What Is the Male Orgasm?

If you’re dealing with any of these issues, you’ll be relieved to know they’re common and often treatable. This guide breaks down the science of the male orgasm, including how it happens, potential difficulties, and what you can do to improve your experience.

“This chemical causes blood vessels in the penis to relax, allowing for increased blood flow and the formation of an erection,” says Justin Houman, MD, an assistant professor of urology at Cedars-Sinai Medical Center in Los Angeles. “As blood flows into the erectile tissue (the corpora cavernosa), tiny valves close off the veins so blood can’t escape; this is what maintains the erection.”

The main differences between a male and female orgasm are less about the sensation itself and more about the body’s mechanics and what happens afterward.

“Male and female orgasm contractions are indistinguishable,” says Nicole Prause, a sexual psychophysiologist, a neuroscientist, and the founder of Liberos, an independent research institute in Los Angeles. “You cannot tell from the contractile patterns alone if they are male or female.”

Desire

Arousal (Plateau)

Orgasm

The orgasm is the climax of the sexual response cycle. While it feels like a single intense event, the physical process actually happens in two stages.

She adds that this process is what leads to the climax. “This propulsion moves semen into the urethra and out through ejaculation, typically coinciding with peak sexual pleasure,” she says. “That’s the climax, and it’s more of a spinal reflex than many people realize.”

Resolution and the Refractory Period

“Anxiety, depression, and performance pressure can interfere with the brain-body connection needed for orgasm,” says José Ramirez, a licensed mental health counselor and certified sex therapist with the Psychology Group in Fort Lauderdale, Florida. He explains that psychological stress can sometimes shut down this connection to protect the psyche.

Here are some of the most common orgasm-related issues that men face.

Anorgasmia and Delayed Ejaculation

“Anorgasmia” is the medical term for being unable to reach orgasm, even with plenty of stimulation. A less severe but related issue is delayed ejaculation, which is when it takes a very long time to reach orgasm.

• Medications Antidepressants — especially selective serotonin reuptake inhibitors (SSRIs) — and blood pressure medications are frequent culprits.
• Nerve Damage Conditions like diabetes or injuries to the spine or pelvis from surgery can interfere with the necessary nerve signals.
• Hormonal Imbalances Low testosterone can reduce libido and the intensity of arousal needed for orgasm.
• Prostate Conditions An enlarged prostate can physically disrupt the ejaculation process.

On the psychological side, what’s happening in your head can also impact your ability to reach orgasm.

“Performance anxiety, intrusive thoughts, and self-criticism sabotage sexual pleasure,” says Michael Stokes, a licensed professional counselor, a sex therapist, and the founder of Stokes Counseling in Naugatuck, Connecticut. “A lot of men are so stuck in logistics — ‘Am I hard enough?’ ‘Will I last?’ ‘Is this position working?’ — that they miss the experience of pleasure entirely. That mental preoccupation is often the hidden cause of both premature ejaculation and anorgasmia.”

Dry Orgasm

Premature Ejaculation

Your personal habits can also be a factor. Jennifer Litner, PhD, a licensed marriage and family therapist, a sexologist, and the founder of Embrace Sexual Wellness in Chicago, says that a common nonmedical reason for PE is a fast masturbation pattern that’s difficult to override with a partner. In other words, if you always rush to orgasm during solo sex, it may be hard to slow things down later on.

Retrograde Ejaculation

If you're dealing with any of these issues, it's important to talk with a doctor or a certified therapist. They can help figure out the underlying cause and recommend a treatment plan that's right for you.

“Ejaculatory challenges are common and treatable,” says Amy Pearlman, MD, a board-certified urologist specializing in male sexual and hormonal health in Coral Gables, Florida. “Don’t settle for just dealing with it — the sexual medicine field is constantly evolving and innovative therapies are becoming increasingly available.”

Treating Anorgasmia and Delayed Ejaculation

The goal here is to restore the ability to climax by addressing the physical or psychological barriers that are getting in the way.

A doctor may suggest these treatments:

• Sex Therapy A therapist can help address performance anxiety, stress, and other psychological factors. They might use techniques like sensate focus, which involves touch-based exercises that remove the pressure to perform and help you reconnect with physical pleasure.

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   “Reducing porn consumption, vibrational therapy, and even red light therapy can help — each in the right context, depending on the individual,” says Dr. Pearlman.
• Off-Label Medication Pearlman says that sometimes medications are used off-label to help with orgasm. For delayed ejaculation, she says that some men may benefit from medications like flibanserin (Addyi) or bremelanotide (Vyleesi).
• Adjusting Medications If a medication is causing problems, a doctor may adjust the dose or switch to a different drug.

Treating Premature Ejaculation

For PE, treatment focuses on gaining control and delaying orgasm for longer.

A doctor may suggest these treatments:

• Behavioral Techniques Doctors and therapists often recommend pause-squeeze techniques. These exercises help you learn to recognize the sensations leading up to orgasm and give you more control.

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• Pelvic Floor Exercises Strengthening the pelvic floor muscles (with exercises like Kegels) can improve ejaculatory control. However, these exercises should only be done under medical guidance, says Andrés Suro, a resident sexologist at the male sexual health brand Myhixel. “Overtraining or misusing these exercises can cause pelvic tension and pain, and even contribute to premature ejaculation in some cases,” says Suro.
• Medication Pearlman isn’t a fan of prescribing daily SSRIs to help with PE because of their side effects. Instead, she recommends PDE5 inhibitors, such as sildenafil (Viagra) or tadalafil (Cialis).
• Topical Delay Sprays Over-the-counter creams and sprays containing numbing agents like lidocaine can be applied to the penis to reduce sensitivity and help delay climax.

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   Pearlman says these can be “game changers.”

Treating Dry Orgasm and Retrograde Ejaculation

The approach here depends on the underlying cause and whether you're trying to have children.

A doctor may suggest these treatments:

• Sperm Retrieval If you and your partner are trying to conceive, Dr. Honig recommends seeing a reproductive urologist for sperm retrieval. The sperm can then be used for artificial insemination or in vitro fertilization.
• Medication If nerve damage is the reason for retrograde ejaculation, whether it’s from diabetes, multiple sclerosis, or other conditions, a doctor may prescribe medications to help the bladder neck muscle stay closed during orgasm.

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Houman says additional testing, like penile Doppler ultrasounds, semen analysis, and postejaculate urinalysis, can also help determine the cause and inform next steps.

To get there, experts recommend engaging both the body and mind to build sexual tension, strengthen the relevant muscles, and remove barriers like stress or muted sensations.

Here are some effective methods.

Kegel Exercises and Pelvic Floor Health

“Kegel exercises are actually included in medical guidelines for improving pelvic floor strength, which can enhance orgasm control and intensity,” says Ambardjieva. Just remember that overdoing pelvic floor exercises may result in pelvic tension, pain, or even premature ejaculation. Consulting a healthcare professional for guidance on proper technique and frequency is a must.

Edging and Orgasm Control

Breathing and Stress Management

Explore Different Forms of Stimulation

Moving beyond routine stimulation can help you build a more complex and intense orgasmic experience.

“Stimulating the prostate can produce powerful, full-body orgasms,” says Stokes. “It’s not for everyone, but medically, it’s a valid and safe technique when done correctly.”

“Sexual challenges are common, and they’re treatable,” says Stokes. “Most men struggle in silence because of shame or outdated beliefs about what sex should look like, but your pleasure, your orgasm, and your relationship to sex belong to you, not to anyone else’s definition.”

If you're experiencing ongoing issues with orgasm, whether that means you're finishing too early, can't reach climax at all, or feel pain when you do, it's best to consult a healthcare professional for a thorough evaluation and personalized recommendations.

A doctor's visit is about finding what's behind the issue. They'll help you explore the possible causes, from your physical health and current medications to psychological factors like stress, and then suggest the most appropriate treatments or lifestyle changes for you.

“It’s never too early or too late to talk to a healthcare provider about concerns with ejaculation — whether it's happening too soon, too late, or not at all,” says Pearlman. “However, not all providers are trained to handle this. You want someone who specializes in sexual medicine.”

• Your mind and body both play a huge part in your orgasm, which is why common issues like finishing too soon or taking too long are often linked to a treatable mix of stress, anxiety, or your physical health.
• You can take an active role in improving your sexual experience through techniques like behavioral exercises for ejaculatory control and edging for more intense orgasms. Lifestyle adjustments like managing stress and practicing breathing techniques can help, too.
• If something feels off with your orgasm consistently, talking to a doctor is a smart move. Your best bet for effective treatment is a provider who specializes in sexual medicine.