From the Guidelines
Ejaculation without feeling is called anorgasmia or ejaculatory anhedonia. This condition occurs when a man can physically ejaculate but doesn't experience the pleasurable sensation typically associated with orgasm. It can be caused by psychological factors like stress, depression, or anxiety, or physical issues such as nerve damage, hormonal imbalances, or medication side effects, as noted in the guidelines for disorders of ejaculation 1, 2, 3, 4.
Key Points to Consider
- Common medications that may cause this include certain antidepressants (particularly SSRIs like fluoxetine or sertraline), antipsychotics, and some blood pressure medications.
- Treatment depends on the underlying cause and might include adjusting medications, psychological counseling, or treating any medical conditions.
- If experiencing this symptom, it's essential to consult with a healthcare provider, as they can help determine the cause and recommend appropriate treatment, as emphasized in the guidelines for managing disorders of ejaculation 1.
Diagnosis and Treatment
The diagnosis of anorgasmia or ejaculatory anhedonia involves a comprehensive evaluation of the patient's medical and psychological history, as well as a physical examination, as outlined in the AUA/SMSNA guideline for disorders of ejaculation 2.
- The guideline defines delayed ejaculation as a condition where a man experiences difficulty achieving sexual climax, which can be caused by various factors, including psychological and physical issues 3.
- Lifelong delayed ejaculation is defined as a lifelong, consistent, bothersome inability to achieve ejaculation, or excessive latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate, as stated in the guideline 4.
Importance of Seeking Medical Attention
This condition can significantly impact sexual satisfaction and relationships, but with proper diagnosis and treatment, many men can find relief. Therefore, it is crucial for individuals experiencing ejaculation without feeling to seek medical attention to address any underlying issues and improve their quality of life, as highlighted in the guidelines for disorders of ejaculation 1, 2, 3, 4.
From the Research
Definition and Classification
- Ejaculation without feeling is referred to as anejaculation or anorgasmia, which is defined as the persistent or frequent absence of orgasm after a normal phase of sexual arousal 5.
- Delayed ejaculation is considered a minor form of anorgasmia, and it is characterized by the delay or absence of orgasm that results in personal distress 6.
- Ejaculatory dysfunction covers a broad range of disorders, including premature ejaculation, delayed ejaculation, unsatisfactory sensation of ejaculation, and absent ejaculate 7.
Types of Ejaculatory Disorders
- Premature ejaculation is the most common sexual dysfunction among young men, and it is often considered psychogenic in origin 8.
- Retrograde ejaculation and anejaculation are predominantly related to organic causes, particularly neurogenic ones 8.
- Delayed ejaculation can be caused by various factors, including psychological, neurological, and drug-related factors 5, 6.
Diagnosis and Management
- The diagnosis of anorgasmia is essentially based on clinical interview, and a psychological assessment should be proposed for patients with anorgasmia with no organic risk factor 5.
- Management strategies for delayed ejaculation include psychological and sexual therapy, pharmacotherapy, and penile vibratory stimulation 6.
- There are different treatment options reported for ejaculatory disorders, all with limited evidence supporting their efficacy, and identifying the etiology of the disorder is important to appropriately target therapy 6, 9.