Maria Pease
Article by: Maria Pease
Estimated 10 minutes read

The candles are lit. The mood is set. You're feeling closer to your partner than ever before. Things are just clicking - everything feels right. But then, you start getting intimate, and you realize you're just not feeling it. You remember that you haven't felt the rush of pleasure from an orgasm in what seems like ages. If you've experienced this kind of situation, you might be dealing with something called sexual anhedonia.

This condition causes a marked lack of pleasure during sexual activities.  This can happen even if everything seems to be working just fine physically.

But what causes sexual ejaculatory anhedonia - and what can be done to treat it? It's more common than you might think, and there are plenty of treatment options for you to explore.

Let's take a closer look.

What is Sexual Anhedonia?

Sexual anhedonia, also known as orgasmic anhedonia or pleasure dissociative orgasmic disorder, is a condition.  It makes individuals unable to experience pleasure or sensation during sexual activity, particularly during orgasm.

There are various causes of sexual anhedonia, including

  • Psychological issues (e.g., depression, schizophrenia, dissociative disorders).
  • Neurochemical imbalances (e.g., low dopamine levels).
  • Medication side effects (e.g., antidepressants, antipsychotics).
  • Physical conditions (e.g., spinal cord injury, hormone imbalances). 

We'll discuss these in more detail below.

People with sexual anhedonia may be able to physically engage in sexual activity and achieve ejaculation or orgasm. However, the main problem is a lack of pleasure or satisfaction. This condition can significantly affect sexual desire, function, and overall quality of life. Furthermore, as you might expect, it can create significant difficulties in forming and maintaining intimate relationships.

The science behind sexual anhedonia, in simpler terms, is related to problems in the brain's reward center. This usually messes with signals, especially from the nucleus accumbens, which deals with feelings of pleasure and motivation. It's firstly tied to having too little dopamine, a chemical that controls happiness and motivation.  And secondly, too much prolactin, a hormone that puts the brakes on sexual desire and orgasm.

What is Sexual Ejaculatory Anhedonia?

Often, you'll hear both the terms “sexual anhedonia” and “sexual ejaculatory anhedonia” thrown around interchangeably. Technically, they're the same - but also a bit different.

Sexual anhedonia is the broader term that refers to the inability to experience pleasure or satisfaction during sexual activities, even when stimulated. It can occur in both men and women.

Sexual ejaculatory anhedonia, on the other hand, specifically refers to the inability to experience pleasure or satisfaction during ejaculation. Of course, this can often lead to frustration, disappointment, and even shame. Various factors contribute to sexual ejaculatory anhedonia, including low testosterone levels, spinal cord injuries, or the use of some antidepressants or antipsychotics.

As you might expect, sexual ejaculatory anhedonia is, of course, a condition exclusive to men.

How Do I Know If I Have Sexual Anhedonia?

Do you find yourself unable to reach orgasm or feel aroused even during masturbation? If so, you may be suffering from sexual anhedonia - but that's not the only symptom to watch out for. Let's take a closer look at how sexual ejaculatory anhedonia can impact your sexual health.

Decreased Libido

One typical symptom of sexual anhedonia is a reduced libido or an overall decline in interest in sex. Various factors contribute to this, including hormonal imbalances (such as low testosterone levels), side effects from medications, and psychological factors like depression or anxiety.

Inability to Experience Pleasure During Sexual Activity

Since sexual anhedonia causes no or little pleasure during sex, it makes sense that this would be the hallmark symptom.

Ejaculatory Dysfunction

Ejaculatory dysfunction, premature ejaculation and erectile dysfunction can all be symptoms of sexual anhedonia. 

Why Do I Have Sexual Anhedonia?

Sexual Anhedonia doesn't have one particular cause. Various factors like diet, lifestyle, mood, and genetics play a role in how men experience their sexual health. If you have this condition, help is certainly available. So, let's explore some of the most common ejaculatory anhedonia causes and the best treatment options.

Psychological Factors

Several psychological factors have a strong connection with sexual anhedonia, such as schizophrenia, depression, and dissociative disorders. Studies suggest that individuals with schizophrenia are more susceptible to sexual anhedonia, primarily due to imbalances in neurochemicals like dopamine.

Depression is a common symptom of schizophrenia and can also occur on its own. It contributes to sexual anhedonia by dampening the mood and causing a lack of interest in sexual activities.

The cortex and nucleus accumbens are important parts of the brain that deal with pleasure and motivation. When someone has dissociative disorders, these areas are significantly affected. So, it makes sense that disorders like this can lead to issues with sexual function.

Neurochemical Imbalances

Your dopamine levels, or neurochemical imbalances in general, also play a significant role in this disorder.

Dopamine is a neurotransmitter crucial for the brain's reward and pleasure pathways, like the nucleus accumbens. The nucleus accumbens is like the brain's switchboard for motivation and action. It's crucial for things like eating, sex, rewards, dealing with stress, and even behaviors related to drug use. When dopamine levels are low, it can lead to decreased pleasure and motivation.

Several factors can contribute to dopamine imbalances, such as hormonal changes, spinal cord injuries, and side effects of certain medications like antidepressants and antipsychotics. Blood tests and other diagnostic tools can help identify if dopamine levels may be a factor in sexual anhedonia.

Hormonal Imbalances

Hormonal imbalances can also lead to anhedonia. Prolactin is a common culprit.

High levels of prolactin are associated with a variety of sexual dysfunctions in both men and women. These include decreased sexual desire and difficulty achieving orgasm.

Low testosterone and thyroid imbalances can also contribute to sexual anhedonia by interfering with sexual function and reducing libido.


Using antipsychotics and anti-depressants in treating mental health problems can be a game-changer for some. However, these medications can have a downside - they're linked to side effects of sexual anhedonia

Although we're not entirely sure why these drugs might cause this, experts believe they affect dopamine levels in the brain.

How is Sexual Anhedonia Diagnosed?

Sexual anhedonia diagnosis is through a physical exam and blood tests. During the physical exam, the doctor may assess the genitals to check for any abnormalities or signs of infection. Blood tests can also show potential underlying issues, such as low testosterone or thyroid imbalances.

Once diagnosed, it's best to work with a healthcare professional to develop a comprehensive ejaculatory anhedonia treatment plan. 

How Do You Treat Sexual Anhedonia Naturally?

If you're struggling with sexual ejaculatory anhedonia, there are a few treatment options you can try. Let's take a closer look.


This approach is all about addressing any underlying psychological issues that might be contributing to your lack of pleasure during sexual activity.

A licensed therapist can work with you to identify and explore any emotional or mental barriers that might be keeping you from experiencing pleasure. They may also suggest different coping mechanisms or relaxation techniques to help you better manage these barriers.

Sex Therapy

Another option is sex therapy. Unlike psychotherapy, this approach is focused solely on addressing sexual issues within the context of your relationship(s).

A sex therapist can help you and your partner(s) work through any issues with sexual desire, function, or communication, all of which can play a role in the experience of sexual anhedonia. They may also suggest specific exercises or techniques designed to help you better connect with your body and your partner(s) during sexual activity.


Exercise is a great way to promote healthy blood flow and improve mood, both of which can help in the bedroom.

Regular aerobic exercise increases dopamine levels in the brain, which can result in a more positive outlook and increased feelings of joy and pleasure.

Not only that but engaging in regular exercise can help reduce anxiety levels and improve self-esteem, which may lead to an overall improvement in sexual functioning.

Stress Management

Stress management is another crucial factor to consider when treating sexual anhedonia naturally. Chronic stress can interfere with the body's natural hormonal balance, leading to a decrease in libido and sexual function.

By practicing stress management techniques like meditation, yoga, or therapy, one can reduce the negative impact of stress on their sexual health.

Dietary Changes

Dietary changes may also have a significant impact on sexual anhedonia. Some foods, like those high in sugar and saturated fats, can negatively affect hormonal balance and decrease libido.

On the other hand, foods high in nutrients like zinc, magnesium, and vitamin B6 support healthy sexual functioning. Adding more whole foods, leafy greens, and lean protein to your diet can help improve sexual health over time.

Tips for Coping With Sexual Anhedonia

Sexual anhedonia can be a pretty frustrating and disheartening experience, but it's important to remember that there are ways to cope and improve your situation. Here are some tips to help you on your journey.

Communicate With Your Partner

Communication is key! Talk to your partner about what you're going through so they can understand and support you. It may seem scary or embarrassing, but it can bring you closer in the long run.

Experiment with Different Types of Stimulation

Sometimes, traditional sexual activities may not be as enjoyable, so try exploring other areas of your body or different techniques that may bring you pleasure.

Encourage Non-Sexual Intimacy

When we're so focused on everything we can't do or can't enjoy, we forget what we can do. So don't forget about non-sexual intimacy! Cuddling, kissing, and even holding hands can be incredibly fulfilling and help strengthen your emotional bond.

Try to Improve Your Overall Quality of Life

In addition to sexual experiences and intimacy in other areas, try to improve your overall quality of life. Eating healthy, exercising, and engaging in hobbies or activities you enjoy can contribute to a more positive mindset and potentially enhance your sexual function.

Can You Take Medications for Sexual Anhedonia?

Typically, treatment is a combination of psychological treatment and medication. Other drugs that may help include dopamine agonists, oxytocin, phosphodiesterase type 5 inhibitors (Sildenafil/Viagra), and alpha-2 receptor blockers like yohimbine.

It's important to understand that Sexual Ejaculatory Anhedonia is a condition influenced by psychological, hormonal, and neurochemical factors. While medical treatments, including Testosterone Replacement Therapy (TRT), may be considered, incorporating lifestyle changes is essential.

Regular exercise enhances blood flow and mood and stimulates dopamine release. Coupled with stress management techniques, such as meditation or yoga, individuals can relieve chronic stress on hormonal balance, possibly leading to a healthier libido and improved sexual function.

Dietary modifications can also help. A nutrient-rich diet, abundant in zinc, magnesium, and vitamin B6, provides essential support for sexual health. Simultaneously, reducing the intake of sugar and saturated fats, known to disrupt hormonal balance, becomes a crucial step toward a healthier sex life.

At Male Excel, we understand the importance of sexual health and pleasure for overall well-being. We know that treating sexual ejaculatory anhedonia is not simple and that it takes time and a personalized approach to find the treatment that's right for you.

Our online men's health clinic offers various services, including Testosterone Replacement Therapy (TRT) and ED treatment, to help men live their best lives. There's no reason to suffer in silence.

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