An inability to reach orgasm

The inability to reach orgasm during sexual intercourse is better documented for women than men. Whilst anorgasmia, also known as orgasmic disorder, orgasmic dysfunction or orgasmic inhibition, is less common in men there are similarities in both sexes in terms of the possible causes and therapeutic outcomes.

Statistics vary widely on the extent of the problem with men, but a range of between 1 to 10 million has been cited. One reason for the wide statistical variation is to do with the defining qualities of anorgasmia in men. For some men the disorder presents itself in terms of an inability to reach orgasm only during sex. In such cases it is often possible for orgasm to be reached but only after prolonged and intense non-intercourse stimulation.

Psychological Causes

It is estimated that around 90 per cent of anorgasmia problems are related to psychological issues. Surveys point to performance anxiety as the number one psychological problem. Performance anxiety in this context is not necessarily related to 'staying power' or duration of intercourse. It may relate more to attempts to 'will' a state of sexual resolution which in turn leads to a vicious cycle of anxiety. Many psychological problems, such as work stress, are often intense but of short duration and are easily identified by an individual as the cause of their current sexual difficulty. In such cases the problem is often self correcting and of relatively short duration. Other causes may, for example, be rooted in the development of negative attitudes towards sex, sometimes from childhood. There is also a relationship between anorgasmia and childhood or adult sexual abuse or rape. Marital strife, boredom within a relationship coupled with a monotonous sex life are other known contributory factors. 

Other Causes

The sedative effects of some drugs, including alcohol, are known to impair the orgasmic response. Chronic illness and pain can have a general debilitating effect over many aspects of life including sexuality. It is also known that spinal cord injury, multiple sclerosis, hormone conditions and Diabetes can be implicated. As men age there is a natural slowing down of many physiological processes. Many men are unaffected by this or in fact regard the reduction in their sexual drive as actually beneficial. For others however the changes are a cause of anxiety and may also be wrongly regarded as symptomatic of others ills.

Treatments

In situations where the condition is causing concern, it is normal practice for a physical examination to be conducted and organic causes ruled out before other treatment options are considered. Treatment is likely to be facilitated by a qualified sex counselor or sex therapist. Typically, treatment is based around an educational package which includes homework that addresses the sexual activities and relationship issues identified by the couple in question. Communication training is a key element and the therapist will place emphasis on couples developing playful and/or relaxed interactions and reducing the need to perform sexually and routinely. Graduated assignments lead eventually towards a resumption of sexual activity, but this time underpinned by new insights and greater enjoyment. Success rates for this form of therapy are estimated between 65 to 85 per cent.