ABSTRACT Female anorgasmia, which the DSM-5 defines as a marked delay, marked infrequency or absence of orgasm, occurs in the orgasm phase of sexual response being the second most frequent sexual dysfunction in women. It is widely accepted that drugs usage has devastating consequences on sexual response. The aim of this study was to analyse the relationship between drug use and anorgasmia and sexual satisfaction, and other variables that can affect sexual response. An ex post facto study was conducted. Two groups of women were selected through cluster sampling from 28 drug rehabilitation centres belonging to the same institution throughout Spain: drug-using females (n = 129) and non-drug-using females (n = 129). They completed questionnaires about sexual function, sexual satisfaction, anxiety and sexual attitudes. Female drug users presented higher percentages of anorgasmia (13.18%>2.33%), sexual dissatisfaction (34.10%>3.87%), sexual avoidance (47.28%>17.05%), infrequency (59.68%>44.96%) and less erotic foreplay (3.10%>0.77%) compared to the control group. Moreover, higher scores were obtained in state anxiety (23.82 > 14.56) and trait anxiety (30.93 > 16.95), while lower scores were obtained in erotophilia (84.93 < 95.81). Female drug users reported significant impairments in sexual satisfaction, orgasm and sexual attitudes, concurrently with greater infrequency, avoidance and anxiety compared with the control group of non-drug-user females.