The
delay or absence of orgasm following what is typically a normal
sexual excitation phase is not uncommon. As with other sexual
disorders, it can have an onset later in life or have been in
effect for the person's entire life, and it can manifest in specific
situations or in almost all situations.
After a
normal phase of sexual excitement, the man's orgasm is persistently
or repeatedly delayed or absent. The clinician's judgment of
this is based on the man's age and the adequacy of duration,
focus and intensity of sexual activity.
Except for another Sexual Dysfunction.
It is not directly caused by substance use (medication or drug
of abuse) or by a general medical condition.
It causes marked distress or interpersonal problems.
Inability
to achieve orgasm despite adequate sexual desire and arousal
a rare condition in adult males.
Differential
Diagnosis:
Some disorders
have similar or even the same symptoms. The clinician, therefore,
in his/her diagnostic attempt has to differentiate against the
following disorders which need to be ruled out to establish
a precise diagnosis.
Cause:
In
its life long form, Male Orgasmic Disorder is fairly rare. In
its acquired form this dysfunction is not uncommon. The cause
of this dysfunction is rarely physical although it is sometimes
confused with retrograde ejaculation. Retrograde ejaculation is
when the man ejaculates into his bladder instead of out the urethra.
More often than not, the cause is a traumatic sexual experience,
strict religious upbringing, hostility, over control, or lack
of trust.
Treatment:
There
are physical causes and drug related causes which must be differentiated,
and there are psychological causes, the predominance of which
is the anxiety associated with once again experiencing the frustrating
outcome.
Counseling
and Psychotherapy [
See Therapy Section]:
It is important to seek a complete psychological and physical
evaluation since there are a number of causes that may have this
as a symptom and not be the core cause of the problem. Most communities
have specialists in the area of sexual dysfunction and/or have
university programs that deal with the problem.
