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Male orgasmic disorder may be defined as recurrent inability to attain ejaculation despite prolonged sexual intercourse. The Diagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR), places this disorder among the sexual dysfunctions, along with premature ejaculation. A man affected by retarded ejaculation cannot attain ejaculation following a normal level of sexual excitement. The man in question may regularly experience delays in ejaculation, or may be unable to attain orgasm altogether. A normal orgasm is made up of two stages: emission followed by ejaculation. The word emission means the sensation of approaching ejaculation caused by contractions of the prostate gland, seminal vesicles, and urethra accompanied by generalized muscular tension, contractions of the perineum, and instinctual pelvic thrusting. Ejaculation is followed by a period of resolution which is characterized by feelings of relaxation and well-being. There is also a refractory period. In this phase, men may be unable to respond to more sexual stimulation, may not be able to get an erection, and attain orgasm for a varying length of time. Despite the fact that we talk of orgasm and ejaculation as though they were the same thing, they are separate processes which occur almost simultaneously. What we call orgasm is a high level emotional and physical sensation, whereas ejaculation is simply an unconscious reflex Which occurs when we are aroused enough to stimulate a reflex occurring at the lower part of the spinal cord. Some men can separate these processes and experience multiple orgasms without ejaculation. After you have ejaculated, a period of time to recover is required before another orgasm can happen. Orgasm differs between individuals, and different orgasms may differ in one man. All orgasms share certain characteristics which include regular body and pelvic contractions, increased heart rate, more rapid breathing and the sudden release of tension. Our sexual response cycle is controlled by a balanced interplay between the two major nervous systems, the sympathetic and the parasympathetic. The sympathetic nervous system prompts action whereas the parasympathetic system promotes recovery and relaxation. When the penis becomes erect, its smooth muscles are relaxed and allow blood to flow into the penis. This process is mediated by complex cascade of humoral, neurological and circulatory events controlled by the parasympathetic nervous system. Orgasm and ejaculation and subsequent relaxation of the sexual arousal are predominantly functions of the sympathetic nervous system. So while emission is controlled by the interaction of the parasympathetic and sympathetic nervous systems, orgasm and ejaculation are predominantly under the control of the sympathetic nervous system. We know that orgasm has more to do with the brain than with the body. The fact that orgasm occurs during sleep is supportive of this concept. In any event, this may be blocked by various abnormalities. If retarded ejaculation only occurs under a particular set of circumstances, for example with only one sexual partner, it is known as "situational" rather than "generalized" retarded ejaculation. The cause of retarded ejaculation may be related to some physical condition, but is more often some combination of psychological factors. The physical causes include hormonal problems such as hypogonadism, hyperthyroidism, hypothyroidism, and excessive production of the hormone prolactin. Other physical causes include certain medications, including drugs to treat high blood pressure, and antidepressants. The most common causes of retarded ejaculation are psychological. Some likely candidates include depression, anxiety, and fear of getting the partner pregnant. Other possible factors include an unsatisfactory sexual relationship with one's partner, a history of strict sexual taboos in the family. A diagnosis of retarded ejaculation depends on the following factors being noticeable: a persistent or recurrent delay in, or absence of, orgasm following a level of normal sexual excitement that would be expected to produce orgasm. Most males who have retarded ejaculation also complain of anxiety, shame and frustration, and low sexual self-esteem. Although this particular sexual problem usually occurs during partner sex, it can happen during masturbation as well! If it occurs during masturbation, it's more likely to be about the man's body than any feelings associated with his partner. Male orgasmic disorder may be part of a wider set of sexual malfunctioning that can range across erectile dysfunction, ejaculation problems such as premature ejaculation or retrograde ejaculation, and hypoactive sexual desire disorder. Male orgasmic disorder is found in all men. It may develop around puberty or it may start later in life. If some obvious physical cause is linked to male orgasmic disorder, the cure may be easy; for example, cessation of excessive drinking or a change in medications. But in most cases, counselling will be required. Since most men are too embarrassed to seek professional advice, the availability of self-help programs on the internet is a blessing. Treatment usually requires the partner's assistance for both the psychological and the physical aspects of the treatment. Behavioural programs can allow a man to recover the ability to ejaculate normally quite easily and quickly.
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