I’m a male, 34 years old and in health issues

Patient: I’m a male, 34 years old and in health issues. Eat reasonably well and exercise Going out with my girlfriend for four months now. The problem I have is that I can’t orgasm when having sex with her.

Doctor: Hello,Thanks for the query to ATD for an opinion,The individual affected by male orgasmic disorder is unable to experience an orgasm following a normal sexual excitement phase. The affected man may regularly experience delays in orgasm, or may be unable to experience orgasm altogether. It can also be defined as an inability to reach orgasm (climax) with a partner; or the inability to achieve orgasm without lengthy sexual contact; or the inability to have an orgasm during intercourse. In some cases, orgasm can be achieved only through masturbation or oral sex.If your sexual problem only occurs under a particular set of circumstances, or only with certain sexual partners, then your condition is considered to be “situational” rather than “generalized” (occurring regardless of the circumstances or partner). Organic causes of male orgasmic disorder include the following:1.Hypogonadism, in which the testes do not produce enough testosterone.2.Thyroid disorders (both hyperthyroidism—too much thyroid hormone— and hypothyroidism, or abnormally low levels of thyroid hormone).3.Pituitary conditions (Cushing’s syndrome, excessive production of the hormone that induces lactation called prolactin).4.Diseases that affect the nervous system, such as strokes, multiple sclerosis, diabetic neuropathy, spinal cord injuries.5.Surgery affecting the prostate and other pelvic organs, diseases of the penis.6.Substance abuse, including alcohol.The most common causes of the male orgasmic syndrome are psychological in nature. The responsible psychological mechanisms may be “intrinsic” (due to basic internal factors), or “extrinsic” (due to external or environmental factors).Intrinsic psychological factors that may cause male orgasmic disorder include:depression, feelings of guilt, anger, fear, low self-esteem, and anxiety, fear of getting the partner pregnant or of contracting a sexually transmitted disease or HIV.Extrinsic psychological factors that may cause male orgasmic disorder include:1. living under conditions that cause undue stress2.unsatisfactory relationship with sexual partner3.past history of traumatic sexual encounters such as sexual abuse, rape or incest4. having been raised in an atmosphere of strict sexual taboos.So as can be seen that there could be multitude of causes responsible for the male orgasmic disorder, hence it is important to get a complete detailed examination done by your physician including psychosexual evaluation in detail. The treatment can range from removing the cause and often psychotherapy under trained hands. Hence, it is suggested that you visit your physician and discuss the options after an evaluation for a healthy sexual life.I hope I have been able to address your concerns in detail,Regards