“I've always had trouble having an orgasm, but my latest partner does too, and it's the first time I've come across this in a man. We just end up stopping before anyone climaxes. Any advice on how to resolve this?”
To see Dr. Glickman's answer, read more.
While we hear a lot more about women having this concern, it’s estimated that somewhere between 1 and 10 million men do too. There can be many different reasons, including medications, health issues, psychological factors, or specific circumstances.
The first thing that I’d ask is whether this is a new issue for him or not. If it’s something he’s been dealing with for a while, can he identify when it started? Does he have health issues that might affect things? Some of the health issues that can cause this are:
- Hypogonadism (when the testicles don’t produce enough testosterone)
- Thyroid disorders
- Pituitary conditions
- Surgery affecting the prostate and other pelvic organs
- Diseases of the penis
- Substance abuse, including alcohol
- Certain medications such as high blood pressure meds, beta blockers, and antidepressants
Unfortunately, doctors often neglect to tell their clients when their medications or their health issues can affect sexual response or orgasm. And since many men feel embarrassment around this concern, they may be unwilling to talk to their docs. But it’s a good place to start because there may be an easy solution.
On the other hand, there may be a psychological issue at play here. Depression, anxiety, low self-esteem, long-term stress, a history as a survivor of sexual abuse, fears around sexually transmitted infections or pregnancy, or any number of other factors can have this effect. Of course, I can’t make either a medical or a mental health diagnosis, so I definitely suggest that he get checked out to see if he can find out what’s going on. To find a therapist, check out the listings on the American Association of Sexuality Educators, Counselors and Therapists website.
I’d also want to know if this is something that happens every time that the two of you have sex. Did it happen with his previous partners? Does it happen if he masturbates? Or if the two of you have different types of sex, such as oral sex? If it happens in some situations and not others, that could give you some important information. If it turns out that he simply needs something different to offer the sorts of stimulation he needs, you could try some different positions, fantasy play, or toys. There are plenty of books with lots of helpful tips. It won’t necessarily address a medical issue or a deeper emotional concern, but experimenting with different ways to have sex can definitely be a lot of fun!
Whatever the root of the situation is, I hope that both of you find ways to have the pleasure and joy that you deserve.