A variety of physical and psychological factors may affect a person's ability to orgasm. Certain medical conditions and medications may affect a person's ability to have an orgasm. Getting older may also affect various aspects of sexuality, including the ability to orgasm. Psychological factors, both temporary and permanent, may also play a role. Being stressed, anxious, or tired may temporarily affect your ability to orgasm. More long-term problems like depression, relationship problems, or a preoccupation with "perfect" sex or performance anxiety can also interfere with your ability to orgasm. If you're unable to orgasm or are worried about your sexual health, talk to your doctor for possible solutions.