Close menu. Because there are so many possible reasons for an inability to reach orgasm, this condition sometimes can present challenges in regards to diagnosing a cause. For men with ED, doctors can prescribe any of several effective medications. Is it situational, or does it happen every time? We come crashing into more dumb stereotypes here; yes, guys do have feelings. So don’t penetrate the minute you get hard. But I’ve treated many men who had difficulty ejaculating where it turned out the main thing they needed was to know it’s okay to be a bit rougher in bed. These are often associated with ejaculation problems, but not always. He’s been sexually abused in the past. Good. But make sure you have a back-up plan, just in case. Usually, when an orgasm happens, the semen produced is squirted out of the penis (ejaculation). Some people need focused stimulation, where they can pay attention to receiving without simultaneously worrying about pleasuring their partners. Male anorgasmia can be frustrating, embarrassing, and distressing for a man at any age or stage of life, as well as for his spouse or sexual partner. But the four rules above are a good place to start. If you’d like more advice on how to nurture your own genuine arousal — and how to enjoy it for life with someone you love — check out my book, Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship (St Martin’s Press, 2018). So do men’s. But most women’s thresholds are somewhat higher. You can also use masturbation to help out in the moment with a partner, by masturbating and getting yourself close to orgasm before getting it on. The causes can be physical or psychological. It’s natural to want to orgasm, but so many of us tend to forget that pleasure is not only the pathway to orgasm, but the reason why orgasm feels so great in the first place. Here are some recent ones, along with the answers: Sex & Relationship Therapist: Stephen Snyder, MD, New York, NY, Is TeleHealth Sex & Relationship Therapy Effective? We’re all familiar with the “death grip” by this point, right? If you’re like most men I see who have difficulty ejaculating, your partner will probably be thrilled that you trusted them enough to “really let go.”. Biologically speaking, an orgasm is simply a reflex.That’s true no matter which gender you are. So now let’s get to the nuts and bolts. Some men with delayed ejaculation are unable to ejaculate at all.Delayed ejaculation can be temporary or a lifelong problem. Click here to browse! One important reason men with high orgasm thresholds have difficulty ejaculating during intercourse is that they hurry to penetrate before they’re really ready. The more you can pay attention to pleasure, the more enjoyable your sexual experiences will be, and the more likely you’ll be to orgasm. Oftentimes, all that men (and women, for that matter) need to reach orgasm is some additional stimulation. Sensory inputs get processed by the central nervous system. Use lube—it can greatly heighten sensation. There are at least 8 ways for men with premature ejaculation to last longer in bed, including both traditional work-arounds and sex therapy techniques. Sometimes it’s because he’s doing something he knows he shouldn’t, like cheating on his partner. Sometimes his partner may even be mocking him or upset with him for having a hard time reaching orgasm. If in doubt, check with your partner of course — since people’s tastes do vary. Assuming you have a good, trusting relationship with your partner, chances are they won’t mind if you focus entirely on your own arousal for a bit. It’s OK for you to want and need foreplay, focused or other specific types of stimulation. Like their female counterparts, they can’t get off unless they’re seriously aroused. Having a high orgasm threshold has certain advantages. Depression (yes, both depression and anti-depressants can make it harder for you to orgasm). If you can start listening to it, you can get back on the same page. (Another stereotype is that men are never the victims of sexual abuse. Don’t bother looking for advice about difficulty ejaculating on the internet, or on Amazon. Accordingly, the most common clinical situation in sex therapy with men who have difficulty ejaculating is that they can’t ejaculate during intercourse. The main symptom of orgasmic dysfunction is the inability to achieve sexual climax. That’s just not true.). Sure, it’s nice to ejaculate during intercourse. But there are lots of men with high thresholds too. Like most things in life, intercourse just doesn’t deliver the same thrill on the hundredth thrust as it did on the first. Have you struggled with orgasm for your entire life, or have there been recent changes? In sex therapy, it can be important to consider his masturbation habits, his age, his neuro-psychological wiring, and any medications he might be taking. If you’re a young, healthy man, you can be plenty hard during sex and still be focused on lots of other things and not be that into it. Anti-depressants and anti-anxiety medications are the most frequent culprits, but anti-psychotics, high blood pressure medications, beta-blockers, and pain relievers can all make it harder to orgasm. And your pleasure is just as important as your partner’s—remind yourself of that in the moment. Sure, intercourse can be exciting. That way, it won’t be such a big jump to get to 80 before intercourse gets boring. Sometimes this is religious or moral guilt. But most heterosexual couples don’t feel quite right unless intercourse is somewhere on the menu. Alcohol, amphetamines and cocaine can all make it much more difficult to reach orgasm in the moment, and long-term usage can lead to long-term problems. It’s a good idea to book an appointment with your doctor to talk about potential medical factors. Reading an article like this is no substitute for an office consultation. Medications and medical conditions can make it harder or impossible to reach orgasm. Nothing evokes panic about keeping up with the Joneses quite like sexual frequency. In my sex therapy office, I encourage couples to give a man who has difficulty ejaculating the same consideration. Prescription drugs. And no, you don’t have to be neurotic to suffer from this problem. There are a good number of men who can orgasm just fine on their own, but have a hard time getting there with a partner. When I’m working with a client in my practice, we do a lot of digging to try to get at the root of what’s going on for that particular dude. Some men are overly focused on their partners, and not very much on themselves. If you’re suffering from a sexual problem, it’s crucially important that you see someone who understands the difference between a sex therapist and a “regular therapist.”. TeleHealth sex therapy & TeleHealth couples therapy can be the 21st Century version of the "house call." Try a sex toy. But after being a perfect gentlemen, most men with this condition have difficulty ejaculating. most guys who have difficulty ejaculaing), then just going through the motions isn’t going work. If your sex life includes penetration on your part, lube will also make things more comfortable for your partner, and allow the two of you to go for longer. Don’t bother asking your doctor or our therapist either. But here are the basics — what I typically recommend for men whom I see in the office: Remember, genuine arousal is a state of mind. If arousal reaches a particular level — what we call your “orgasm threshold” — then the reflex happens. But your orgasm threshold is up around an 80 (i.e. And if he wants one after you both feel intercourse has gone on long enough, for heaven’s sake let him pull out and give himself one with his own hand. If you use the death grip, it can be a lot harder to orgasm if you don’t have that level of intensity. Vanessa Marin is a sex therapist who helps people have way more fun in the bedroom. You won’t find anything useful in either place. Read more information from the Sexual Advice Association on what to do if you have ejaculation problems. A modern man with a high orgasm threshold should expect the same consideration most modern women get under the same circumstances. Your body is full of reflexes:  The knee-jerk reflex, the gag reflex, the cough reflex, the sneeze reflex — they all basically work the same way. But now that you’re fully hot and bothered, this is not the time to act like a gentleman. Most women and men with high orgasm thresholds eventually figure out on their own how to get aroused enough to climax. The reality is that difficulty ejaculating is rather common. But they often have trouble doing it in bed when someone else is present. They have to be seriously aroused in order to reach orgasm. Your body needs something to respond to; it’s not just going to orgasm out of nowhere. Finding a good sex therapist isn’t easy. Accordingly, the most common clinical situation in sex therapy with men who have difficulty ejaculating is that they can’t ejaculate during intercourse. Most straight couples put a lot of emphasis on penetrative sex. It’s usually not that hard to treat,  once you know how. You’ll most likely expend lots of effort trying to keep your arousal very low, in order not to ejaculate immediately once lovemaking gets started.