Orgasm MIA
Male Anorgasmia After Age 50 – Causes and Practical Management | Theoretical Health Male Anorgasmia After Age 50 Retention of erection without orgasm (anorgasmia) is distinct from absent ejaculation. The two may coexist but are neurologically separate. Principal Causes Cause Mechanism Reversible? Low total or free testosterone Reduced central orgasmic trigger Usually SSRIs, SNRIs, tricyclics Serotonin-mediated inhibition of orgasm pathway Often Diabetic or post-surgical neuropathy Impaired afferent signaling from penis/pelvis Partially Pelvic-floor hypertonicity or weakness Disrupted expulsive reflex Usually Chronic masturbation with high-pressure grip Desensitization of glans mechanoreceptors Usually Diagnostic Steps Morning serum testosterone (total + free) and SHBG. Medication review—focus on psychotropics and alpha-blockers. Neurological exam of perineum and bulbocavernosus reflex. HbA1c...