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Primary Anorgasmia, over forty years so far
Meriwolf posted:
I'm over 50 and never yet experienced orgasm. I have no problem achieving erection or ejaculation, but orgasm doesn't happen. The head of my penis becomes painfully sensitive at ejaculation, making it unbearable to continue with any kind of stimulation. The situation was more or less tolerable as long as I had a sex life, as I find sex pleasant and mildly satisfying. But my wife's total hysterectomy ended her interest in sex (in all affection, really) and totally killed our sex life.
Frustrated with unsatisfying masturbation, I talked to my doctor. Focusing on the wrong part of the problem, he suggested fluoxetine (generic Prozac) to delay ejaculation. It seems to me that fluoxetine is next to castration. Severe crash in libido. So I quit that and consulted an endocrinologist who specializes in sexual function.

The endocrinologist pulled out his orchidometer and diagnosed hypogonadism, confirmed by blood tests. Completely surprised me, as all my secondary sexual characteristics seem normal. Only the male pattern baldness shown by my father and grandfathers is behind schedule. The endocrinologist prescribed Testim (topical testosterone gel). He also suggested experimenting with Levitra. Levitra's very good at what it does, but doesn't address my problem. Subsequently he had me try intermittent clomipramine to delay ejaculation. It does that way too effectively -- by a couple of days -- and is also nauseating and sedating. Even a half dose sickens me. Other people must get along better with it, especially those who report spontaneous orgasm. Most recently he suggested Yohimbine HCl, an over-the-counter nutritional supplement. It does nothing at all that I can detect despite the doctor's published papers. Likewise for Actataine (brand of lidocaine-based spray desensitizer), which I tried on my own initiative.

After six months at the current dose of Testim my testosterone level is normal but my sexual response is unchanged. There's no way to know if I could have used hormone supplements at puberty forty years ago, if my levels declined in recent years, if I need years of supplementation, or if none of this treatment makes a difference. My frustration and anxiety are rising. When I was a virgin, I pinned my hopes on intercourse. When that didn't work, I hoped that time and experience would help. Time has passed and my experience is fading into the past. Not only can't I reach orgasm, I'm losing hope of any improvement.

Web sites touting cures lean heavily toward hypnosis (I'm skeptical) and testosterone (I'm already on it). Any advice will be greatly appreciated.
Meriwolf responded:
After reading and searching more, maybe the better term for my condition is ejaculatory anhedonia or anesthetic ejaculation, as some sources use anorgasmia (in men) to describe an inability to ejaculate. Incredibly frustrating, whatever you call it.
GuardSquealer replied to Meriwolf's response:
Wow seems that you have a rather unusual condition. I have nothing to offer, sorry for that. I hope that someone does.
Meriwolf replied to GuardSquealer's response:
After much more searching, I found an active discussion at I'm skimming through the postings there, but without high hopes. I haven't yet found anyone with a life-long case, many who claim to be cured tried many different therapies so it's not clear what worked, and some posters are pretty clearly shills for various nutritional supplements. So it's not like there's a clear path forward.
Jeremy3456 responded:
I would say your condition is pretty rare, whatever it is. Possibly some of your nerves that promote orgasm didn't develop as a result of hypogonadism, but I don't know. How often and under what circumstances do you ejaculate? Do you get "horny" in the usual sense? Is it relieved by ejaculation?
Meriwolf replied to Jeremy3456's response:
Ejaculation has never been difficult, either in masturbation or intercourse. Ejaculation in intercourse has mostly been premature, misleading me to equate premature ejaculation with the lack of sensation. But delaying ejaculation doesn't change the sensation. I've tried masturbating repeatedly in the same day and also taking clomipramine. There's no improvement in sensation, nothing resembling an orgasm, even when it takes 25 minutes to reach ejaculation.

Yes, my libido seems normal and the urge toward sexual activity is reduced -- but not really satisfied -- by ejaculation. You cannot imagine how frustrating this is.

While continuing with hormone therapy, I'm also going to consult a sex therapist. First meeting is this week.

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