Having an orgasm shouldn't be like solving a difficult math problem but for a lot of women, it really can seem like that. Cosmopolitan.com spoke with several doctors to find out the real reasons why you're not getting there.
1. You're on a medication that is making orgasms nearly impossible. Michael Krychman, MD, executive director of the Southern California Center for Sexual Health, says that medications like SSRIs (used to treat depression, anxiety, and other conditions) can diminish sex hormones in the body, and often lead to having crappy orgasms or no orgasms at all. So if the sex is actually good and it's just not happening for you, that could be why. Talk to your doctor and see if there's another medication with fewer sexual side effects that you could be taking.
2. You're only having penis-in-vagina sex. Dr. Krychman says a lot of the time, guys think they're incredibly good at sex but they actually have no idea what they're doing. According to Justin Lehmiller, PhD, author of The Psychology of Human Sexuality, only about half of women can orgasm from penetration alone, so it's no wonder you're having problems with the jackhammer method. Try adding in clitoral stimulation via your own hand or a vibrator on your clitoris during sex.
3. You're not getting enough (or *gasp* any) foreplay. A lot of women fake orgasms because a lot of men fake foreplay, according to Dr. Krychman. Definitely a mic drop quote, but seriously, if your guy isn't giving you enough (or any) foreplay, you're never actually getting turned on and it's pretty hard to have an orgasm when you're not even turned on. So tell him to slow the hell down already and give you the time to get there.
4. You're too stressed out to really enjoy sex. Many women spend a lot of time during sex worried about unintended pregnancy and STDs, as well as whether this guy is good for them or whether he's faithful. According to Raegan McDonald-Mosley, MD, MPH, chief medical officer at Planned Parenthood Federation of America, that makes it really hard for women to let go and be in the moment sexually.
5. You have no idea what works for you. The vagina has a lot of parts to it and it's not like we learn a ton about how it all works when we're growing up, so Dr. McDonald-Mosley says many women don't even know what feels good to them. She suggests trying to masturbate while stimulating your clitoris and inside your vagina at the same time (try The Rabbit) or separately to figure out what you like, and then share that with your partner.
6. You're putting way too much pressure on yourself to have an orgasm quickly. If you're lying there nervous or tired or feeling uncomfortable about how much time has passed with you still not having had an orgasm, you're creating a vicious cycle of no orgasms. Dr. McDonald-Mosley says that having that pressure to have or give an orgasm just results in everyone being stressed out and not coming. Not ideal. Try not to think about orgasming and just enjoy the sensations instead. You'll come when you least expect it.
7. You might just need some lube. About 40 percent of women don't produce enough natural lubrication to enjoy sex. Dr. McDonald-Mosley says that even if your body normally gets wet, sometimes the chemistry of condoms, hormones, and emotions can throw that off and leave you dry. Just adding lubricant (ALERT: it's not just for old ladies, it's for every lady) is an easy way to make you feel more comfortable and orgasm-ready.
8. There's an actual anatomical or physical problem you need to get checked out. True medical problems that affect your ability to orgasm are rare, according to Karen Elizabeth Boyle, MD, FACS, but it is possible to have things like clitoral entrapment, which is when the clitoris literally gets trapped under the clitoral hood skin, making it less sensitive. If you're having significant trouble orgasming, check with your gynecologist to make sure nothing like that is going on. But mostly, Dr. Boyle says it's about finding out what you like via masturbation or toys, and then finding a partner who wants to take you there.
This article originally appeared on Cosmopolitan.com. Minor edits have been made by the Cosmo.ph editors.