No orgasms with intercourse (male)

Dear Alice:

I have been going out with the same woman for several years and our relationship has never been better. However, lately I can only have an orgasm when she performs oral sex - never, during sex. It used to be the case that upon entering her vagina I would ejaculate almost prematurely, but now I can't seem to ejaculate at all. Do you have any suggestions or thoughts on how I might cure my little problem?

Vaginally-Ejactorally Challenged


Dear Vaginally-Ejactorally Challenged,

It sounds like you’re in a strong, happy relationship that has endured the test of time, and that’s something to celebrate! However, your high level of relationship satisfaction may render your inability to orgasm from intercourse that much more perplexing. The good news is that it’s completely normal for men to experience delayed ejaculation from time to time. What makes this a little easier to approach is that you’re able to orgasm under certain conditions, and that you’ve successfully reached orgasm from vaginal intercourse in the past. There are many potential physical and psychological conditions that could explain your concerns, and talking it out with your sweetheart may be a great starting point. Additionally, keep in mind that there are lots of healthcare providers who are able to help, and you should never be too embarrassed or ashamed to reach out.

Physical conditions that cause delayed ejaculation include certain medications, infections, excessive alcohol consumption, older age, hormone-related conditions, drug use, injuries to the pelvic nerves, and certain diseases such as diabetes. Psychological causes of delayed ejaculation include depression, anxiety, relationship concerns, stress, poor communication, performance anxiety, cultural or religious taboos, and discrepancies between fantasy and reality during sex. Think about whether any of these physical or psychological risk factors for delayed ejaculation apply to you, and if so, talk to your healthcare provider or a counselor for more information and treatment.

In addition, consider simply discussing your concerns with your partner in a neutral space — that means outside of the bedroom. Ask your partner if she has noticed your inability to climax from vaginal intercourse, and if she has, determine whether it has affected her level of sexual satisfaction. You may come to find that she’s satisfied by other means and doesn’t mind if you don’t orgasm through intercourse. However, if she does share your concerns, discuss how you can work on it together. Although she may have some great suggestions herself, ask her if she’d be interested in trying the following:

  • Use a sex toy, such as a vibrating cock ring, to keep sensations strong during intercourse. Your lady will experience more intense clitoral stimulation, which might just bring her closer to orgasm as well!
  • Experiment with different positions and determine what feels best. You may find it easier to climax with deeper or shallower penetration according to the position you’re in.
  • Have your partner stimulate you manually or orally until you’re close to having an orgasm. At that point, insert your penis into her vagina and continue until you climax.
  • The next time you receive oral sex, be mindful of what you enjoy about it. For example, do you like the pace or pressure your partner applies during oral sex? Emulate those sensations during intercourse — doing so just may get you there.
  • When you or your partner uses manual stimulation, loosen up that grip. Manual stimulation may apply significantly higher levels of pressure and friction than vaginal intercourse, and a man may habituate to these sensations, making it more difficult to orgasm during sex.
  • Don’t fixate on orgasm during sex. Reaching orgasm isn’t necessarily the most important or even the most enjoyable part of sex — lots of people enjoy foreplay more than the main event! The next time you’re intimate, focus on being more present in the moment. This may help you relax to the point that you’re able to orgasm through intercourse.
  • Reassure your partner that your inability to orgasm from vaginal intercourse is unrelated to your sexual interest. Let her know that you’re still attracted to her, and that there’s nothing wrong with her body or sexuality that precludes your ability to orgasm.

Perhaps you’re experiencing residual anxiety from your previous experiences with premature ejaculation during vaginal intercourse. This may be a concern that can only be properly addressed through treatment with a healthcare provider, counselor, or sex therapist. Treatment for delayed ejaculation has a high success rate — between 70 to 80 percent. Good luck!

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