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Orgasmic Disorders in Males

Published on Sep 27, 2022 and last reviewed on Feb 28, 2023   -  4 min read


The recurrent or persistent inability to attain orgasm, even after the sexual stimulation, is called an orgasmic disorder. Read the article to learn about it.


Anorgasmia, Coughlan's syndrome, or orgasmic disorder, is when a person cannot achieve sexual pleasure even after sexual stimulations. This condition can be seen both in males as well as in females. But, it is more prevalently seen among females than in males. Anorgasmia can cause stress among men who experience it, and it can be accompanied by other sexual problems such as delayed ejaculation, erectile dysfunction, and low libido. However, it is not always accompanied by other sexual functional issues; therefore, anorgasmia should not be directly linked to other sexual problems.

What Is the Physiology of Sexual Orgasm in Men?

There are four distinct steps in a sexual response cycle, namely,

  1. Sexual desire (libido).

  2. Sexual arousal (excitement).

  3. Sexual orgasm (pleasure).

  4. Resolution.

The sexual orgasm is the third step in a normal sexual response cycle. In men, orgasm occurs after sexual arousal and sexual activity. Sexual orgasm is a complex mechanism involving hormones and nerve transmissions. Testosterone is the male hormone synthesized in the testicles. It is engaged primarily in stimulating sexual desires and orgasms in males. Certain groups of muscles of the penis and perineum are involved in the ejaculation of semen and the orgasm. The orgasm affects males if any physical or emotional processes are interrupted.

What Are the Types Of Orgasmic Disorders In Men?

Men are affected by one or both types of orgasmic dysfunction or anorgasmia.

Primary Anorgasmia:

When a person has never experienced orgasm since birth due to any interruption in the normal sexual process, then this condition is called primary anorgasmia. Primary anorgasmia is often accompanied by other sexual dysfunctions such as erectile dysfunctions, premature ejaculation, or low libido.

Secondary Anorgasmia:

This type of anorgasmia is also called situational anorgasmia. In this type of anorgasmia, the person can reach orgasm only during certain situations, such as masturbation or oral sex. The situation varies from person to person. This condition is often related to psychological reasons and is not usually linked to other sexual abnormalities.

What Are the Common Causes of Anorgasmia In Men?

The causes of anorgasmia in men can be physiological reasons or it could be due to psychological causes.

Physiological Causes of Anorgasmia In Men:

  • Nerve damage like multiple sclerosis in people with unmanaged diabetes and hypertension.

  • Conditions like hypogonadism which may lead to hormonal imbalances that result in lower testosterone levels, may cause anorgasmia in men as testosterone levels play a vital role in sexual health.

  • Radiation therapy in treating cancers may affect the sexual health of men.

  • Surgical complications in surgeries like prostatectomy can lead to anorgasmia.

  • Substance abuse, such as heroin abuse, may lead to sexual problems.

  • Specific drug use that can lead to side effects that cause sexual damage are opiates, antipsychotics, and antidepressants.

  • Antidepressants, mainly selective serotonin reuptake inhibitors, are known to cause anorgasmia.

Psychological Causes of Anorgasmia In Men:

  • Mental health issues like anxiety and depression can cause anorgasmia among men.

  • The most common mental health problem leading to erectile dysfunction or anorgasmia in men is anxiety surrounding performing well at sex. Some men have exaggerated expectations around sex, which may lead to anxiety and stress during sex, leading to orgasmic disorders.

  • Family or repressive religious upbringing can lead to a negative attitude towards sex, and it may lead to other sexual problems and orgasmic disorders.

  • Early sexual abuse and history of trauma.

How to Diagnose Orgasmic Disorders In Males?

The physician can diagnose anorgasmia in men by taking proper history and physical examination.

  • Proper history taking helps in the diagnosis and can help the physician find the cause because sometimes a drug you started recently might cause anorgasmia.

  • Your physician might ask for some or all of the following tests to confirm the diagnosis and causes.

  • Blood tests measure the levels of the hormones such as testosterone, prolactin hormone that helps with the function of testosterone, and thyroid-stimulating hormone (TSH).

  • The test used to test the sensitivity of the penis is known as biothesiometry.

  • A penile sympathetic skin response test can assess the nerve supply function of the penis.

The physician makes a proper and detailed diagnosis and may refer the affected person to a specialist like a urologist in cases of physical problems, or he can refer the affected person to a psychotherapist or psychiatrist if he assesses the person concerned to be under stress or anxiety or any other psychological problems.

How to Treat and Cure Male Anorgasmia?

More often, the treatment for anorgasmia or orgasmic disorder in men is as simple as withdrawing a drug from use or reducing the dosage of a drug already prescribed to the affected individual. However, there is no one-step-fits-all treatment for anorgasmia as each individual is different, and the causes might differ from person to person. Therefore, it is essential to consult a doctor regarding the problem without embarrassment because the treatment and cure might be quick and straightforward. The doctor will prescribe medicines or ask you to perform certain lifestyle modifications based on the diagnosis and cause.

Some of the standard treatment measures for anorgasmia in men are as follows,

  • Testosterone replacement therapy can be done.

  • Your general physician or psychologist can promote Dopamine-promoting drugs such as Dostinex.

  • In cases of psychological problems such as depression or anxiety, therapy sessions are given to the individual that helps with their overall well-being and sexual health.

  • Couple therapies are given if any problems are noted between the couple that affects their sexual lives.

  • Counseling or therapy sessions can help remove false beliefs or fears around sexual topics.

As mentioned earlier, there is no one-step-fits-all treatment for anorgasmia. Treatment options and cure varies from person to person. It is essential to find the exact cause and diagnosis by a physician.


Anorgasmia can cause stress and affect a person's and their partner's life. Therefore, proper treatment as soon as possible is crucial. Most cases of anorgasmia are known to be cured after appropriate diagnosis and treatment. Thus, no amount of embarrassment should block a person from getting adequate help from a doctor.


Last reviewed at:
28 Feb 2023  -  4 min read




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