Definition of Anorgasmia:
Inability to climax or difficulty climaxing with typically sufficient stimulation in a significant percentage of sexual interactions.
Prevalence of Anorgasmia in men:
1 million to 10 million men
*Estimates on the prevalence of male anorgasmia vary widely, and are almost completely a function of definition. When evaluating your own situation, remember that unrealistic expectations can shape your perception of the seriousness of your difficulty. If you feel you have a problem, talk with your partner(s). An evaluation by a physician, psychologist, or therapist may also be helpful.
Background of Anorgasmia:
The first issue to discuss about this is medication side effects. Difficulty ejaculating is a common side effect of antidepressants, tranquilizers, antihistamines, and other medications. Before a man decides that he has a sexual dysfunction, he should examine his use of prescription drugs, street drugs, and alcohol. A simple physical exam can also help rule out health problems such as diabetes or multiple sclerosis.
Symptoms and Diagnosis of Anorgasmia:
Delayed or missing orgasm occurs in two entirely different groups of men. One group experiences orgasm difficulties as the natural result of the aging process, typically starting between 40 and 50. As we age, all of our reflexes slow down. That's why sports and driving are different at age 50 than they are at 20. Ejaculation is a reflex, and it slows down in many men. This often has a big impact primarily because it is so contrary to the expectations and experience of men in their youth, when orgasm is almost inevitable and typically quick. Many women are distressed by this development. Accustomed to seeing men explode with orgasmic pleasure, many women assume that a man who has difficulty coming is not sufficiently aroused or emotionally connected. This assumption is simply incorrect. Other women feel "deprived" of the closure of a man's ejaculation.
While some men are terribly upset by their slowed or missing ejaculation, others accept it quite easily. These men say that since they're enjoying themselves -- sometimes far more than when they were young -- the lack of orgasm doesn't trouble them. Furthermore, for some men it seems like divine intervention: after spending 20 or 30 years struggling to delay orgasm, the body finally delivers its own solution.
On the other hand, younger men who experience delayed or missing orgasm may have a serious psychological difficulty. These are often men who have great anxiety about sex, women, or intimacy. While some have had many partners, others have had little or no sexual experience. In both cases, however, the man may be unconsciously withholding part of himself or refusing to participate in an activity he regards, consciously or not, as dangerous or disgusting.
Other fears that unconsciously interfere with ejaculation include the fear of pregnancy, whether contraception is used or not. Another is the fear of being metaphorically swallowed up or engulfed.
Treatment of Male Anorgasmia:
Such primitive fears, and the symptoms that express them, are among the most difficult sexual problems to treat. Indeed, anorgasmia in younger man is notoriously difficult to resolve, because it typically represents primitive wounds or unconscious decisions. A year or two of therapy is not uncommon -- and the results are not always guaranteed. Women considering partnering with such a man should understand that they might be in for long-term difficulties.
Remember, however, that healthy ejaculation is triggered by stimulation, mental and/or physical. Some men are quite shy about announcing exactly what they want, whether it's pressure on the scrotum, red high heels, or the words "I love you." If a man has trouble ejaculating, his mate should make sure he's getting the stimulation he prefers. As men get older, the stimulation needs to be more direct, and frequently firmer. Partners should work together to explore what works best.
Marty Klein has been a licensed Marriage and Family Therapist and sex therapist for over 20 years. His entire career has been aimed at a single set of goals: telling the truth about sexuality, helping people feel sexually normal and powerful, and supporting the healthy sexual expression and exploration of women and men.