Anorgasmia is the inability to have an orgasm or when it is extremely difficult to have an orgasm.
An orgasm is different than when a man ejaculates. Ejaculation is when the semen comes out of the penis. Orgasm is the pleasurable sensation that the man experiences. They usually occur at the same time. But a man can have an ejaculation without an orgasm and he can have an orgasm without an ejaculation.
Men who have had prostate surgery often become unable to ejaculate. This is usually because the prostate is removed and the amount of semen produced is dramatically reduced. It can also be because when a man ejaculates the semen goes back into his bladder instead of coming out of his penis. When this occurs this is called retrograde ejaculation.
Prostate surgery, procedures and radiation therapy can also make it more difficult for a man to reach his climax or have an orgasm. This is sometimes a result of damage to the nerves supplying the penal.
Many other factors can make it difficult or impossible for a man to experience the pleasurable sensation of his orgasm. These include many medicines, including, antidepressants (amitriptyline, desipramine, doxepin, imipramine, maprotiline, nortriptyline, protriptyline, clomipramine, fluoxetine, paroxetine & venlafaxine), alpha blockers (prazosin, terazosin & labetalol), sympathetic nerve blockers like guanethidine, anti- ulcer medications like cimetidine, MAO inhibitors like isocarboxazid, phenelzine & tranylcypromine, neuroleptic drugs like haloperidol, thiothixene, perphenazine, trifluoperazine & resperidone, and mood stabilizers like topiramate.
Many of these medications not only make it difficult or impossible for a man to experience an orgasm, they greatly reduce the amount of fluid that comes out when it does ejaculate. Some men find that the reduced amount of semen means that their orgasm is less intense or pleasurable.
Sometimes a man's low testosterone level plays a part in his or her ability to have an orgasm.
Other factors that may inhibit orgasm are the use of alcohol, marijuana, cocaine, opioids, amphetamines and ecstasy.
Psychological factors such as gender identity and sexual orientation confusion, history of trauma, rape or sexual abuse may cause anorgasmia. Men who have been taught that masturbation is bad for them sometimes have a difficult time ejaculating. Men who are overly concerned about getting a woman pregnant are sometimes unable to ejaculate. Men with psychological or emotional issues that prevent or interfere with ejaculation can usually benefit from counseling.
Most men masturbate. Masturbation, for the most part is healthy for a man and his penis. Some men masturbate multiple times every day. As long as a man who masturbates several times a day can still ejaculate when he wants to, there is no problem. Some men however, have a difficult time ejaculating more than once a day. These men, may find that they have an easier time having an orgasm and ejaculating if they leave a few days between each ejaculation.
Some severe medical illnesses have been shown to inhibit the male orgasm, including diabetes, high blood pressure and pain syndromes.
There are no FDA approved drugs specifically approved to treat anorgasmia or inhibited male orgasm.
The approach to achieving a man's ability to have an orgasm is multi-factorial and includes the following:
eliminate medication causes
Eliminate drug use causes
It is much easier to treat a man for erectile dysfunction than it is to help him have an orgasm. That said, we have seen some encouraging results with nasal oxytocin spray. This spray needs to be used during intercourse just before a man would normally expect having an orgasm. Some of the possible side effects of nasal oxytocin are difficulty urinating, tightness in the chest, irregular heartbeat, difficulty breathing, confusion, swelling, seizures, rash, headache, nausea, vomiting, loss of appetite, allergic reactions, high blood pressure and subarachnoid hemorrhage.
The use of nasal oxytocin spray during intercourse might seem odd or inconvenient, but for those men that oxytocin can have an orgasm, it is well worth it.