. Before I went on anti-depressants I was only with one other partner and I never had an orgasm with him. It's hard to tell if I could have had one because I wasn't completely comfortable with my body at that point.

I'm 24 years old, a university graduate, I have sex appeal and I'm pretty relaxed in bed. I was inspired to retry my vibrator recently and I've never been so aroused in my life! I was about to come and then all of a sudden my clitoris was overly stimulated and hence, my body rejected the intensity and I needed to stop. It's extremely frustrating plus, I've decided to start telling my lovers that I've never orgasmed before but I realized some of them become selfish and don't really try to make me come because they know it's impossible. Do you think it's a combination of psychology, not finding the right partner, and chemical imbalance (meds/genetic)? I'm also naturally anxious which may have something to do with it. I made an appointment with my gyno to see if she could help me out. My GP, two years ago, referred me to the Jewish General's sexual dysfunction clinic to seek therapy but it's too expensive for the moment.

"Inhibited" Laura

Dear Laura,
I wouldn't be surprised if the after-effects of anti-depressants combined with your anxiety are contributing to this maddening barricade, but I ain't no doctor, so let's try to find you one. Like anything free or subsidized, you will have to wait for treatment (from one to a couple of months in some cases), and one administrative coordinator told me it's even slower in the summer since many professionals are on vacation.

Some teaching hospitals have a sliding scale for those who are short of money. For example, the Royal Victoria Hospital in Montreal's Sex and Couple Therapy department (www.sexandcoupletherapy.com) offers treatment from zero to $55 an hour and they do address anorgasmia. And since you already have an appointment to see your gyno, ask her to refer you to a gynecologist who specializes in sexual function and not just reproduction. You'll also find resources on the Women's Health Matters site (www.womenshealthmatters.ca/index.cfm), an initiative led by the Women's College Hospital in Toronto. Keep your eyes peeled for issues that deal with sexual health on their Ask an Expert page and get on those discussion boards.

Sex therapist Rae Dolman also advises calling therapists to see if they offer sliding scale. When asked about books she recommends to women dealing with anorgasmia, she says Sex For One by Betty Dodson is a good place to start, though she finds it a bit over-the-top. (I know what she means - Betty's Bay Area sex vibe occasionally rubs this East Coast gal the wrong way, too)

High anxiety is one thing that can definitely contribute to sexual dysfunction so she recommends taking the focus off of orgasm during sex. Be in the moment so that arousal is able to build, making it about the journey, not the destination. Yep, I just wrapped up this answer on a Bay Area sex vibe note. Sorry, dude, but it's true: we all need to calm the fuck down.

Questions? Comments? Contact Sasha at pouledeluxe@yahoo.com.