An orgasm is an intense, diffuse and pleasurable sensation experienced during sexual intercourse or masturbation. In the male it is associated with ejaculation (but please note that ejaculation may occur before and after orgasm) and in the female with uterine and pelvic muscular contractions, and a warm flooding sensation throughout the pelvis.

Orgasms may vary in intensity, depending very much upon the state of the nervous system both physically and psychologically. Persistent friction on the head of the penis, the clitoris or a small area just inside the upper aspect of the vagina (colloquially known as the ā€˜Gā€™ spot) sends off nervous impulses to the central nervous system. An accumulation of these impulses triggers a profound neurotransmitter release that principally affects the pleasure centres but also blocks both pain and some neuromuscular channels. Co-ordination is particularly affected momentarily, heart rate, blood pressure and peripheral circulation can increase.

Achieving an orgasm requires a conscious effort but the actual nervous reflex is governed by the parasympathetic, autonomic (uncontrolled) nervous system. Damage to these nerves can cause a decrease in intensity or a total loss of orgasm, whereas a hypersensitivity may cause an orgasm to arrive too quickly. Often associated with premature ejaculation, this oversensitivity can be created by natural hormones, excitement or stimulation and by the use of certain drugs. Other drugs may have a converse effect: alcohol, amphetamine, cocaine and ecstasy are commonly abused for this purpose .

The yogic philosophy believes that energy known as the kundalini is stored in the pelvis. Genital stimulation awakens this energy, which flashes up the spinal column and affects the brain. Masters of meditation can release this energy without physical stimulation and there are reports of telepathy being able to create orgasms in the partners of meditators. Certainly meditation will remove inhibitory chemicals and lead to easier attainment of orgasm.

Some physical disorders such as multiple sclerosis or other nerve diseases and problems with the prostate gland can interrupt the nerve supply and prevent orgasm. Damage to the central nervous system may also cause a loss. Anxiety, stress and phobias, often resulting from failed previous sexual experiences or guilt from religious teachings, can affect the ability to have an orgasm or might cause premature ejaculation. These are usually not serious conditions but may require some time and some special counselling.

Delayed or absent orgasm may be a process of age but may also be caused by disease process and should be reviewed by a GP or specialist in the field.

Meditation and counselling to alleviate anxieties or phobias may have a profound effect. Sexual counselling may be required.