Ejaculatory Anhedonia: What Is It and Are You At Risk?

You’re getting it on with your partner and you’re as hard as a rock. You’re able to ejaculate, but there’s one thing missing—one important thing. You lack the intense pleasure you used to experience during orgasms. 

It’s not like you’ve had insufficient sexual excitement. The two of you have had many hot and heavy moments in bed. So why can't you feel pleasure when you climax?

What is it called when you have this lack of sensation during intercourse even after there’s been plenty of sexual stimulation? In men, it’s called ejaculatory anhedonia, but because some women also can’t feel their orgasms, it’s also known as orgasmic anhedonia or sexual anhedonia. Scientists call it pleasure dissociative orgasmic disorder or pleasure dissociative orgasmic dysfunction. 

What causes sexual anhedonia and is this something that could happen to you? Let’s dive deeper into the topic. 

What Is Orgasmic Anhedonia?

Orgasmic anhedonia, or pleasure dissociative orgasmic disorder, is a type of sexual dysfunction that can affect men and women. It refers to the lack of sensation during sexual orgasms that can happen in some people. 

In people with this problem, there’s no difficulty achieving orgasm, it’s just that they don’t feel the orgasm and are missing out on an important part of sex.  

For men, sexual anhedonia is a type of ejaculatory dysfunction that results in a loss of ejaculatory sensation—in other words, you achieve ejaculation but you don’t feel anything when you climax, which is why it’s often called ejaculatory anhedonia when it happens in men.  

Lack of Sensation During Sex in Males

Orgasms happen due to a sudden release of brain chemicals and hormones during sexual stimulation. They’re due to a complicated mixture of brain chemistry, sexual arousal, and emotions. When a man ejaculates but doesn’t feel the intense pleasure of orgasm, this sexual dysfunction can cause a lot of frustration and distress. 

What Causes Anhedonia?

Anhedonia is based on the Greek word for pleasure, hedonism. Anhedonia means lack of pleasure. Anhedonia can occur during sex, but it’s also a term used whenever someone feels a lack of pleasure in an activity they once enjoyed.

What Causes Ejaculatory Anhedonia?

Orgasmic disorders like sexual anhedonia can be caused by physical or psychological factors. If you don’t feel anything when you ejaculate, you might want to look into these possible causes:

Mental Health Disorders 

People who have depression or schizophrenia and other underlying psychological issues often suffer from all types of anhedonia including sexual anhedonia and ejaculatory anhedonia.

People with schizophrenia often have imbalances in brain chemicals like dopamine. This chemical messenger in the brain is involved in feeling pleasure and how we respond to rewards.  

Other psychological factors involved in sexual anhedonia include depression, which is often linked to a lack of pleasure in activities that once felt pleasurable, including sex. By affecting mood and dopamine levels, depression causes you to lose interest in sexual activities.(1) During sexual stimulation, these mood changes can lead to ejaculatory anhedonia and sexual dysfunction. 

Low Dopamine Levels

Although depression and schizophrenia are two reasons for low dopamine levels, you don’t have to have either of those conditions to have low levels of this brain chemical, which doubles as a hormone. 

In addition to depression and schizophrenia, low dopamine levels can be caused by:(2)

• Parkinson’s disease

• ADHD

• Drug abuse, such as using too many stimulants

• High levels of saturated fat or lack of protein

• Obesity

• Spinal cord injuries

• Medications like antidepressants and antipsychotics

Dopamine plays a role in the brain pathway known as the nucleus accumbens, which is involved in eating, sex, feelings of reward, and how we act during stress.(3) When dopamine levels take a nosedive, it puts a damper on pleasure and motivation, including during sexual activity. 

Your doctor can order blood tests or other labs to find out if low dopamine levels may be to blame for your sexual anhedonia. 

Hormonal Imbalances

As far as hormones go, low testosterone is one of the possible causes of ejaculatory anhedonia. In addition, thyroid hormone imbalances might cause the problem. 

Prolactin levels that are too high can also trigger ejaculatory dysfunction. Prolactin is a hormone that is produced in both males and females. Levels that are too high in males can lead to reduced testosterone and the resulting ejaculatory anhedonia, as well as low sex drive, decreased muscle mass, infertility, and other male sexual health dysfunctions like erectile dysfunction. 

Medications 

In addition to hormonal and psychological factors, sexual anhedonia is a common side effect of certain prescription drugs. Selective serotonin reuptake inhibitors—SSRIs for short—used to treat depression are known to cause this problem.(4)

Antipsychotics and some blood pressure medications such as beta-blockers also are linked to sexual anhedonia.  

So why do these medications increase the risk of sexual anhedonia? Scientists aren’t 100% sure, but the medications affect dopamine levels in the brain, which could play a role. 

In addition, illicit drugs like cocaine and amphetamines can cause orgasmic anhedonia.(5) Since these drugs are linked to depression, which in turn is associated with anhedonia, their effects on mood might explain why they dampen the pleasure usually associated with orgasms. 

Neuropathy

The neuropathy (nerve damage) that happens in diabetic patients can cause sexual dysfunction including orgasmic anhedonia. The ongoing problems with high blood sugar that occur in diabetes can damage nerves, which in turn reduces pleasure sensations during sexual activity and can lead to ejaculatory anhedonia. 

Spinal Cord Injury

In men with a spinal cord injury, ejaculatory anhedonia is a common form of ejaculatory dysfunction. In this group of men, it’s caused by the spinal cord injury affecting the nerves involved in sexual arousal and orgasm. 

Not feeling pleasure during sex often involves the nerves controlling psychogenic erections, depending at what point in the spinal cord the man was injured.  A psychogenic erection is due to arousal from fantasies, visual input, or other mental stimulation. During this type of erection, messages travel from the brain via the spinal cord to the nerves in the genital area

Diagnosis of Ejaculatory Anhedonia

Diagnosing ejaculatory anhedonia is complicated because the healthcare provider is relying on the patient to report the problem and its symptoms. There is no test to measure orgasmic function. 

The usual approach is for the doctor to rule out possible sexual anhedonia causes like medications, mental health disorders associated with anhedonia like depression, and hormonal issues such as low testosterone. 

Your doctor will sometimes test for low dopamine levels, especially if you’re working with a functional medicine provider.  

Does Sexual Anhedonia Go Away?

Sexual anhedonia and ejaculatory anhedonia don’t go away on their own without treatment. But the good news is that in most cases, there are solutions to restore normal sexual function.

Solutions for Ejaculatory Anhedonia

If you’re a man suffering from orgasmic anhedonia, you’ve got some options. Work with your doctor to try a number of medical and psychological interventions to improve sexual function. These treatments and lifestyle changes can include: 

Go to Counseling

Psychotherapy is a type of counseling that involves working with a licensed therapist to help you deal with mental health issues like depression that may be to blame for your sexual anhedonia. This type of counseling is also known as talk therapy.

The therapist can work with you to uncover any emotional blocks that might stop you from feeling pleasure when you ejaculate. Once they’ve identified these blocks, the therapist will suggest strategies you can use to cope such as relaxation techniques.  

Try Sex Therapy

Sex therapy is a type of psychotherapy that zooms in specifically on sexual issues. A sex therapist can help you pin down the root cause behind your ejaculatory anhedonia, especially if it’s related to mental health issues that affect your sex life. 

There’s no touching involved during sex therapy sessions, but the therapist may recommend certain techniques you can do in the privacy of your home to help you get back in touch with your body and improve sexual function.      

Balance Your Hormones

Men who have sexual anhedonia can work with a doctor, usually a functional medicine provider, to have their testosterone and prolactin levels checked along with their thyroid function. 

The healthcare provider can suggest ways to balance your hormones, such as testosterone replacement therapy, which can improve sexual function. The doctor can also order lab tests to measure your dopamine, and if it’s low, suggest ways to raise levels of this important brain chemical/hormone.  

Try a Cock Ring

A cock ring, also known as a penis ring or constriction ring, is used around the penis base. Some cock rings are also worn around the testicles. This may make your orgasms more intense and improve the male sexual response. Unless your inability to feel pleasure during orgasms is a side effect of medication or caused by psychological factors, a penis ring may help. 

Change Your Diet

Diet can make a difference if you’re experiencing sexual anhedonia. Eating a diet low in sugar and unhealthy fats and high in lean meats, vegetables, and fruit can make your body healthier overall and less likely to experience sexual dysfunction. 

Eating healthier foods that are high in zinc, magnesium, and vitamin B6 may improve male sexual dysfunction, including ejaculatory anhedonia. A healthy diet may also improve the mood of patients suffering from depression, a common cause of anhedonia.

Get Moving

Exercise stimulates blood flow and boosts your mood, which can improve male sexual function. If you find yourself feeling blue, exercise is a good remedy, especially if your depression is mild or moderate. In fact, according to Harvard Health, exercise is as effective as antidepressant medications.(6)   

Regular aerobic exercise can trigger the release of proteins called neurotrophic growth factors, which stimulate nerve cells to grow and make new connections. This nerve cell growth is particularly important in the mood-regulating region of the brain called the hippocampus, which is smaller in people who are depressed. Increasing nerve cell growth in the hippocampus can relieve depression.(6) 

Another way exercise benefits mood and sexual function is through increasing dopamine levels. As mentioned earlier in this article, dopamine is often low in people with orgasmic anhedonia. 

Manage Your Stress

If you’re under stress, it can lower levels of key sex hormones like testosterone. Long-term stress also can lower your body’s dopamine level, which can increase your risk of depression and in turn, sexual anhedonia.(7) 

Stress-management strategies like yoga, meditation, a walk in the woods, and deep breathing can reduce stress, eliminate depression, and play a role in normal male sexual function.

Ask Your Doctor About Medications for Orgasmic Anhedonia

Although lifestyle changes and counseling may be the most effective, talk to your doctor about medications that may help with loss of sensation during sex. These include dopamine agonists, oxytocin, and ED drugs. Testosterone replacement therapy is another possible option. 

Frequently Asked Questions About Sexual Anhedonia

Why am I not feeling pleasure when ejaculating?

Lack of sensation during sex in a male is called ejaculatory anhedonia and is a type of sexual dysfunction. During this condition, men don’t feel any pleasure even though they’re able to have an orgasm. A similar problem can happen in women, too, which is why it’s sometimes called orgasmic anhedonia or sexual anhedonia. 

What is ejaculatory anhedonia?

Ejaculatory anhedonia is a type of sexual anhedonia that occurs in men who have a loss of feeling during sex. When this happens, a man is able to ejaculate, but he isn’t able to feel the pleasure that’s usually associated with having an orgasm during sexual activity. 

This loss of ejaculatory sensation causes a great deal of frustration and stress because the man is missing out on one of the best parts of sex. He may even cease sexual interaction with his partner, causing stress in the relationship. 

How do I get rid of ejaculatory anhedonia?

Sexual anhedonia usually doesn’t go away on its own. You need to take steps to solve the problem by going to a doctor, counseling, or for sex therapy. Changing your lifestyle may also help. Possible solutions for sexual anhedonia include:

• Counseling

• Sex therapy

• Balance your hormones, including monitoring thyroid function and testing dopamine levels

• Eat healthy

• Exercise

• Reduce stress

• Using a cock ring

Sources:

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC3181880

2. https://www.medicalnewstoday.com/articles/320637#conditions

3. https://pubmed.ncbi.nlm.nih.gov/10870199/ 

4. https://pubmed.ncbi.nlm.nih.gov/34627736/

5. https://pmc.ncbi.nlm.nih.gov/articles/PMC3307593/

6. https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression

7. https://lms.mrc.ac.uk/chronic-stress-dampens-dopamine-production/