Male orgasmic disorder is relatively rare, with only 8% of men reporting problems reach­ing orgasm (Laumann et al., 1994). It is defined as a delay or absence of orgasm follow­ing a normal phase of sexual excitement. As we discussed previously, many men who take psychotropic medications experience problems with orgasm.

Treating Male Orgasmic Disorder

Male orgasmic disorder is uncommon and is rarely treated by sex therapists (Heiman, 2002). Treatment options include psychotherapy and if necessary, changing medications. As we discussed earlier, psychotropic medications can cause a delayed or absent orgasm. If this is the case, changing medications can often improve orgasmic functioning.

Premature Ejaculation

Defining premature ejaculation (PE) has always been difficult for professionals (Renshaw, 2005). Does it depend on how many penile thrusts take place before orgasm, how many minutes elapse between actual penetration and orgasm, or whether a man reaches orgasm prior to his partner? All of these definitions are problematic because they involve individual differences in sexual functioning and also make the assumption that females always reach orgasm during sexual intercourse.

Although the time it takes to ejaculate may vary based on a man’s age, sexual expe­rience, health, and stress level, premature ejaculation usually refers to a man reaching orgasm just prior to, or directly following, penetration (Grenier & Byers, 2001). If the couple believes there is a problem, then it is often treated like one. However, in some cultures premature ejaculation may not be viewed as a problem because only male plea­sure is considered important in sexual encounters.

Research has found that worldwide, premature ejaculation is the most prevalent sex­ual dysfunction (Jannini & Lenzi, 2005). In the United States, estimates are that close to 30% of men report experiencing PE in the last year (Laumann et al., 1994). Although we don’t know exactly what causes premature ejaculation, some evolutionary theorists claim that PE may actually provide a biological advantage in that a male will be able to mate quickly, decreasing his chances of being killed or pushed away. Masters and Johnson (1970) originally proposed that PE develops when a man’s early sexual experi­ences are rushed because of the fear of being caught or discovered. These fears, they be­lieved, could condition a man to ejaculate rapidly. Others have pointed out that PE oc­curs in men who are unable to accurately judge their own levels of sexual arousal, which would enable them to use self-control and avoid rapid ejaculation (H. S. Kaplan, 1989). Like other erectile problems, premature ejaculation has been found to be associated with depression, anxiety, drug and alcohol abuse, and personality disorders.