No orgasm during sex

My fiancé has never had an orgasm during sexual intercourse or manual/oral stimulation with a partner. He has only ejaculated during orgasm and with one partner about 10 years ago: he was lying on top of her and only pressing onto her, both clothed. I’m very worried about this and we don’t know where to turn for help.

A It is important that your fiancé has a blood test to make sure he does not have diabetes, which could cause sexual difficulties in men while no other symptoms are apparent. Another cause may be smoking nicotine or taking any prescription or recreational drugs. A number of other medical conditions, such as hypertension, may be causing his inability to achieve the level of sexual arousal he needs to ejaculate during sex with a partner. If none of this applies, then the issue could be psychological.

His problem is not uncommon for men but the symptoms can range from occasional problems having an orgasm to being able to orgasm and ejaculate only though masturbation and only when alone. However, many times there are emotional issues that contribute to the inability of a man to ejaculate with a partner. Guilt about sexual pleasure, fear of pregnancy, embarrassment about nudity with another person can all get in the way of being able to have an orgasm with a partner. I strongly suggest you get a copy of The New Male Sexuality, by Bernie Zilbergeld, PhD, and read this book together. It is loaded with information that you can both use as a first step in overcoming this difficulty together.

– Judith A. Seifer, PhD, RN
Professor of Clinical Sexuality
Institute for the Advanced Study of Human Sexuality