Dr. D,

I've been with my boyfriend for more than a year. We have a great relationship and a great sex life … except for one thing. I can't, you know, enjoy myself. I am not sure if I have ever had one. Is it possible that there's something medically wrong with me? Or am I really just that inadequate in bed?

-No O

Dear No O,

I believe you are referring to The Big O, the "Oh, yes," the petite-mal, the climax. Whatever you call it, and I have heard it called just about everything, it is what is thought to be the end-all to a sexual encounter: the orgasm.

Although your question is very common and I have answered literally hundreds of students who have asked it, I was hesitant to address it in this context. Why? Well, unfortunately there will be readers who will protest that it's even in The State News, and then others who will exercise free speech and send me a pervert-a-gram on my immorality. But I took my multi-vitamin, turned on my spam filter and decided to exert my role as a health educator.

Sex is a small part of one's sexuality, but it is a really important part for many. Choosing to engage in sex with another person is not as easy as just "doing it." William Masters, famous sexologist, said there are only two reasons to engage in sex: procreation and pleasure. Since you didn't mention wanting to produce a little Sparty bundle, I'm assuming you've decided to engage in sex for pleasure, since that's really what it's all about for some people.

Being able to orgasm as a part of sex may be important, but it is not and should not be the ultimate goal. The receiving and giving of pleasure, as long as there is mutual consent, is really what is important.

Nearly all women can climax. For most, it is just a matter of allowing themselves permission and then learning how to get there. Many women find it difficult to learn how to enjoy themselves sexually. When there is difficulty in achieving orgasm, it may be physical, but in most cases, it is related to either lack of knowledge or a mental hurdle.

Some women — and men, for that matter — are just nervous to experience something new. Others just feel a lot of pressure, especially if they know it's important to their partner. There are those who also feel guilt for different reasons: religious, family or societal views. Then again, others just might not be in the moment or can't relax. Most of the time it really is mind over matter.

That being said, if you are ready for an orgasm, then here are a few things you can think about doing to help increase your chances. Most sex therapists recommend masturbation as a great way to become orgasmic. You can learn what you like and then communicate with your partner about how to efficiently please you. During sexual activity, it's important to remember the vagina doesn't have very many nerve endings. However, the clitoris has 6,000 to 8,000 nerve endings. In fact, most believe that the reason for the clitoris IS pleasure! Try including clitoral stimulation in your sex life. Many women report finding it easier to climax from oral sex because there is more focus on the clitoris. If you choose to have vaginal intercourse, try to use positions that involve more direct clitoral stimulation.

Having said all of the above, I would like you to consider my question: Is the goal of sexual activity to climax? Examine the reasons you are sexually active and why you are both choosing to be sexually active, specifically with each other. There are many reasons people decide to be sexually active — pleasure is definitely one of those reasons.

You did describe your sex life as great. If you are pleased with it, don't put so much pressure on the end result and just enjoy the process. If you stop worrying about it, you might just find that it happens a little easier. Maybe you will go from "Oh, no" to "Oh, yes!"

Peace. Dr. D.