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Fertility and Sterility Nov 2015Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes... (Review)
Review
Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress. Delayed orgasm and anorgasmia are associated with significant sexual dissatisfaction. A focused medical history can shed light on the potential etiologies, which include medications, penile sensation loss, endocrinopathies, penile hyperstimulation, and psychological etiologies. Unfortunately, there are no excellent pharmacotherapies for delayed orgasm/anorgasmia, and treatment revolves largely around addressing potential causative factors and psychotherapy.
Topics: Animals; Ejaculation; Humans; Male; Orgasm; Penis; Predictive Value of Tests; Prevalence; Recovery of Function; Risk Factors; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Terminology as Topic; Treatment Outcome
PubMed: 26439762
DOI: 10.1016/j.fertnstert.2015.09.029 -
Sexual Medicine Reviews Jul 2020Many men experience distressing issues regarding the timing of orgasm and ejaculation, such as premature ejaculation (PE) and delayed ejaculation (DE). Despite being... (Review)
Review
INTRODUCTION
Many men experience distressing issues regarding the timing of orgasm and ejaculation, such as premature ejaculation (PE) and delayed ejaculation (DE). Despite being highly prevalent, both PE and DE are poorly understood and present a management challenge for sexual medicine specialists.
AIM
To summarize existing data on the medical management of PE and DE.
METHODS
A comprehensive literature review pertaining to the management of PE and DE was conducted using PubMed and clinicaltrials.gov for data published up until May 2019. Our focus was on double-blind, placebo-controlled trials and meta-analyses of such studies.
MAIN OUTCOME MEASURE
Peer-reviewed studies on treatment options for PE and DE were critically analyzed for results and methodological rigor.
RESULTS
The peer-reviewed data on PE management continue to evolve. Psychotherapy, pharmacotherapy, and procedural interventions have all been associated with some degree of efficacy. A strong evidence base supports the off-label use of selective serotonin reuptake inhibitors and local anesthetics in PE given consistent increases in ejaculation latency time. Education and mental health assessments remain important components of PE management despite a dearth of peer-reviewed data on these interventions. Numerous treatment strategies have been evaluated for DE; limited data support psychotherapy, pharmacotherapy, and/or penile vibratory stimulation as management options.
CONCLUSION
A number of management options for PE or DE exist but none has been formally approved by the US Food and Drug Administration. New and novel treatments would be of great value in managing issues regarding the timing of ejaculation/orgasm. Martin-Tuite P, Shindel AW. Management Options for Premature Ejaculation and Delayed Ejaculation in Men. Sex Med Rev 2020; 8:473-485.
Topics: Ejaculation; Humans; Male; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological
PubMed: 31668585
DOI: 10.1016/j.sxmr.2019.09.002 -
International Journal of Impotence... May 2024Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm.... (Review)
Review
Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm. Etiologies of DO/AO include medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia. Given the multifactorial complex nature of this disorder, a thorough history and physical examination represent the most critical components of patient evaluation in the clinical setting. Treating DO/AO can be challenging due to the lack of standardized FDA-approved pharmacotherapies. There is no standardized treatment plan for DO/AO, though common treatments plans are often multidisciplinary and may include adjustment of offending medications and sex therapy. In this review, we summarize the etiology, diagnosis, and treatment of DO/AO.
PubMed: 37061617
DOI: 10.1038/s41443-023-00692-7 -
International Journal of Impotence... 2012Of all the male sexual dysfunctions, delayed ejaculation (DE) is the least understood, least common and least studied. This paper aims to review and integrate the... (Review)
Review
Of all the male sexual dysfunctions, delayed ejaculation (DE) is the least understood, least common and least studied. This paper aims to review and integrate the diverse psychological theories and proposed psychological interventions for DE. Clinicians will then be able to more clearly discern the relevant psychological/interpersonal issues of the patient/couple and implement systematically based effective interventions. After reviewing the literature, it is clear that no one theory accounts for all the varied presentations of DE, and no theory by itself has strong empirical support. However, awareness of the diverse points of view helps clinicians conduct better assessments and broaden their understanding of the patient's ejaculatory dysfunction. Similarly, no one psychological intervention works for all patients, nor will unsystematic random selection of interventions. This paper stresses on the need to clearly identify the source of the dysfunction and select treatments based upon the precipitating and maintaining factors. Much work remains to be done with regard to our understanding and treatment of DE. Specifically, we need to craft an evidence-based definition, assess the true prevalence of the dysfunction, demonstrate the efficacy of psychological interventions and design validated outcome measures.
Topics: Adult; Aged; Ejaculation; Humans; Male; Masturbation; Middle Aged; Orgasm; Psychotherapy; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 22378496
DOI: 10.1038/ijir.2012.2 -
Translational Andrology and Urology Aug 2016A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished... (Review)
Review
A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency.
PubMed: 27652226
DOI: 10.21037/tau.2016.05.10 -
The Urologic Clinics of North America May 2022Ejaculation and orgasm are complex phenomena within the male sexual response cycle. Disordered ejaculation commonly presents as premature or delayed ejaculation,... (Review)
Review
Ejaculation and orgasm are complex phenomena within the male sexual response cycle. Disordered ejaculation commonly presents as premature or delayed ejaculation, although issues with painful ejaculation, retrograde ejaculation, or postorgasmic illness syndrome are also seen. This article will review the pathophysiology of these conditions as well as the current pharmacologic treatments available.
Topics: Ejaculation; Humans; Male; Orgasm; Sexual Dysfunctions, Psychological
PubMed: 35428428
DOI: 10.1016/j.ucl.2021.12.001 -
American Journal of Primatology 1981The major genital responses of arousal in women are vasocongestion, resulting in tumescence of the vaginal walls, and vaginal lubrication, facilitating penile... (Review)
Review
The major genital responses of arousal in women are vasocongestion, resulting in tumescence of the vaginal walls, and vaginal lubrication, facilitating penile intromission and thrusting. During orgasm, several involuntary muscular reactions occur, the most adaptive being in the outer third of the vagina and the uterus. Uterine suction of the ejaculate seems to occur when the reproductive apparatus is functioning at full efficiency. Coitus may result in reflex ovulation. Indices of female nonhuman primate orgasm thus far proposed include rhythmic vaginal and anal contractions, hyperventilation, involuntary muscle tension, arm and leg spasms, grimacing, and uterine contractions. Orgasm in our species may exist as a result of phylogenetic inertia, not as a novel response selected during protohominid or hominid evolution. A theory for the evolutionary nature of orgasm in women states that the orgasmic vaginal contractions stimulate ejaculation. Reasons for the common asynchrony of this adaptive pattern are the usually lowered ejaculatory threshold because of non-species-typical orgasmic frequency in the male, and the frequently delayed female orgasm because of psychological inhibition and/or inadequate control and development of the pubococcygeus.
PubMed: 31995946
DOI: 10.1002/ajp.1350010104 -
The Primary Care Companion For CNS... Apr 2021
Topics: Ejaculation; Female; Humans; Male; Orgasm; Sexual Dysfunctions, Psychological
PubMed: 34000160
DOI: 10.4088/PCC.20l02746