‘I have never felt what I believe to be a true orgasm.’
These were the words of one helpless 18-year-old on Reddit as he questioned why his climax, something often touted as a treasure trove of pleasure, doesn’t feel as it should.
In fact, there are a few of us who achieve the big-O only to feel… nothing.
This is known as sexual anhedonia, not to be confused with the likes of anorgasmia (difficulty climaxing) or PSSD, which refers to sexual dysfunction due to anti-depressants.
‘I remember masturbating for the first time at 12 and thinking “wait I thought this was supposed to feel amazing…”’ he adds. ‘I have a pretty good sex drive and masturbate regularly with no problem getting hard…
‘When I ejaculate there is no “WOW!” moment, never has been… I wonder if I’m missing out on a key part of life.’
Another man described a similar experience on Mumsnet. ‘If I masturbate or have sex there is literally no pleasure. It’s a “release” but I don’t experience any pleasure when I orgasm,’ he explained.
If this experience holds a mirror up to your own sexual experience, we’ve enlisted the help of a doctor to share what might be going on down there.
What is sexual anhedonia?
‘Basically it’s sex with no feeling, in particular no feeling of orgasm, even though you’re experiencing one,’ Jeff Foster tells Metro.
It can affect both men and women but has different names for each. For men, it’s known as ejaculatory anhedonia, and for women it’s referred to as orgasmal anhedonia. We’re also more likely to hear about men’s experience with the condition because there’s less research into the female side of the condition, according to the GP.
‘Men do physically ejaculate and women do physically orgasm, but neither experience the normal pleasure associated with a climax,’ Dr Foster adds.
The doctor has seen patients who also ‘feel sex has no emotion to it’, as well as who lose their libido, have relationship difficulties, or past sexual trauma, if they’ve been suffering with sexual anhedonia.
What causes it?
There are two primary causes: physical or psychological.
‘Physical causes include neurodegenerative conditions like Parkinson’s or dementia, brain trauma, injury or cancer,’ Dr Foster explains. ‘Psychological causes include depression, schizophrenia, and eating disorders.’
All of these have the potential to alter how our brain or nerves receive those pleasure signals from our orgasm. They trigger sexual anhedonia by ‘damaging the parts of the brain relating to pleasure and sex’.
‘Or the condition can be part of a wider spectrum of symptoms relating to mood disorders, if you feel very low sex can become less enjoyable,’ he adds.
Main causes of sexual anhedonia include:
- 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).
Who is more likely to develop sexual anhedonia?
If we’re generalising, says Dr Foster, those under the age of 35 typically develop it because of a psychological trigger, while those over 35 tend to have a physical cause.
Whatever your age though, you’re more predisposed to sexual anhedonia if you have a mental health condition like depression or anxiety, and if you’re taking SSRIs to help with your symptoms.
You’re also more likely to develop the condition if you have thyroid problems (which cause a hormonal imbalance), chronic stress, or an unhealthy lifestyle.
How do you get a diagnosis?
Sadly there’s no single medical test you can ask for to determine whether you have sexual anhedonia or not, with patients often being referred to urology, gynaecology or even psychiatry.
It’s often a symptom of another condition, so it’s important to determine if it’s one of those first.
‘We need to rule out hormonal conditions like menopause in women, and testosterone deficiency in men,’ Dr Foster explains. ‘It is also important to rule out diabetes (which causes injury to tiny blood vessels), and even neurological conditions like multiple sclerosis.’
All of these can be responsible for reduced sensation, while depression and anorgasmia are also possible misdiagnosis’. Essentially, determining whether you have sexual anhedonia is down to eliminating all other conditions until a trigger is identified.
More on sexual health…
How do you treat it?
There are three avenues of treatment for sexual anhedonia, and your doctor will suggest the right course of treatment based on your specific cause of the condition.
Firstly, there are medication adjustments you can make. ‘Making a change to your antidepressants, and treating hormonal imbalances can be key,’ Dr Foster says.
‘There are also psychological or behavioural treatments like sex therapy, CBT, or PTSD psychotherapy, which can help,’ he adds.
‘Lastly lifestyle factors can be altered, too, such as reducing chronic stress, addressing substance use (alcohol, opioids, stimulants), improving sleep, exercise, and emotional well-being.’
Do you have a story to share?
Get in touch by emailing MetroLifestyleTeam@Metro.co.uk.
