Many men visit urology clinics complaining that while they can achieve an erection, engage in intercourse, and ejaculate, the sensation of climax is almost entirely gone. They describe the intimate process as smooth but feeling like "just going through the motions", leading to confusion and worry about potential weakness or serious illness.
Dr. Tra Anh Duy, a Level II Specialist Doctor at Men's Health Center, explains that medically, this phenomenon is termed male orgasmic disorder or ejaculation with reduced pleasure. Simply put, the ejaculation reflex remains active, but the brain and central nervous system no longer "activate" the sensation of pleasure as before.
According to Dr. Duy, male sexual response involves stages of desire, arousal, orgasm, and resolution. Ejaculation often coincides with orgasm, but they are distinct mechanisms. Ejaculation is a reflex controlled by the autonomic nervous system, while orgasm is a pleasure experience in the brain involving neurotransmitters like dopamine, serotonin, and oxytocin. A review study in the *Journal of Sexual Medicine* indicates that about 1% to 4% of men have experienced orgasmic disorder.
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Dr. Duy consults a patient. *Photo: Lam Anh* |
A common cause is nerve damage from diabetes. Poorly controlled blood sugar over time can degrade nerves that transmit sensations from the genital area to the brain, interrupting pleasure signals. Approximately 35% to 50% of men with diabetes experience ejaculatory or orgasmic disorders.
Additionally, medication side effects, especially from SSRI antidepressants, can reduce the ability to achieve orgasm. Certain antipsychotics, blood pressure medications, antiepileptics, or prolonged opioid pain relievers can also have similar effects.
Psychological factors also play a significant role. Work pressure, marital conflicts, body image insecurity, or prolonged stress can prevent the brain from reaching a relaxed state necessary for orgasm, even if physiological reflexes occur. This condition may also link to testosterone deficiency, increased prolactin, sequelae from pelvic or prostate surgery, alcohol and stimulant abuse, or excessive consumption of pornographic content, which can desensitize the brain to stimulation.
Dr. Duy advises men to seek consultation from a urologist or a sex psychology specialist if experiencing ejaculation without orgasm for over three months, especially if accompanied by genital numbness, erectile dysfunction, or if they are currently taking medication for an underlying condition. Through examination and hormone or blood sugar tests, doctors can identify the cause and recommend appropriate treatment to improve the condition.
Le Phuong
