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Medically reviewed by
Constance Tambakis Odom, MD graduated in 1987 with her Doctorate of Medicine from the New York Medical College, and was an Anesthesiologist Resident from 1988 to 1991 at the Brookdale Medical Center PGY II (CA-I)-PGY IV (CA-III). She is Board Certified by the American Board of Anesthesiology since 1998 and American Academy of Anti-Aging Medicine since 2002. Constance Odom, MD is affiliated with the American Medical Association, American Academy of Anti-Aging Medicine, American Society of Anesthesiology, Georgia Society of Anesthesiology, Hellenic Medical Society of New York, North Carolina Society of Anesthesiology, and Society of Ambulatory Anesthesia.
Sexual disorders are divided into several categories, each with its own defining characteristics. These categories are quite vast. However, male sexual disorders are often assumed to start and end with erectile dysfunction (ED) or premature ejaculation (PE). While these conditions affect a large part of the male population, it's not the only sexual dysfunctions men can suffer from. Males can experience Anorgasmia, a condition that inhibits orgasmic function. Research shows that the condition is becoming more extensively discussed as many men report symptoms.
Below we expand more on what Anorgasmia is, its symptoms, causes, and treatment:
What is Male Anorgasmia?
Anorgasmia, commonly referred to as a delayed orgasm or inhibited ejaculation, is a sexual disorder that causes persistent difficulties in achieving orgasm during sexual stimulation. The inability to reach complete satisfaction can occur in both sexual intercourse or masturbation and often causes men great stress.
Anorgasmia in men is categorized into different groups. Let's look at them below:
Primary Anorgasmia is present for the entire duration of a man's sexual life, which means it may be difficult or impossible for men to reach an orgasm present from the first sexual encounter.
Secondary Anorgasmia develops after a period of normal sexual experiences. Men with secondary Anorgasmia may notice a sudden change in orgasmic function. They will find that they cannot achieve an orgasm or ejaculate even after years of successfully doing it with sex and masturbating. In secondary cases, orgasms may become less frequent, men may take longer to achieve them, or they may stop altogether.
Situational Anorgasmia only occurs in certain situations, ranging from location, partner, the type of stimulation being received, and more. In these cases, orgasms can only be achieved if the situation is fitting. For example, some men may find that they can only reach orgasm through masturbation, and any other sexual stimulation can't take them to that point.
No matter which type of Anorgasmia is present, the condition has a domino effect on sexual health, as symptoms lead to significant sexual dissatisfaction and performance anxiety. This may cause the development of other sexual-related conditions such as erectile dysfunction (ED) and low libidos.
The Male Orgasm vs. Anorgasmia
The male orgasm is an underappreciated component of sex that most take for granted. The processes behind the orgasm are never described as overly complex and are always seen as lightyears apart from the female orgasm. But in actuality, the complexity of the male orgasm is equal to that of the female.
Experts describe normal sexual experiences from both the male and female stance as an interplay between the mental and physical psyche. The physical component involves processes carried out by the endocrine, nervous and circulatory systems, while the mental component involves thoughts, attitudes, emotions, experiences, and beliefs.
These components make up the four phases of the human sexual response cycle. The male orgasm falls under the 3rd phase of the sexual response cycle. Below we explain the cycle in more detail:
Motivation refers to the desire to engage in sex. It can come from any one of the senses (sight, hearing, smell, taste, touch, movement, or body position).
Arousal involves physical and mental mechanisms
-Mental-Feelings and thoughts which facilitate excitement and arousal
-Physical-The promotion of blood flow which causes swelling and lubrication
The orgasm, the shortest phase of the sexual response cycle, is known as the peak of excitement that causes a sudden release of sexual tension. The orgasm is fueled by a combination of sexual activity and arousal. The process involves several nerve pathways, hormones, and organs.
One hormone that plays an integral role in the male orgasm is testosterone. This hormone is produced in the testicles and triggers the body to move through the sexual response cycle to reach orgasm.
The male orgasm also involves the contraction of the muscles of the penis, anus, and perineum (the space between the anus and scrotum). These contractions push semen out from the body through the penis. During an orgasm, the reward center of the brain floods with neurochemicals responsible for intense emotional responses.
This phase is referred to as the after-effects of an orgasm. It involves satisfaction and muscular relaxation—the penis goes from erect to flaccid.
Men who suffer from Anorgasmia experience a disruption in the processes that support an orgasm. These disruptions mean the body does not properly go through the phases of the sexual response cycle resulting in the inability to achieve complete satisfaction or an orgasm even if adequate sexual stimulation is available.
Symptoms and Causes of Anorgasmia
Anorgasmia is typically easy to identify because it only presents one very noticeable symptom—Delayed orgasms or no orgasms, even when sexual stimulation is fully received during intercourse or masturbation. This symptom is, of course, followed by stress, anxiety, and frustration because complete satisfaction tends to linger and is never attainable.
Several factors can cause the onset of Anorgasmia or worsen it. These causes are split into 2 groups—psychological and physical factors. Psychological factors include depression and performance anxiety, while physical factors include low penile sensitivity and nerve damage.
Let's look at these causes in more detail.
Use of medications- Anorgasmia is a common side effect of SSRI use (selective serotonin reuptake inhibitors—common antidepressants). These medications are often picked out as the cause of the condition because they affect the function and release of neurotransmitters such as dopamine and serotonin, which influence orgasmic function. Other medications, such as opioids and antipsychotics, can also be identified as a cause because they affect hormones and neurotransmitters that support sexual performance as well.
Nerve damage- Damage or injury to the nerves in the lower body, spinal cord injuries, recent surgery to the prostate or genitals, pelvic trauma, or other illnesses that attack the nerves can cause Anorgasmia.
Low penile sensitivity- Numbness or lowered penile sensitivity is often seen with age or circumcision. Studies show that decreased sensitivity in the penis leads to a lack of response to sexual stimuli, making it increasingly difficult to reach orgasm. This results in the development of Anorgasmia.
Hormonal imbalance- Hormones like testosterone and prolactin have many functions, but in the male body, it is especially known for their influential role in sexual function. Low levels of these hormones can affect processes that support both orgasms and ejaculation, causing Anorgasmia.
Little to no sexual arousal- There are some cases where physically healthy males who receive full sexual stimulation do not experience arousal, which stops them from achieving an orgasm. This can be due to psychological and mental blocks that are sometimes unknown or unnoticeable.
Masturbation and porn - Over time, the consumption of porn and masturbation can affect sexual performance and habits during sexual activity. These men are conditioned by using unique or idiosyncratic masturbation techniques, meaning that they will only orgasm using these specific movements. Research shows that this will cause a decreased sensation, making it difficult to reach orgasm.
Depression - Anorgasmia is common in men who are suffering from depression. A study that looked at male patients with mild-to-moderate grades of depression showed that sexual dysfunctions were found in 62.5% of the group. This included reduced desire, orgasmic problems, and sexual dissatisfaction.
Anxiety - When you are anxious and stressed, the level of cortisol increases in the body. Cortisol lowers testosterone levels, which contributes to delayed orgasms. The condition can also be caused by performance anxiety, fear of pregnancy, sexual trauma, and general anxiety.
In some situations, the condition may have multiple causes that fall under the physical and psychological categories. A classic example is the consumption of certain medications like an SSRI and the presence of depression or anxiety. While these cases are sensitive and a bit more complicated to handle, they are not impossible, and the Anorgasmia remains treatable.
Sexual dysfunction, like any other medical condition, requires medical diagnosis to adequately treat the intensity and frequency of symptoms. Diagnosis is especially important when dealing with Male Anorgasmia because the condition does not have a one size fits all remedy, and treatment plans vary from person to person depending on various factors.
Depending on the possible cause of the Anorgasmia, healthcare providers may recommend the following tests:
Hormone evaluation like testosterone, prolactin, or thyroid testing
Since these hormones affect sexual performance in some way, checking their levels or functionality can map out possible treatment options for Anorgasmia. Hormone tests are done via a blood test, and results are typically ready in a few days.
Penile sensitivity tests
Penile sensitivity tests usually indicate if physical issues cause the Anorgasmia. Penile sensitivity tests include biothesiometry, skin testing, and sacral reflex testing.
Once these tests are done, diagnosis and treatment typically follow. However, there are some cases where diagnosis doesn't lead to the treatment phase. Standard Anorgasmia treatment may not be possible if you:
Have had a radical prostatectomy (a surgical procedure on the prostate)
Have suffered severe pelvic trauma
Have multiple sclerosis
Treatment Options for Men with Anorgasmia
Unlike other male sexual dysfunctions like ED or PE, which have an extensive list of treatment options available for use, Anorgasmia doesn't have a specific list of pharmaceutical aids that is dedicated to curing the condition. However, there are other approaches that can work to manage the condition and restore orgasmic function.
Below we list some of the common treatment options:
If particular behaviors, situations, or circumstances cause the condition, avoiding the triggers may help reinstate normal orgasmic function. For example, if certain masturbation methods cause a delay in orgasms, changing how you masturbate may improve sexual performance and treat Anorgasmia.
If the condition is caused by psychological or mental issues such as anxiety, depression, mood disorders, and trauma, men might benefit from psychotherapy. A PubMed study presents psychotherapy as an effective treatment option against Anorgasmia, especially when combined with physical intervention.
In some cases, certain medications, such as antidepressants, might cause delayed orgasms, so switching medications or doses can help stop the symptoms of Anorgasmia.
Men suffering from Anorgasmia can benefit from certain forms of sex therapy. This therapy may help men relax, enjoy sex better and reach orgasm more easily. Studies show that sex therapy can involve changing arousal methods and using techniques to reduce sexual anxiety. It can also involve instruction on prostate massages to help stimulate the male G-spot.
Medications for hormonal issues
If the cause behind the Anorgasmia is attributed to hormonal issues, the use of medication to treat the hormonal issue can help eliminate Anorgasmia symptoms. For example, prolactin-based Anorgasmia can be treated with a drug called cabergoline, which regulates prolactin levels. A PubMed study shows that cabergoline can normalize serum prolactin levels, improving orgasmic function, making it an effective treatment for Anorgasmia.
Penile vibratory stimulation
Reduced level of penile sensitivity can cause Anorgasmia. In these cases, vibratory stimulation, which involves vibrating the frenulum (elastic area of tissue close to the tip of the penis), can help induce an orgasm. A study shows that this process is indeed effective in treating Anorgasmia
Testosterone replacement therapy
Anorgasmia caused by low testosterone can be treated with supplementary testosterone like Tlando (testosterone undecanoate) or a dopamine-promoting drug like Dostinex (cabergoline). These treatment options can restore a man's ability to orgasm by correcting and promoting testosterone levels.
The Bottom Line
Although Anorgasmia is complex in some sense and doesn't have a direct line of treatment available to alleviate its symptoms, the condition can be successfully managed if the right steps are taken. Treatment of the condition revolves largely around identifying and addressing potential causative factors. These factors can be picked up through the diagnosing process, so seeking the help of medical professionals is necessary. By following the recommended course of action, men can be certain they have the condition and effectively eliminate causes to reinstate orgasmic function and achieve satisfactory orgasms.
Nu Image Medical has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your physician about the risks and benefits of any treatment. Nu Image Medical may not offer the medications or services mentioned in this article.