No Pleasure In Sex For Man

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Forums > Depression/Mental Health > Male lack of pleasure, orgasm (but erection and ejaculation)

Hello,

I'm a 25 year old male that first began sexual intercourse at age 17 (and masturbation before that, of course).  In any such instances of sexual activity (with or without a partner), I have been able to achieve erection, use that for a while, and then ejaculate.  However, there is no particularly pleasurable sensation to the activity, and definitely no orgasm.  I liken it to shaking hands with my penis - flesh on flesh, but nothing to get excited about.  Sex/masturbation has become an activity performed for one of two reasons:  1.  I have an erection that needs to be satisfied, 2. My partner needs to be satisfied.  In either case, once the erection is present, there is a need to ejaculate that drives me to/through the sexual or masturbatory act, but again, no real "pleasure," either during stimulation or during/after ejaculation.

Of course, I suspect a psychological basis for this, but I'm loathe to expose myself to the stigma of psychological care/diagnosis (and the associated records that will inevitibly be distributed, despite any assurances otherwise).  My questions are thus as follows:

1.  Is this likely to be psychologically based, or is possibly a medical condition?  If so, what is known about this type of thing?
2.  What resources are there for an individual (and perhaps his partner) to be able to work through this on his/their own?  I'm referring to books, primarily.

Thank-you.

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I have a problem with ocd masterbating and deprstion to I am trying to understand and am taking rx for it

i  find  it  good  to  take hrt  and finisteride i find  it  good to  lose interest in  sex,i  just want to be  impotent

i  find  it  good  to  take hrt  and finisteride i find  it  good to  lose interest in  sex,i  just want to be  impotent

Roger Gould, M.D.
Jan 02, 2002

Its most likely psychologically based.  The common dynamics to watch out for is a fear of being out of control, guilt about sexual pleasure, re-igniting half buried memories of traumatic experiences, like over hearing parental sexual intercourse when a young child, or other over-stimulating experiences that would cause you to put up a protective wall.

Regarding books, I can't be of much help, but big bookstores are you best bet.

I wouldn't be so afraid of psychotherapy if I were you. It is a good education in itself, and there is very little stigma these days, half of new york city is in therapy.  It could help a lot.

John C Hagan III, MD, FACS, FAAO Jun 08

John C Hagan III, MD, FACS, FAAO 12/20

John C Hagan III, MD, FACS, FAAO 04/18

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Maria Del Russo is a writer, editor, and consultant specializing in women's issues, relationships, wellness, and beauty. She is currently Branded Content Director for The Newsette. Her first book, Simple Acts of Love, was published by Simon & Schuster under the imprint of Adams Media in 2019. She is currently working on a second book. In the meantime, Maria writes a newsletter, can't relate, about relationships — romantic, friendly, familial, and everything in-between.
Maria's writing has appeared both online and in print, including Elle Magazine, Cosmopolitan, Gossamer, The Cut, The Washington Post, Glamour, InStyle, Elle Magazine, Bustle, Us Weekly, Real Simple, Refinery29, and Playboy, where she wrote the magazine's advice column. She also has contributed editorial content for brands such as Miss Grass, Ro Medical, Avon, and CBD for Life.

As a woman, I have a hard time not blaming myself when my male partner doesn't come during sex. No matter how much I write about sex, or how many experts I speak to, if we're having sex and he can't finish, I spend the rest of the night wondering if there was something I could have done differently. And let me tell you, it's the opposite of sexy.

If you've found yourself in this position, obsessing over the "why," know this: it may be complicated, but this issue is incredibly common. "There's this idea that all a man needs to do to come is to have sex, but that isn't the case," says Megan Stubbs, Ed.D a sexologist and relationship expert. "There has to be a connection between what's happening with their body and their mind, the same way it is for women." So the idea that all men need is a tight, warm space to put their penis? Total myth, it turns out. (Men! They're just like us!)

While most men will experience some sort of inability to orgasm from time to time, there is a more serious condition delayed ejaculation syndrome . This syndrome is defined by an inability to have an orgasm after more than 30 minutes of penetrative sex, despite an erection. It's usually diagnosed after the problem has been happening for six months or more, and it affects one to four percent of men.

Erectile issues often come down to mind games; men are affected much in the same way that women are when it comes to their minds messing with their libidos . "Stress could be a factor, as well as lack of sleep," Stubbs says. Emotions also play a huge role in this. If you and your partner are in a new relationship, that trust level to truly let go may not have been built up yet.

Certain prescription medications can also take the air out of his libido. Daniel Olavarria, LCSW , a therapist in New York City mentions selective serotonin reuptake inhibitors, like Prozac and Lexapro, medications that list sexual dysfunction as a side effect. "This is due to the fact that as the medication is affecting neurotransmitters in your brain, it can inadvertently impact the ones tied to sexual arousal," he says. These medications are improving, and the side effects don't affect everyone, but if your partner pops these pills, that could point to the issue at hand.

Drug and alcohol abuse can also affect your partner's ability to achieve orgasm. "While some may feel that they rely on drugs or alcohol to reduce their inhibitions and their feeling of anxiety around sex, it often has the opposite effect," Olavarria says. "Alcohol, for example, can depress your nervous system, which reduces sensations and negatively affects oxygen flow and blood circulation via dehydration." It can also negatively impact the body's testosterone production, the hormone that's responsible for sex drive.

There is also a buffet of medical issues that can affect your man's ability to get off. "Diabetes, neurological issues, and cardiac conditions affecting blood circulation — like high cholesterol or high blood pressure — are a few examples," Olavarria says, adding that it's important to remember that there might not be just one thing that causes a man to not be able to climax. It can be a combination of factors, many of which are completely normal to experience from time to time.

"Most women can't orgasm every time they have sex, but they still enjoy themselves during sex," Stubbs says. "It's the same thing for men." But if you're noticing it's happening with your partner, don't be afraid to talk about it — in the right way, of course. "The worst thing you could do is be accusatory," Stubbs says. Don't grill them on what's going on. Ask them if they want to talk about it. If they say no, and they say that they're still enjoying themselves, then feel free to proceed as normal.

Try not to put pressure on your partner. Trying to pump until it finally happens can cause issues — from muscle strain to chafing. It may be tempting to play up porn and whisper, "I want you to come" in their ear. "But that might have the opposite effect," Stubbs says. "The pressure to come can take away the ability to come. Just let things play out naturally."

These things tend to come and go, Stubbs says, so the occasional inability to finish is not cause for concern. But if it happens over an extended period of time, you can start to ask some questions. "If he's able to bring himself to orgasm on his own, and not with you, then that's something you guys may need to have a discussion about," she says. If your partner has a masturbation habit that is impeding your sex life (say, if he can only come once a day and he's doing it solo), then you should be able to reach a compromise. But if he's unable to come at all, and it shows no signs of improvement, it may be time for him to talk to a doctor. And that's his conversation to have. Your partner should "seek out the guidance of [their] medical provider or a therapist to begin the process of identifying and resolving the underlying causes," Olavarria says. "The great news is that with the proper support and treatment, [he] can reclaim [his] libido and enjoy sex again."

The most important thing to recognize is that there is a vast universe of what is normal when it comes to sexuality and our bodies — and anyone else experiencing difficulty from time to time has exactly nothing to do with you, your technique, or your efforts. Plus, a fulfilling sexual experience doesn't always include an orgasm for everyone involved; have your fun, and make sure he feels supported, too. If you're both enjoying the act, and no one is chafing, then you're doing A-okay.

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How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!
I’m a straight, 24-year-old male who has never been able to orgasm. I have an otherwise healthy sex life and personal habits. I eat well, regularly exercise, and have even undergone blood testing to confirm that my testosterone levels were in a safe range (they came back somewhat above average). I am able to attain and sustain an erection with no issues (although I sometimes struggle to maintain a solid erection when receiving head or when on bottom), and almost always ejaculate when solo or in partnered sexual encounters. I’m circumcised and there are no physical abnormalities in the shape or size of my genitalia.
It wasn’t until a few years after beginning to masturbate that I realized that my peers were experiencing something quite different than I ever had. The condition is referred to as ejaculatory anhedonia or orgasmic anhedonia in scientific literature, which there isn’t much of, and most of the other cases I’ve heard about involve sudden changes or conditions (i.e., paralysis, severe trauma, antidepressant usage) that don’t apply to me. For me, ejaculation is just an involuntary physical spasm, like a sneeze. I still have sexual urges and desires, and so sex can be a relief in the same way that trail mix after a long hike is, and it’s been the same my whole life. But when I finish, there is no pleasurable, heady, or even stirring sensation. It hasn’t prevented me from developing meaningful romantic connections, but I don’t like having to fake anything or explain why I’m not too vocal. I’ve also heard a lot about how great the sensation is, and I can sometimes feel alienated or dehumanized. I was much more bothered by it when I was younger, including experimenting with men to see if I was just hiding something from myself, but nothing was different. Since then, I’ve learned to live with it, and I haven’t given the issue too much mental real estate recently. Is there anything I can do to make myself orgasm when I ejaculate?
While it sounds like you’re managing this well—and while I’m happy to read that you’re getting some release from sex—I’m sure this is extremely frustrating for you. I imagine that hearing other people talk about the pleasure of orgasms is something like staring into the window of a bakery while being broke and hungry. You don’t need that five-layer red velvet cake, but it sure would be nice. For some expert help, I reached out to my frequent urologist source, Dr. Charles Welliver, professor of surgery at Albany Medical College and an American Urological Association member. In an email, he told me that like many orgasmic/ejaculatory problems, this is a tough one. “There just isn’t good research on these problems and the research done thus far has been unfruitful in improving our understanding,” he wrote.
“An important point to make is that ejaculation and orgasm are different,” he continued. “They usually do go together (and are appropriately grouped) but orgasm is the physical sensation and ejaculation is the physical process of expelling ejaculate. In some conditions, guys don’t have ejaculate (usually prostate surgery) but still have orgasm. His problem does sound orgasm specific as the physical part of ejaculation sounds to be present.”
Welliver said that in the event that he was treating you, he’d ask about general anhedonia—that is, “Does he find pleasure in things other than sex?” Additionally, Welliver wrote that he’d check to make sure you have normal levels of prolactin, “as prolactin and oxytocin are involved with orgasm in men in a way that is not completely understood. … I can’t say I have ever checked an oxytocin level on someone or would even know how to interpret those findings. If his prolactin is abnormal, that can point towards a benign pituitary tumor. This is a long shot and I don’t really suspect an issue but if I were seeing him, I would check a prolactin to be sure. Simple blood test.” Finally, the doctor recommends visiting a sex therapist. “I’m always on the lookout for repressed sexual baggage with something like this,” he wrote.
Additionally, in a 2002 article in the Journal of Sexual and Reproductive Medicine, Dr. Stacy Elliott , a professor at the University of British Columbia, reported that anhedonic ejaculation is, “usually associated with neurological disease (multiple sclerosis and peripheral neuropathy) or, occasionally, psychiatric disorders.” I don’t mean to scare you, and I know it doesn’t get you closer to the sensation you’re looking for, but this, too, perhaps is worth investigating with your doctor, just in case. Additionally, there are notes online from a 2016 presentation on anorgasmia in men that Elliott gave at the Fall Scientific Meeting of the Sexual Medicine Society of North America. (Elliott, unfortunately, did not respond to my interview request.) In addition to checking testosterone, she recommends pelvic-floor awareness (are you doing Kegels ?), and potential psychiatric diagnosis/treatment. Elliott describes several other related orgasm disorders in the notes and various treatments (like vibrators). It’s worth reading through for potential help. I think the most important thing for you right now, though, is to rule out potential causes with your doctor and see a sex therapist for more help. Good luck!
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