by Most men, no less than 70 percent, say they reach an orgasm faster than they would like. But there is a reverse problem that can occur with age: lasting too long.
For some men, reaching climax can take 30 minutes or more. Sex that lasts so long can be uncomfortable, painful and painful for men and their partners.
The delayed orgasm, as the situation is known, is more often associated with women – and for a good reason, given the persistent orgasm gorge in heterosexual relationships. But up to 10 percent of men older than 40 also struggle with it. In extreme cases, some men can never reach a climax, a condition that is called pinnacle.
Orgasmic disorders are not well studied or understood, and the small investigation that exists, has a tendency to concentrate on premature ejaculation, defined as unintentionally reached the orgasm within two minutes according to the American Urological Association.
But experts in the field of sexual health are increasingly recognizing the delayed orgasm as a ‘huge problem’, Dr. Rachel Rubin, a urologist and specialist in sex medicine in Maryland. Although no interventions have been approved by the Food and Drug Administration, there are some treatment options, including off-label medicines, sex therapy and stimulating devices, as well as lifestyle and behavioral changes.
How orgasms work
Orgasms are in fact a huge reflex, a bit like a “gigantic Nieswijk,” said Dr. Rubin. Only one that requires a “perfect genital brain connection”.
The process starts with visual, mental or physical sexual stimulation, which activates the brain to release dopamine, which increases the excitement. After sufficient stimulation, the brain gives a wave of pleasure-inducing chemicals, such as oxytocin, causing the feeling that we consider an orgasm to create.
For most men, ejaculation takes place at the same time: “But they are individual processes,” said Dr. Alan Shindel, a urologist based in San Francisco. Although orgasm usually happens in the brain, ejaculation is a series of involuntary muscle contractions.
Complications that influence the genitals, pelvic floor muscles, spinal cord and brain can make orgasms early, delayed, muted or even painful, Dr. Rubin. Given the complexity, she said, “It is actually amazing that more things are not going wrong.”
Causes of delayed orgasm in men
Many physical, neurological or psychological disorders can contribute to delayed orgasm. Here are some of the most common causes.
Medicine
The most common triggers of delayed orgasm are medicines and other drugs, including alcohol, Dr. Landon Trost, a urologist based in Utah. The guidelines of the Urological Association List 45 different medicines associated with delayed orgasm.
The class of antidepressants called selective serotonin re -admission inhibitors is one of the most common culprits. These drugs increase serotonin, a chemical that inhibits the neural paths involved in the orgasm, which increases the threshold that is needed to climax. (For this reason, SSRIs are a common off-label treatment for men who ejaculate too quickly.)
Opiates, alcohol, antipsychotics and blood pressure drugs, such as beta -blockers, can also make an orgasm difficult by dampening the reaction of the nervous system to sexual stimulation.
Neurological problems
Many neurological disorders – including multiple sclerosis, Parkinson’s disease, strokes and brain injury – influence the neural paths between the brain and genitals, which can lead to a German pleasure, delayed orgasm or painful ejaculation.
Diabetes is another major neurological contribution that often leads to nerve damage. “It’s not just toes and fingers” they are affected, Dr. Shindel. “The penis is also an extremity.”
Spinal injuries are another common cause of delayed orgasm, added Dr. Irwin Goldstein, a urologist based in San Diego. These can contain something similar as a sliding disc.
Partner -related care
Another common trigger is the pain or discomfort that men can cause to their partners, which often results in delayed or lack of orgasm for both. About 75 percent women experience pain during sexual intercourse at a certain point in their lives, some of which are caused by vaginal dryness and irritation, symptoms that can increase considerably at the start of menopause. The condition is easy to treat with options such as local vaginal estrogen, Dr. Rubin, but is often not diagnosed and under treated.
It is “extremely important” for clinicians who treat men for delayed orgasm to “ask for their partners,” Dr. Rubin. Differences in libido, preferred types of sexual acts and performance expectations can also make it difficult to have an orgasm take place.
Psychological factors
Mood disorders – such as depression, anxiety and stress – other common contributors provide delayed orgasm. In one self -reported survey, 41 percent of men said with moderately to seriously delayed orgasm that fear and stress during sex was an important reason that they were unable to reach a climax. Depression in particular can be the ability of the brain to process pleasure, make collision, make the orgasm difficult or damped.
Treatments for delayed orgasm
Before treatment, men and their doctors should discuss when the problem started, Dr. Trost. A sudden start of delayed orgasm can have a clear trigger (new medicines, relationship -related stress or, for example, sleep disorders) and can often be easily reversed. Cases that are delivered more gradually due to age -related conditions and chronic illness can be more difficult to treat.
Cases of permanent inability to achieve an orgasm – caused by the lack of certain dopamine receptors or traumatic brain or spinal injuries – are the most difficult to treat. There are no treatments approved by the FDA for delayed orgasm, but clinicians have a few tools at their disposal.
Medicine
Different dopamine-promoting medicines-such as bupropion, buspirone and Cabergoline hebben helped to prevent the delayed orgasm for men in some small, randomized control tests.
Sex therapy
Sex therapy and counseling are always a good idea for every man with a sexual dysfunction, Dr. Shindel. Therapy should ideally involve partners, he added, because sexual disorders “never just be the problem of one person.”
Stimulation devices
Sometimes “a little more stimulation” can help men to achieve an orgasm more easily, Dr. Rubin. Sex toys, such as vibration devices for the genitals, perineum, prostate or anus, can be useful to sufficiently increase the stimulation to achieve an orgasm, she said.
However, these options do not work for everyone, said Dr. Shindel, who will soon hope for new treatments. Just as Viagra transformed erectile dysfunction, he said, the same could happen in one day for delayed orgasm.
“We are still looking for an orgasm pill,” he said.
David Dodge is a freelance writer who focuses on problems with health, wellness and LGBTQ.
