T Nation

Difficulties in Achieving Orgasm

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I’m actually older than you

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Might be just a TAD to much TMI

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I get it, I act like a crotchety old man on here…

*I think the Marine Corps ages you in dog years.


Lots of joking in this thread, but your problem is somewhat serious albeit apparently rare. I brought this up here once and also found that no one else had experienced it. I found the same exact problem as you, about 6 month into starting TRT…

Like you, TRT improved absolutely everything for me. It’s great. Even libido improved. However, when actually having sex, there would be no build-up of “pressure”…no tingling or pressure to release. It would make you the ultimate porn star because you can be rock hard and pound like a jackhammer for days without cumming. But hey, eventually you want the payoff.

While I haven’t found a “cure” yet, I’ll tell you what I’ve observed. It is somehow stemming from the prostate (despite my PSA scores being very low and having no other prostate symptoms). Regardless, the prostate is where your semen is produced and stored, and I have concluded that this is where the problem lies (for whatever reason).

I don’t recall how or why I ended up trying this, but I ended up trying low-dose cialis (around 1mg/day…your mileage may vary?). I don’t know why I tried this because erections were never an issue. However, cialis fixed the problem. I could feel the tingling and pressure again, and it drives you to building towards that ultimate goal of orgasm and the pleasure of feeling that build-up all along the way. Also semen volume improved (returned to normal).

So then, I don’t know the mechanism of why this is, I just know that it works.

That said, I don’t use cialis all the time…in fact I only do it occasionally.


I know how you feel but nobody says “I’m only 22!” know what I’m saying?


I’m already pretty much bald and my beard has grey in it, ya’ll aren’t helping…


Sounds like more Cardio training is needed :smile:

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Not being able to orgasm can be caused by too much serotonin in the system.

I haven’t read your thread, but did you post any estrogen levels? E2?

Estrogen tends to affect serotonin

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I hear ya, you ain’t old until the grey pubes appear. :+1:

Incidentally, another thing no 22 year old says.


Had my first run in with prostrate several yrs ago, PSA good, just prostatitis. That was not fun. Several rounds of antibiotics over a yrs time finally cleared it up. Doc told me after violating me it was not enlarged. So that maybe some of the problem

I am not sure I can agree that it is “rare”. I think guys confuse issues surrounding ED and lump everything together.

Anorgasmia – is the inability to reach orgasm during sexual stimulation. Doctors (and the internet) will give you a thousand reasons, but for simplicity sake, one of the causes is Hormonal Imbalances. I am also not including psychological reasons which is the number one thing doctors point to.

Another factor that may or may not play a part is “lack of penile sensitivity”.

I can’t find the link right now - but both anorgasmia and lack of penile sensitivity have been shown to be side effects of unusually low Estrogen/Estradiol. Guess what I had?

Both of the above have a common cause - lack of testosterone. But for those of us who have boosted that and still experience problems, we must look other places. Obviously testing Estrogen, as well as prolactin; and yes, I would make sure to get a PSA test. Also include TSH, DHEA, DHT.

Another person mentioned serotonin …

selective serotonin reuptake inhibitors and classic antipsychotics that are not prolactin sparing have been shown to cause disturbances in orgasmic function.

The more out of balance I was, the more problems I had (ED was a major factor; but I couldn’t orgasm from hard-core masturbation either).

There is also evidence that dehydration effects the ability to orgasm (and the ejaculate of course). IMO, the key is to make sure you are getting a good blood profile and looking for any irregularities.

The drug cabergoline has been shown to improve the ability to orgasm, but my guess is, that would be a last resort.

IMO, it is more common that you think … we just don’t discuss as an adjunct problem - it is lumped in with everything ED.

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That’s some great information @traveling-man …the only reason I said it was rare is because I brought up this exact same issue here a while back, and no one (including some very well informed regulars) knew what I was talking about. It seemed as though it was a one-off. So I thought it was just me until THORBAKER brought this up. It’s the only other time I’ve seen it.

I’ve kept my E2 anywhere between 21 to 40 pg/ml and everything in between with zero change. So it’s not my E2. Currently I keep my E2 in the mid 30’s because my doc likes the side benefits of higher E2.

I’ve never had ED (before or after starting TRT). I should also mention (and I wonder if it’s the same for THORBAKER), that when you do climax, it’s different than normal. The spasms are different. And I link that to the “pressure” that isn’t there as much. Rather than a series of spasms, it more like one long one. Not as enjoyable but still good…kinda like the pizza theory…there’s no such thing as bad pizza.

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I have noticed that when I do explode it is also different than my youth. Semen volume much lower since having several bouts of prostatitis. Never had any hormones checked other than Total T, Free T. Often wonder about E2 and prolactin. Refractory time has greatly increased.

I guess this thread brought out the best in all of us

I start the TRT today but at a much reduced rate. 0.1 ml of 200mg/ml, 3 days a week. If that holds me I’ll have enough T for nearly 2 years. Doc wrote the script for 2 MLS a week of 200mg gave me a 6mnth supply with a refill.

I would get the E2 checked. I notice that when mine gets high my ejaculate volume is cut by about 80%. As soon as I drop the E2 it comes back full volume… I have not experienced the inability to orgasm though.


I can vouch for several of these symptoms, weight gain is one of them. Picked about 20lbs here recently with no explanation. Mood is down but not sure of the source now since my wife has been going through a pretty rough time for the past 2-3 years.

So what is the preferred method of reduction of E2 here?

You would need labs to be 100% conclusive. BUT I would wager its your e2. If your TT and Free T are super high, then you can kinda assume your e2 is high also.

First issue I usually notice when my e2 is high. Cant orgasm. Or it takes FOREVER.

Then I start getting “limp” unless there is constant physical stimulation.

High e2.

First answer is always lowering your dose a little bit.

When mine gets high, I drop my dose by 10mg on the next shot and within 2 days I feel zeroed again.

You can also try things like broccoli and warm lemon water. Don’t use an AI.


I agree with Alphagunner.

From the research I’ve done, serotonin is responsible for the ability to orgasm. … well, the speed at which it happens.

Estrogen very much affects serotonin. More estrogen, more serotonin.

Lower dose a bit.

Also, as alpha mentioned, broccoli is good. Dr. Crisler recommends Calcium D Glucarate (500mg x2day) and DIM (200mg day) for helping the body breakdown estrogen and get rid of it.