Male Orgasmic Disorder

Individuals with Male Orgasmic Disorder have a persistent absence, or delay of, orgasm during sexual intercourse.

The diagnostic criteria includes the following symptoms:

• Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person's age, judges to be adequate in focus, intensity, and duration.

• The disturbance causes marked distress or interpersonal difficulty.

• The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Subtypes

Subtypes are provided to indicate the onset, context, and etiological factors associated with the Sexual Dysfunctions.

Lifelong: This subtype applies if the sexual dysfunction has been present since the onset of sexual functioning.

Acquired: This subtype applies if the sexual dysfunction develops only after a period of normal functioning.

Generalized Type: This subtype applies if the sexual dysfunction develops only after a period of normal functioning.

Situational Type: This subtype applies if the sexual dysfunction is limited to certain types of stimulation, situations, or partners.

Due to Psychological Factors: This subtype applies when psychological factors are judged to have the major role in the onset, severity, exacerbation, or maintenance of the Sexual Dysfunction, and general medical conditions and substances play no role in the etiology of the Sexual Dysfunction.

Due to Combined Factors:

This subtype applies when 1) psychological factors are judged to have a role in the onset, severity, exacerbation, or maintenance of the Sexual Dysfunction; and 2) a general medical condition or substance use is also judged to be contributory but is not sufficient to account for the Sexual Dysfunction.

If sexual dysfunction is attributed solely to substance abuse or a medical cause, Sexual Dysfunction Due to a General Medical and/or Substance-Induced Sexual Dysfunction is diagnosed.

Associated Features

Many males affected describe feeling aroused at the beginning of a sexual encounter but that thrusting gradually becomes a chore rather than a pleasure. A pattern of paraphilic sexual arousal may be present. Paraphilias are powerful sexual interests in situations, objects or events that are not part of normal sexual behavior such as voyeurism or exhibitionism.

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.