Overcoming Sexual Dysfunction: Seeking Solutions for Low Libido and Orgasm Issues

Inability to achieve orgasm?

Hello, Doctor: My main issue currently is the lack of sexual pleasure and the inability to reach orgasm.
I can achieve an erection and ejaculate, but the hardness is not as it used to be.
The frequency of morning erections has significantly decreased, and my sexual impulses and desires have diminished greatly compared to before.
In the past, I always needed to relieve myself, as if the water was overflowing; after release, I felt relieved and satisfied.
However, this situation has persisted for about a year without improvement.
I previously visited a urologist for examinations, and blood tests and urinalysis showed normal levels of testosterone, kidney, liver, and thyroid function.
I do not smoke or have a habit of excessive drinking.
Additionally, I have issues with palpitations and anxiety, for which I am currently taking medication prescribed by a psychiatrist.
At that time, it seemed that my emotional issues and sexual function problems occurred simultaneously.
I later discussed my sexual function with my psychiatrist, who mentioned that the medication I am taking has gradually alleviated some symptoms, but that sexual function is somewhat related to the sympathetic and parasympathetic nervous systems, although it is not within his area of expertise.
Through exercise, my palpitations and anxiety have improved significantly, but there has been no progress in my sexual function, which sometimes makes me feel inferior.
Just thinking about this issue can lead to feelings of depression and unhappiness.
Doctor, could you give me some advice? What should I do? I want to live a normal life like everyone else.

Xūyào bāngzhù de rén, 20~29 year old female. Ask Date: 2018/07/19

Dr. Fu Shizhang reply Urology

It is recommended to arrange for an autonomic nervous system evaluation in the neurology department to determine if the functional impairment is caused by neurological factors.

Reply Date: 2018/07/19

More Info

Overcoming sexual dysfunction, particularly issues related to low libido and orgasm difficulties, can be a complex and multifaceted challenge. Based on your description, it seems that you are experiencing a combination of physical and psychological factors that are contributing to your current situation. Here are some insights and recommendations that may help you navigate this issue.

Firstly, it’s important to recognize that sexual dysfunction is a common problem that affects many men at various stages of life. The fact that you can achieve an erection and ejaculate indicates that there may not be a complete physiological dysfunction, but rather a component of your experience that is linked to libido and sexual pleasure. The decrease in morning erections and sexual desire you mentioned could be influenced by several factors, including hormonal levels, psychological state, and overall health.

Since you have already undergone tests that show normal testosterone levels and other health indicators, it may be beneficial to focus on the psychological aspects of your sexual health. Anxiety and depression can significantly impact libido and sexual satisfaction. The medications you are taking for anxiety may also have side effects that affect your sexual function. It’s crucial to have an open dialogue with your psychiatrist or prescribing physician about these concerns, as they may be able to adjust your medication or suggest alternatives that have fewer sexual side effects.

In addition to medication management, consider incorporating lifestyle changes that can enhance your overall well-being and potentially improve your sexual health. Regular physical exercise is known to boost mood and reduce anxiety, which can, in turn, enhance libido. Activities such as aerobic exercise, strength training, and even yoga can help improve blood flow, increase energy levels, and reduce stress.

Moreover, exploring mindfulness and relaxation techniques can also be beneficial. Practices such as meditation, deep breathing exercises, and progressive muscle relaxation can help alleviate anxiety and improve your mental state, which may positively influence your sexual desire and pleasure.
Communication with your partner is another critical aspect of overcoming sexual dysfunction. Discussing your feelings, concerns, and experiences openly can foster intimacy and understanding, which may help alleviate some of the pressure you feel regarding your sexual performance. It’s essential to create a supportive environment where both partners feel comfortable expressing their needs and desires.

If you find that these strategies do not lead to improvement, it may be worthwhile to consult a specialist in sexual medicine or a therapist who specializes in sexual dysfunction. They can provide tailored interventions, including cognitive-behavioral therapy (CBT), which has been shown to be effective in treating sexual dysfunction related to anxiety and depression.

Lastly, consider exploring sexual health resources, such as books or workshops focused on sexual wellness. These can provide valuable insights and techniques to enhance sexual pleasure and intimacy, helping you to reconnect with your sexual self.

In summary, overcoming sexual dysfunction involves a holistic approach that addresses both physical and psychological factors. By working closely with healthcare professionals, engaging in healthy lifestyle practices, and fostering open communication with your partner, you can take significant steps toward improving your sexual health and overall quality of life. Remember, you are not alone in this journey, and seeking help is a positive step toward finding solutions.

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