Sorry for the Delay:
Anorgasmia in Men
It can sometimes feel like men have a lot to worry about in the bedroom. First and foremost, there’s the matter of achieving and maintaining an erection firm enough for sex. Erectile Dysfunction (ED) affects anywhere from 5 to over 50 percent of men and represents a major psychological stressor for those who experience it. But for the lucky men for whom that part of the love-making process is a fait accompli, there are a handful of other pressures to consider.
Performance anxiety, for example, comes in many forms. Often, it’s a feeling of worry around an inability to sexually please their partner via the aforementioned erectile dysfunction or premature ejaculation. These topics are thankfully becoming more mainstream, with effective treatments for the former and some promising research being conducted on the latter. And yet, there is another sexual performance issue that is rarely talked about that can prove just as stressful and embarrassing.
Anorgasmia (also known as delayed orgasm or DO) is a condition where men have persistent difficulty in achieving an orgasm. Usually it takes two forms: an orgasm that is severely delayed even with what would otherwise be sufficient stimulation; or the complete absence of an orgasm. No matter how you slice it, anorgasmia, like other sexual performance issues, can cause a lot of mental hardship on both the person experiencing it and their partner.
Delayed Orgasm Defined
When it comes to delayed orgasms, it’s not always clear what constitutes how long is too long. Some men — arguably many men (and their partners) — probably wouldn’t mind a bit of a delay when it comes to orgasms. There is however a baseline for time to ejaculation. A 2004 multinational study found the average time from penetration to ejaculation in sex with a man and woman to be 5 minutes and 24 seconds.
The definition to qualify for a Delayed Orgasm (DO) diagnosis is, generally speaking, the inability to achieve an orgasm after 22 minutes of intercourse — and the patient considering this to be a problem, due to physical or mental discomfort. The most important factor though is the perception that the delay is an issue. After all, it is possible for men to enjoy sex without achieving orgasm.
DO Prevalence
A 2015 updated paper examining the causes and prevalence of DO examined several studies that each made reference to the disorder. The author of the paper acknowledges that since delayed orgasm is such an uncommon complaint, it may be hard to truly know how many men experience it.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5) states that only 25 percent of men regularly achieve an orgasm in all sexual encounters. The Manual goes on to state that this already low number begins to decline even further once men pass the age of 50.
Causes of DO
As with most sexual performance issues, there is an important psychological aspect at play when it comes to DO. More often than not, it can be a mix of both psychological and physiological — and sometimes is purely psychological. Though the root cause of DO is not always clear, these are the main causes based on existing research.
- Testosterone deficiency
- Hypothyroidism
- Hyperprolactinemia
- Antidepressants (SSRIs)
- Antipsychotics
- Opioids
- Psychosexual disorders
- Hyperstimulation
- Penile sensation loss
Treatment Options
As more research on DO is conducted, we are slowly gaining a better understanding of how to treat it. Simple lifestyle changes like a healthier diet and more physical activity have shown promise in coping with other men’s sexual performance issues like erectile dysfunction — so it’s never a bad idea to consider making those kinds of adjustments. For DO specifically, Harvard Health Publishing outlines several options to consider:
- Sexual therapy
- Testosterone therapy
- Lower dosage of or switching antidepressants
- Try new sexual positions
- Penile vibratory stimulation
Open the discussion
It’s no doubt that men already had enough to worry about in the bedroom without considering that an orgasm may take too long instead of happening too quickly. But whether it’s erectile dysfunction, premature ejaculation, delayed orgasm, performance anxiety or any other sexual discomfort you might be feeling, it’s important for men to begin openly and honestly discussing their experiences.
If you’re experiencing sexual performance issues, talk to your doctor to explore what your options are. And no matter what, everyone needs to do their part to build a society where everyone feels comfortable talking about their sexual health. It starts with you.
