An orgasm represents the wonderful climax between sexual tension and release, so it can be frustrating if you’ve never been able to get there, or if you can only get there in certain scenarios, but not all. If you’re having trouble finishing things off in the bedroom, you might have anorgasmia.
Anorgasmia, or Coughlan’s Syndrome, is the inability to have an orgasm, or having unsatisfying or painful orgasms. Some experts expand the definition to also include delayed orgasms, when it takes longer than your usual time to climax. Anorgasmia can be a major obstacle for anyone who enjoys sex, since people often see climaxing as a key part of their sexual satisfaction, says pelvic floor physical therapist Uchenna Ossai. Of course, orgasms should not be the only goal of a sexual experience, but it can make sex even more fun to be able to have them.
The male orgasm occurs through a mixture of testosterone, arousal, and muscle contractions of the penis and its surrounding area. If anything psychological or physical gets in the way of that process, it can trigger anorgasmia or delayed orgasm, which is estimated to affect 8% of men, according to VeryWellHealth. (FYI, Anorgasmia is not the same as erectile dysfunction, which is difficulty in getting or sustaining an erection.)
Anorgasmia does not mean your sex life is over, Ossai says. An orgasm is not the only good part of a sex session; it’s merely a side effect of an overall pleasurable experience.
Want to learn more about anorgasmia in? Read on to find out symptoms, treatment and more.
What are the types of anorgasmia?
There are two types of anorgasmia, Ossai says: primary anorgasmia and secondary anorgasmia.
Primary anorgasmia is when you are unable to orgasm (or orgasm satisfactorily) in any sexual situation, and is usually a condition ongoing since puberty.
Secondary anorgasmia (also called situational anorgasmia)
Secondary anorgasmia is when you experience orgasm difficulties in certain sexual situations: for instance, only during partnered sex, but not masturbation. Secondary anorgasmia also refers to people who lose the ability to orgasm later in life, versus people who’ve never been able to do it.
Regardless of which type of anorgasmia you have, the condition is worth looking into if you feel sex is no longer pleasurable.
What are the causes of anorgasmia in men?
There are two overarching causes of anorgasmia in men: physical causes and psychological causes. “The absence of an orgasm means that there are other games afoot that you’re competing with,” Ossai says.
Physical causes of anorgasmia can include:
- Pelvic floor dysfunction
- Underlying illness
Ossai’s first question for a patient experiencing anorgasmia is: “What medication do you take?” Some medications, such as SSRIs, have anorgasmia as a possible side effect. Your doctor may be able to switch the dosage of your medication, or move you to a different medication entirely that can relieve your anorgasmia.
Anorgasmia may also be associated with whatever your underlying illness is, Ossai says. Diabetes and certain cardiovascular conditions, for instance, can impact a person’s ability to climax.
A recent injury can also foster anorgasmia. Breaking a hip, femur, or other bones in the section around the reproductive organs could make sex painful or uncomfortable.
Pelvic floor dysfunction is an often-overlooked cause of anorgasmia, Ossai adds.
“If your pelvic floor is really tight, or if your pelvic floor is not really coordinated, that can actually really make it difficult for people to have like a nice, satisfying sexual or orgasm,” Ossai says.
Psychological causes of anorgasmia can include:
Performance anxiety is a common factor that contributes to anorgasmia, Ossai says. The tricky thing is, the more you obsess about whether or not you’ll be able to orgasm, the harder it’ll be to climax.
“I tell people all the time that it’s almost like chasing a dog,” Ossai says. “The harder you chase — and if you’re questioning yourself — that dog is gonna run faster because they think it’s a game.”
Your anorgasmia might also be linked to stress — about work, family, relationships, finances, etc. — or another mental health issue that’s worth seeing a therapist about.
Anorgasmia may also be connected to past trauma, an underlying source of stress that can make sex uncomfortable, painful, or emotionally fraught. If your anorgasmia feels sudden, or you’re having trouble during sexual encounters after a traumatic experience, consider speaking to a therapist or other professional.
What does treatment for anorgasmia look like?
Depending on the reason behind your anorgasmia, Ossai says treatment will vary.
At-home treatment could mean pelvic floor exercises, or what Ossai calls “directed masturbation and mindfulness,” which means paying close attention to your body and what feels good to you during solo play. Relax any tense muscles, and try a new position. For example, if you masturbate while standing in the shower, Ossai suggests trying to lay down instead of relaxing your pelvic floor and improve blood flow to the penis. Or if you clench your butt during sex, try not to.
Penis-owners who orgasm during vaginal intercourse generally take 5-6 minutes to climax, according to research in The Journal of Sexual Medicine. But Ossai says you should not be timing yourself based on what other people report; whether it takes you 10 minutes or an hour, focus on making every sex session an enjoyable experience for you.
“I always say to not put a time limit on orgasms,” she says. “Always focus on the sexual experience itself, and the orgasm will come when it wants to come.”
And if you’re thinking of taking Viagra to solve the problem, do not bother. According to VeryWellHealth, Viagra (and its generic name Sildenafil) helps improve blood flow to the penis so you can gain and sustain an erection. It will not help you achieve an orgasm, though.
Since anorgasmia can be linked to serious underlying medical conditions, it’s always a good idea to talk to your doctor when you notice something’s off.
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