Orgasm and Heart Conditions

Q: Can women of mature age experience lack of orgasm due to coronary artery problems?

First, I want to make the point that it’s been clearly established  that erectile dysfunction is an early warning signs of heart disease–so much so that I would urge any person who has experienced a sudden change in their erectile capacity to consult a doctor immediately. Changes in erectile capacity very often precede a heart attack by 3-5 years. It’s not just a sex problem, it’s a health problem, and taking swift action could save your life.

It’s important to make a distinction between erection and orgasm. Erection I will define here as filling of the erectile tissue regardless of gender. Orgasm, on the other hand, is a reflex response to sustained stimulation. Erection and orgasm are very different, but related. In many cases, people with impaired erectile capacity can still reach orgasm. They just don’t think they can because nobody told them to try. On the other hand, erection/engorgement feels good and increases enjoyment and arousal. Engorgement makes orgasm easier and more likely.

Most female-bodied people aren’t really aware of their clitoral engorgement; it is harder to notice and comes and goes more than for males. While male-bodied people are very conscious of their erections, female-bodied people are more likely to notice the presence or absence of an easier-to-spot sign: orgasm.  While engorgement necessarily involves blood vessels, diminished or absent orgasm has dozens of causes.

Engorgement works very similarly between all genders and sexes. We all need healthy blood vessels for the blood to make it to the erectile tissue. So I’d say a woman in midlife might well experience a lack of ENGORGEMENT due to arterial damage. She might then face more difficulty noticing feelings of arousal (some of which are related to the engorgement itself) and thereby more difficulty reaching orgasm.

Heart attack is the leading cause of death for women. It’s diagnosed much later than with men, and with a much lower survival rate. If you notice changes in your arousal patterns, see a doctor. Better safe than sorry.


  • Start to notice signs of engorgement in the vulva and clitoris
  • Regardless of gender and sex parts, take lack of engorgement seriously
  • Since orgasm and engorgement are related, lack of orgasm could hypothetically be the first sign a female-bodied person notices that could be related to coronary artery disease.
  • Orgasm is possible without engorgement/erection. So keep on trying while you wait for your appointment with your cardiologist.

Body Positivity and Health Consciousness

Are you worried that if you are kind and forgiving of your body you will not be motivated to make lifestyle changes to benefit your health? I have never known this to be true. Hating any aspect of yourself is a surefire way to get stuck in a wrestling match with yourself. I truly believe if you want to make healthful changes in your life, the only way to create lasting change is to love yourself into it.

But how? This is a very tall order, and if it is a necessary ingredient for success, that might feel a little daunting. Don’t lose hope! You can do whatever you set your mind to. If you haven’t tried focusing on love and kindness, give it a try. See how much easier it will be to reach your goals.

Gentle, Kind, Loving Change

Do you feel clear that there are changes you want to make in your life to improve your health? If so, I invite you to carefully consider these questions.

Do you feel angry with yourself when you don’t achieve a goal? If this describes you, please consider carefully how you might change this pattern. Making lifestyle changes is challenging. Despite what marketing campaigns might tell you, change is not linear and setbacks are inevitable. When you begin to make changes, your self-criticism will have many opportunities to take over. If you let it, it will undermine your motivation to try new things.

Are you a good starter? There is a lot of attention on sticking with lifestyle changes, and I can agree that endurance helps. However, I have noticed that life is full of very real setbacks like getting the flu, injuring a knee, a trip out of town, a stressful week, sheer exhaustion, etc. Flexing when life throws you a curve is a GOOD thing, not a lack of willpower. This is why starting again is at least as important as sticking with it. When you hit a roadblock, instead of telling yourself “I’m bad at sticking with things” (or worse), try telling yourself, instead, “I’m good at this. I’m restarting now.”

Are you a kind coach? If you can be encouraging to friends who are taking risks or braving new challenges, you have the skills you will need to lovingly coach yourself. But there is a catch: can you turn your own approval onto yourself? You will need to love yourself if you want change to happen. Please be a loving coach and cheerleader for yourself. You deserve it!