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Problems with orgasm

Problems with orgasm (men)

Introduction

Orgasm in men is directly related to the act of ejaculation. Failure to reach orgasm despite ejaculation, pre-mature ejaculation and orgasm, staying dissatisfied even after ejaculation, retrograde ejaculation are some commonly seen problems with orgasm in men. The entire process of sexual arousal, erection and ejaculation is highly complicated, involving multiple systems in the body. That is why; problems pertaining to male orgasm can have varied causes. Although problems with orgasm in men rarely have physically debilitating effects, they can surely have long term psychological impact. At times, problems with orgasm in men can also just be a symptom for underlying physical and neurological problems. Hence it is essential to get such problems diagnosed and treated in a timely manner.

Risk factors

Problems with orgasm can be categorized primarily into three categories – premature ejaculation, delayed or absent ejaculation, retrograde ejaculation. While in case of premature and retrograde ejaculation, a man can experience orgasm, in delayed or absent ejaculation orgasm can be highly elusive. Physical risk factors associated with orgasm prematurity or delay are rare to non-existent. But psychological risk factors are very high. As sexual performance of a man depends heavily on his mental condition, problems with orgasm can slowly diminish sexual desires and self-confidence. Also in case of retrograde ejaculation, semen quality and fertility of a man suffers, making it difficult for his partner to conceive.

Causes

  • Lack of testosterone: Testosterone is a male reproductive hormone produced in testes. If produced inadequately, it can affect male sexual performance and can cause complications like erectile dysfunction or premature ejaculation.
  • Malfunctioning thyroid: Conditions of hypothyroidism and hyperthyroidism can have multi-dimensional effects on human body. Orgasm related issues and problems can also arise from malfunctioning thyroid or erratic TSH production in the body.
  • Prostate malfunctioning: This is the most easily suspected cause for orgasm related problems in older men. As the prostate gland swells up, it makes intercourse and subsequent orgasm difficult for a man to achieve.
  • Cushing’s syndrome: This condition is a result of excessive Cortisol or stress hormone production in the body. Under duress, a man can feel incapable of performing sexually, let alone reach orgasm.
  • Spinal cord injury: Injuries related to spinal cord or in the nerves of adjoining area can have a direct impact on the nature of ejaculation and associated orgasm in a man.
  • Multiple sclerosis& Parkinson’s disease: A fall in sexual desire as well as sexual performance as a result of neurological problems is quite common in older men. Although in some men, lack of orgasm can be an early symptom of mental illness, in others it may not surface until later stages of the disease.
  • Injury on Penis or diseases of penis: For obvious reasons, injury or inflictions and subsequent surgery of penis or scrotal area can also affect a man’s ability to experience orgasm.
  • Chronic diabetes or heart disease: Men with long standing heart conditions and other complications pertaining to diabetes can face the problem of premature ejaculation or retrograde ejaculation.
  • Post traumatic stress: In addition to physical causes of problems related to orgasm, there can be strong psychological factors to impact sexual performance too. Especially in men suffering from post traumatic stress or with increased level of anxiety, the lack of orgasm or inability to achieve orgasm with a partner is quite common.
  • Substance abuse: Excessive use of substances like alcohol, tobacco and recreational drugs can also affect the sexual performance of a man.

Diagnosis

Problems with orgasm can be diagnosed by analysis of nervous system, hormonal constituency of blood and circulatory system performance as these three systems participate in the sexual cycle. Commonly adopted methods of diagnosis include –

  • DSM-IVTR is a diagnostic procedure adopted by physicians to correctly diagnose orgasmic disorder and differentiate it from other existing sexual disorders like erectile dysfunction or hypoactive sexual desire.
  • Diagnostic evaluation of testosterone levels in blood plasma to identify hypogonadism
  • Diagnostic evaluation of pituitary, thyroid and adrenal hormones in blood plasma
  • Orgasmic tendency at the time of masturbation and penile function during night is also analyzed to correctly diagnose the causes of orgasmic disorder in men

Treatment

The treatment for orgasmic disorders in men is directly dependent on the causes diagnosed. If the primary causes are physiological, then the treatment is designed to either alleviate underlying problems such as diabetes, penile or spinal injuries, substance abuse, etc. If the primary cause is psychological disorders, then treatment is psychotherapy. In-fact, even when psychological factors may be secondary in causing orgasmic disorders; psychotherapy is advised in complement to physiological treatments. Age and over-all health of a man are crucial factors recognized by physicians, while devising treatment for problems related with orgasm in men.