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Psychological:
- guilt, fear and trauma from childhood
- problems of letting go, and fear of losing control
- lack of information: the woman may not be aware that orgasm is possible or what to expect or even that what she is experiencing is an orgasm
- lack of experience [including no or little masturbatory experience],
- poor communication about sexual preferences
- inadequate stimulation, distractions, intrusive thoughts, lack of privacy
- conflict in the relationship, stress, financial problems
- age related changes may be physical [need for more direct and prolonged stimulation] or psychological [“I should not be having sex at my age”].
- trauma or surgery that affects the genitals, vessels or nerves in the pelvis
- acute/chronic illness, depression
- male dysfunction [See: Premature Ejaculation]
- medication [anti-depressants, anti-hypertensive treatments]
