Dear Alice,

My boyfriend recently told me that he rarely has orgasms when he ejaculates. I was aware that men could have orgasms without ejaculation, but I didn't think it worked the other way around. Are men more complicated than I thought?

Dear Reader,

Many people experience orgasms differently, those with penises included. For people with penises, ejaculation and orgasm are often so closely tied that they’re considered to be one and the same, but this isn’t always the case! It’s possible to experience orgasm without ejaculation and ejaculation without orgasm.

Ejaculatory anhedonia is the term used to describe the rare condition in which individuals are able to ejaculate physically but don't have the accompanying feelings of release, pleasure, or orgasm. Sometimes referred to as anorgasmic ejaculation or pleasure dissociative orgasmic dysfunction, this phenomenon is characterized by the ability to have an erection and experience sexual stimulation but an inability for the brain to recognize the sensations as pleasurable.

While anorgasmic ejaculation itself causes no physical harm, it could point to a concerning underlying cause, such as medication and psychological causes. It may also point to a physical cause, such as a spinal cord injury. Adjusting medication may be helpful, but if the underlying cause is psychological, it may require the assistance of a mental health professional. Because of the limited research on the subject, there’s no direct cure for those who experience ejaculatory anhedonia, so the treatment options depend heavily on the root cause of the condition.

It could be helpful for your boyfriend to run through some questions to better understand if he’s experiencing ejaculatory anhedonia and if this concerns him. You mentioned that he rarely orgasms when he ejaculates. Does he have orgasms at other times — perhaps during oral, vaginal, or anal sex, but not when ejaculating? Does he find that other sexual sensations give him the feeling of release or orgasmic pleasure? What about when he masturbates? And, exactly how rare is "rarely"? Does he find the experience distressing, or is he comfortable with having few or no orgasms? The answers to these questions may determine what, if any steps, may be helpful for him to take next.

If it's a concern your boyfriend would like to address, a health care provider, specifically a urologist, could work with him to find out exactly what's happening. A few simple tests may provide the answer. If the cause isn’t hormonal or physiological, then the next step may include seeing a mental health professional or sex therapist. You or your boyfriend can check out the American Association of Sex Educators, Counselors, and Therapists (AASECT) website to find a therapist in your area. Ultimately, sexuality is complex and unique to each person, regardless of gender or sexual anatomy. If your boyfriend isn't bothered by this experience and feels that his sex life is fulfilling, continued communication between you and your boyfriend about your orgasm experiences may help determine what works best for you both.   

Alice!

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