FAQs on types, causes, treatment and more

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An orgasm represents the wonderful culmination of 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 some scenarios, but not all. If you have trouble finishing things in the bedroom, you may be suffering from anorgasmia.

Anorgasmia, or Coughlan’s syndrome, is the inability to have an orgasm, or to have unsatisfactory or painful orgasms. Some experts expand the definition to also include delayed orgasms, when it takes longer than usual to reach orgasm. Anorgasmia can be a major hurdle for anyone who enjoys sex, as people often view orgasm as a key part of their sexual satisfaction, says pelvic floor physical therapist Uchenna Ossai. Of course, orgasms shouldn’t be the only purpose of a sexual experience, but it can make sex even more fun to be able to have them.

Male orgasm occurs through a mixture of testosterone, arousal, and muscle contractions of the penis and its surrounding area. If something psychological or physical gets in the way of this process, it can trigger anorgasmia or delayed orgasm, which is estimated to occur in 8% of men, according to VeryGoodHealth. (FYI, anorgasmia is not the same as erectile dysfunction, which is difficulty getting or keeping an erection.)

Anorgasmia doesn’t mean your sex life is over, says Ossai. An orgasm isn’t the only good part of a sex session; it’s simply a side effect of an overall pleasant experience.

Want to know more about anorgasmia in? Read on to find out the symptoms, treatment, and more.

What are the types of anorgasmia?

There are two types of anorgasmia, says Ossai: primary anorgasmia and secondary anorgasmia.

Primary anorgasmia

Primary anorgasmia occurs when you are unable to have an orgasm (or a satisfying orgasm) in any sexual situation, and is usually a condition that lasts from puberty.

Secondary anorgasmia (also called situational anorgasmia)

Secondary anorgasmia occurs when you have difficulty orgasming in certain sexual situations: for example, only during partnered sex, but not during masturbation. Secondary anorgasmia also refers to people who lose the ability to have an orgasm later in life, compared to people who were never able to.

Regardless of the type of anorgasmia you suffer from, the condition is worth looking into if you feel that sex is no longer pleasurable.

What are the causes of anorgasmia in men?

There are two main causes of anorgasmia in men: physical causes and psychological causes. “The lack of an orgasm means there are other games going on that you’re competing against,” Ossai says.

Physical causes of anorgasmia can include:

  • Medication
  • Wound
  • Pelvic floor dysfunction
  • Underlying disease

    Ossai’s first question for a patient with anorgasmia is, “What medicine are you taking?” Some medications, such as SSRIs, have anorgasmia as a possible side effect. Your doctor may be able to change your medication dosage or switch you to an entirely different medication that can relieve your anorgasmia.

    Anorgasmia may also be associated with your underlying condition, Ossai says. Diabetes and certain cardiovascular diseases, for example, can impact a person’s ability to reach their peak.

    A recent injury can also promote 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 isn’t really coordinated, it can actually make it difficult for people to have pleasurable and satisfying sex or orgasms,” Ossai says.

    Psychological causes of anorgasmia can include:

        Performance anxiety is a common contributing factor to anorgasmia, Ossai says. The tricky thing is that the more obsessed you are with whether or not you can orgasm, the harder it will be to achieve orgasm.

        “I tell people all the time that it’s almost like chasing after a dog,” Ossai says. “The more you chase – and if you’re wondering – that dog is going to run faster because they think it’s a game.”

        Your anorgasmia may also be related to stress (at work, family, relationships, finances, etc.) or another mental health issue that warrants seeing a therapist.

        Anorgasmia can also be linked to past trauma, an underlying source of stress that can make sex uncomfortable, painful, or emotionally charged. If your anorgasmia seems sudden or you’re having trouble having sex after a traumatic experience, consider talking to a therapist or other professional.

        What does the treatment for anorgasmia look like?

        Depending on the reason for your anorgasmia, Ossai says treatment will vary.

        At-home treatment can mean pelvic floor exercises, or what Ossai calls “directed masturbation and mindfulness,” which means paying close attention to your body and what feels good during play in solo. Relax any tight muscles and try a new position. For example, if you masturbate standing up in the shower, Ossai suggests trying lying down instead to relax your pelvic floor and improve blood flow to the penis. Or if you squeeze your buttocks during sex, try not to.

        Penis owners who orgasm during vaginal intercourse typically take 5-6 minutes to climax, according to The Journal of Sexual Medicine. But Ossai says you shouldn’t time yourself by what others report; whether it takes you 10 minutes or an hour, focus on making every sexual session a pleasurable experience for you.

        “I always say don’t put a time limit on orgasms,” she says. “Always focus on the sexual experience itself, and the orgasm will come when it wants.”

        And if you’re considering taking Viagra to fix the problem, don’t bother. According to VeryWellHealth, Viagra (and its generic name Sildenafil) helps improve blood flow to the penis so you can get and maintain an erection. However, this will not help you reach an orgasm.

        Since anorgasmia can be linked to serious underlying health conditions, it’s always a good idea to talk to your doctor when you notice something is wrong.

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