Trouble reaching orgasm during vaginal intercourse

Q: I’ve always had great trouble reaching orgasm during vaginal intercourse, and now I can’t do it at all. I have no difficulty ejaculating when I masturbate. I’m a 43-year-old male in good health, and my inability to experience the pleasure of coming inside my lover during sex really bothers me. What causes this? What can I do to overcome this difficulty?

Dr. Klein: This can be a very difficult syndrome. Assuming you really are in good health (because this can be a symptom of various endocrine and neurological disorders), I generally see this difficulty as a hesitation to let go. Men with this problem sometimes have control issues; distrust their partner or all women or sex in general; or are holding onto anger or other strong emotions. Some men who feel overwhelmed by their mother or partner unconsciously withhold their orgasm in defiance.

There are two other possibilities. Perhaps you are not getting the stimulation you need to ejaculate, or perhaps you are afraid of unwanted pregnancy.

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