Anne is distressed by a persistent delay in or complete absence of orgasm during sexual intercourse. her difficulty is most clearly an indication of

This can either be a hormonal or psychological issue such as anxiety or stress. Although health classes don't generally go into the emotional aspects so I would say Annie is suffering a hormonal imbalance. Likely low estrogen levels.

Hopefully this is helpful! :)

youll get beat if you dont listen to the older parental figures rules