Known Causes of Anorgasmia

[Stew52]

Thanks for your empathy, brickbat. However, the greatest part of my despair about my anorgasmia is not being able to orgasm and ejaculate WITH MY WIFE. Your post only dealt with masturbation. That doesn't address the failure to launch with a partner. BTW, please add a signature to your posts so that we can all be more helpful to you and know the basics about your penile status from ED through post implantation.

Barry, that list of "fixes" way above was a fine list and I've tried much of it and have similar stats (teststerone 550 and prolactin fine) but it's been 3 years now without a vaginal orgasm. BUT no implant. Just ED and increasing DE/anorgasmia.

I used to really admire stories of Sting for his tantric prolonged sex performance, and I have now attained that without even trying!! I can go for hours - save the monomix or trimix wearing off - but clearly the wife can't. Maybe 45-60 minutes or so and she's toast and I'm actually sore. One guy here says we were "not designed" for that rigor, the nerves numb, the skin frays. I'm thinking of cavemen, and rival tribes and suitors, and self-protection. Sex is not the most defensible position, so we had to get off quickly and grab our spear. Long languorous sex was dangerous.

One difference, while we have great sex and wife is sexy and wet as hell, and I just cant get off inside, but I CAN get off in 4-15 minutes afterwards most of the time. Which leads me to this. I have asked before here, without answer, could it be that something in the texture of the older woman's vagina not being as tight, tubular, muscular and defined, but "sloughy", that is a contributor at least. It's not blame, were in this together, but stuff physically changes, look at the content of this website. The good news is that she is good with all this and quite content sexually, but as you say it would be so nice to "come together".

[October26]

For whatever it's worth, I'll contribute my knowledge and experience about difficulty/inability to orgasm.

Please add to this list any substance or factor that you know of that interferes with your ability to orgasm, or the quality of your orgasms.

Please add anything you know about the loss of penile sensitivity:

1. Any substance that reduces pain will tend to reduce pleasurable sensations as well, since pain and pleasure sensations involve the use some of the same neurotransmitters in the brain. These substance will likely reduce the quality of your orgasms as well as reduce your ability to orgasm:
1.a. Opiods and Synthetic Opiods. (I'm a chronic pain sufferer, have been on pain management narcotics for 12 years due to osteoarthritis. Eventually, I got used to the effects of the narcotics. They cause some decrease in the quality of and/or my ability to orgasm, but not so much as they did when I first started taking them. However, that last statement is not true with higher doses than I now take. Higher doses will completely prevent my orgasms from occurring. The physical feelings leading up to orgasm are completely absent. I am generally numb all over.)
1.b. NSAIDs. If I don't take an NSAID the day before or on the day my wife and I have sex, I am more likely have a good orgasm. This statement includes: Aspirin, Celebrex, Ibuprofen (Motrin, Advil), Diclofenac (Voltaren), and others.
1.c. Alcohol. Its initial ingestion reduces pain. I know from experience that in large amounts, it reduces all sensations.
1.d. Nicotine. It is well documented that nicotine reduces pain. Does this reduce pleasurable sensations, too? Probably. I haven't used tobacco in decades so I can't speak from experience about nicotine interfering with orgasms. Nicotine does reduce blood flow to the penis. Draw your own conclusions.
1.e. Amphetamines. Small amounts, like those found in normal Adderall prescriptions, seem to enhance our sexual experiences. (My wife and I, both.) But slightly higher doses seem to reduce pain and inhibit orgasmic pleasure, possibly to the point that I can't orgasm. I'm not quite sure about this because the effect is subtle. But, oddly, at slightly higher doses, our sexual pleasure is markedly increased and sexual desire lasts for hours, even if I can't climax.
1.f. Flomax. This drug is used to treat male difficulty in urination because of BPH. It significantly reduces the feelings associated with an impending orgasm, and in some cases, the desire to have sex at all. I do not take it on the nights before we have sex the next day. Its sexual side effects are well documented: https://www.healthline.com/health/enlarged-prostate/flomax-side-effects#side-effects
1.g. Trimix. The pain from prostaglandin is the problem. It can be so intense that I can't tell if I can have an orgasm or not. That being said, if I can keep my injection to the minimum dose that will produce a hard and long lasting erection, Trimix is not a terrible problem but it is damn aggravating and an interference.
1.h. Gabapentin. A drug to treat neuropathy, it reduces nerve pain. https://americanaddictioncenters.org/neurontin-abuse/gabapentin-lyrica
1.i. Lyrica. A drug to treat neuropathy, it reduces nerve pain. https://americanaddictioncenters.org/neurontin-abuse/gabapentin-lyrica
2. Age. It is well documented that male and female sex organ sensitivity declines with age, no matter if hormone replacement therapy is being used.
4. Poor quality/insufficient sleep and rest.
5. Hunger.
6. Having frequent sex. I am very familiar with this one, all my life. It seems my sexual appetite has always been bigger than ability to consume. Penile injections have aggravated this because my wife and I now have sex very frequently. Our love making is so wonderful that we don't care (a lot). However, there's a price to be paid for this. The price is that our brains become soaked with the "happy" neurotransmitters (endorphins, oxytocin, dopamine, serotonin). Staying in that condition for days or weeks reduces the number of neuroreceptors because the brain thinks they aren't necessary. It can take some time (days, weeks, months) for the rebalancing of the ratio of transmitters to receptors to occur. The brain has to create more neuroreceptors and that can take time.
7. The Male Refractory Period. It varies from minutes to days. https://atlasbiomed.com/blog/whats-going-on-with-hormones-and-neurotransmitters-during-sex/. This is mostly about the "happy" neurotransmitters (endorphins, oxytocin, dopamine, serotonin). With regard to sex, the male brain works differently than the female brain.
8. The longer we make love, the harder it is for us to orgasm. Both of us get slightly numb. I never had this problem until we started making love for hours (Trimix). Our sex organs, especially the penis, were never designed to be used like this.
9. Leaving cock rings on too long or having them too tight. Either one will slowly make my glans numb. This lack of penile sensitivity interferes with my ability to orgasm.
10. Dehydration. Too little water in your body? Less water for your penis, diminished results for inflation of the penis in an erection. Less inflation, less sensitivity. Also, semen is primarily water. If you want more semen, stay hydrated.

Items 6 and 7 in this list are closely intertwined.

I know this is an old thread, but I wanted to add that before I had my implant, I had this problem too. My uro prescribed Cabergoline and the supplement Yohimbe. Problem solved for me. Good luck!