What Causes A Man To Not Be Able To Climax?

What causes a man to not be able to climax? 

Psychological and physical factors can cause it. 

However, having trouble ejaculating is one of the most common sexual problems among men. 

Approximately 8% of men suffer from delayed or absent orgasms. It’s less common among younger men and increases with age. 

Often problems with ejaculating can occur unexpectedly or may start to develop more after certain situations. 

Typical causes of a man having trouble coming include side effects from surgery, psychological issues, physiological problems present at birth, and certain medications.

Individuals with sexual fantasy issues often suffer from attachment problems, anxiety, depression, low self-esteem, or intense emotional trauma. These can all cause stress on the mind and affect performance. 

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What causes a man to not be able to climax?

Many men will experience some incapability to orgasm from time to time; it can occur naturally. However, if it is more severe, it can be an ejaculatory disorder.  

What is ejaculatory disorder? It is the inability of a man to ejaculate at the moment of sexual climax efficiently. 

To diagnose, it has continued for the past six months or more. There is a difference between this condition, low libido, and erectile dysfunction, the inability to achieve an erection. However, these conditions may co-exist. 

Several reasons cause an ejaculatory disorder, including medications, chronic health conditions, and surgery. 

In addition, it might result from substance abuse or mental health issues, such as depression, anxiety, or stress. But, in many cases, it is due to physical and psychological problems.

Physical causes

Physical causes of ejaculation disorders include:

  • Cardiac conditions affecting blood circulation, such as high cholesterol or high blood pressure 
  • Nervous system conditions, such as nerve damage to the spinal cord
  • Disabilities affecting the male reproductive system
  • Prostate surgery
  • Chronic diseases like diabetes
  • Retrograde ejaculation
  • Delayed ejaculation
  • Excessive alcohol use
  • Certain prescription medications like Prozac and Lexapro
  • Loss of ejaculatory sensation due to Injury to the pelvic nerves that control orgasm
  • Certain infections, such as a urinary tract infection
  • Hormone-related conditions, such as low testosterone level

Psychological causes

Psychological causes of ejaculation disorders include:

  • Mental health problems such as depression
  • Sexual health problems such as anxiety about performance
  • Cultural or religious taboos
  • Relationship problems due to stress, poor communication, or other concerns
  • Poor body image
  • Lack of sleep
  • Stress 
  • Emotions
  • Relationship problems
  • Unfulfilled sexual fantasies

Is it normal to struggle to climax?

Orgasms are intense feelings of pleasure after receiving sexual stimulation but reaching climax isn’t always easy. 

The occasional inability to orgasm is not a cause for concern. But if it happens over an extended period, it can be worrisome. 

If the situation persists, it can result in poor sexual satisfaction by the man and his partner, embarrassment, emotional trauma, or inadequate reproduction. 

Orgasm vs ejaculation

It can be essential to tell the difference between an orgasm and the process of ejaculating. An orgasm is not the same as ejaculation, although the two often occur together. 

An orgasm is a pleasurable sensation that precedes ejaculation, it can be seen as the climax of sexual arousal, or the release of built-up sexual tension felt throughout the body. 

Ejaculation is most common in men and involves the discharge of seminal fluid or sperm-filled semen during sexual activity. 

The two often happen simultaneously, but sometimes, a man can orgasm without ejaculating. 

After a man has an orgasm, the body sends signals to the brain. It immediately prepares it to enter its refractory period

During an orgasm, your pelvic muscles contract, your heart rate climbs, and your blood pressure increases.

When ejaculation only occurs in certain situations, there’s usually a psychological cause. For example, you may be able to ejaculate normally when masturbating but not during sex. 

However, for other men, a minor physical problem that causes a delay in ejaculation might cause anxiety about ejaculating during a sexual encounter. 

These can also stem from fear and anxiety during sex, childhood sexual abuse, sexual trauma, repressive sexual education, religious beliefs, sexual and general anxiety, and relationship difficulties. So partners should not feel responsible but rather try to work together for a solution. 

Risk factors for ejaculation disorders

Several factors can increase your risk of having ejaculation disorders, including:

  • Older age
  • Medications
  • Relationship problems
  • Excessive alcohol use
  • Psychological conditions
  • Diabetes or multiple sclerosis
  • Specific medical treatments, such as prostate surgery

Ejaculatory dysfunction or disorder is classified into four types: 

  • Premature ejaculation: when the man ejaculates within a minute of vaginal penetration or, more generally, when he ejaculates sooner than he or his partner would like.
  • Delayed ejaculation: one to four percent of men have a condition in which it takes an extended period of sexual stimulation for men to reach sexual climax and release semen from the penis.
  • Retrograde ejaculation: It is when some or all of the ejaculation is discharged back up into the bladder at sexual climax rather than out of the body through the penis.
  • Anejaculation: When orgasm occurs, semen isn’t released from your penis, or when no ejaculation occurs at sexual climax. 

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What happens if a man does not climax?

Orgasm is a complex biological process that comes as a result of sexual activity and arousal.                    It involves multiple hormones, organs, and nerve pathways. 

During orgasm, the brain’s reward center floods with neurochemicals that give an intense, enjoyable emotional response. 

When a man may not achieve a normal orgasm, it can lead to the following complications:         

  • Male infertility
  • Diminished sexual pleasure for you and your partner
  • Stress or anxiety about sexual performance
  • Marital or relationship problems due to an unsatisfactory sex life

Should you see a doctor?

Your primary care doctor is an excellent place to start when you have to experience a problem with ejaculation or any other rising issues affecting your sexual health, such as: 

  • Finding blood in your semen
  • Having cloudy urine
  • Sexual issues for you or your partner
  • You take medications that could be causing the problem
  • You have other symptoms along with delayed ejaculation that might or might not seem related.

The good news is that with the appropriate support and treatment, you can overcome ejaculation issues and start enjoying sex again.


The cause of the problem determines the purpose of treatment. It may include stopping any drugs causing the pain, psychotherapy, or using oral medications such as pseudoephedrine or imipramine to trigger ejaculation. 

Let’s break down the treatment for ejaculation problems according to the types:

Premature ejaculation

The treatment goal is to decrease penile sensitivity. Therefore there are oral medications that can delay ejaculation. 

Also, a topical lidocaine-prilocaine cream can be applied to the penis before intercourse to reduce sensitivity and delay ejaculation

However, physical therapy and psychotherapy are the best tools to increase the patient’s control over his behavioral responses and reduce difficulty in ejaculating. 

Delayed ejaculation

Traditional behavioral sex therapy for delayed ejaculation and psychotherapy can help deal with any underlying mental health and psychological issues. 

Counseling can involve just the male or he and his partner. Androgens such as testosterone or a sexual aid can be applied to stimulate sensitivity.

Retrograde ejaculation

IVF might be the best option for couples wanting to conceive. Withdrawal of the offending medication can be an easy solution. 

However, neurologic causes are difficult to treat if there is complete nerve damage, but psychotherapy is beneficial in dealing with underlying mental health and psychological issues. 


Finding out if it is caused by a particular medication so that it would be changed or substituted. But counseling would be a great option if difficulty ejaculating is due to a  psychological issue.

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Tips to reach climax

It may take some time, but you can get your groove back regarding your libido and sexual health. 

Remember, orgasms are a subjective experience, so it feels different for everyone. So make sure you’re having fun and continue listening and understanding your body. 

Sometimes even failing to orgasm can be a good time, especially as you try new things yourself or with your partner. 

Here are some tips you may want to try:

  • Take a break from masturbating to reduce the effect of conditioning your orgasm abilities. If you’re not interested in pausing masturbation, try mixing up your technique with a different hand, less speed or pressure when pleasuring yourself. 
  • Lubricating creams or jellies can make the physical act of sex more comfortable and relaxing.
  • Roleplaying games, erotic fantasies, and “sex games” can make sex more exhilarating.
  • Try increasing sexual arousal by thinking about more sexual thoughts. Your partner can help incorporate some of your fantasies.
  • Communicate more by telling your partner what you want and need during sex to maximize overall pleasure. For example, you mention what sexual practices turn you on or what technique works best for you to orgasm.  


Problems with ejaculation can strain your relationship or affect your self-confidence. Don’t forget you’re not less of a man for not being able to climax. 

As we’ve explored,  there’s nothing wrong with you, and these ejaculation disorders often arise from mental and physical causes. 

However, the proactive approach is doing research and understanding your body. Coping with the condition can be difficult for the man, but they can seek help from a physician as soon as possible or from therapy. 

In addition, men can take some practical steps by taking a break from masturbation, mixing up their masturbation techniques, fantasizing during sex, and communicating about what they need sexually.

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  1. Di Sante, S., Mollaioli, D., Gravina, G. L., Ciocca, G., Limoncin, E., Carosa, E., Lenzi, A., & Jannini, E. A. (2016). Epidemiology of delayed ejaculation. Translational andrology and urology, 5(4), 541–548. 
  2. Jenkins, L. C., & Mulhall, J. P. (2015). Delayed orgasm and anorgasmia. Fertility and sterility, 104(5), 1082–1088. 
  3. Alwaal, A., Breyer, B. N., & Lue, T. F. (2015). Normal male sexual function: emphasis on orgasm and ejaculation. Fertility and sterility, 104(5), 1051–1060. 
  4. Otani T. (2019). Clinical review of ejaculatory dysfunction. Reproductive medicine and biology, 18(4), 331–343. 
  5. Miranda, E. P., Taniguchi, H., Cao, D. L., Hald, G. M., Jannini, E. A., & Mulhall, J. P. (2019). Application of Sex Aids in Men With Sexual Dysfunction: A Review. The journal of sexual medicine, 16(6), 767–780. 
  6. Mallory, A. B., Stanton, A. M., & Handy, A. B. (2019). Couples’ Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis. Journal of sex research, 56(7), 882–898. 

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