Objective: The deficit of male orgasm is an unusual clinical condition. This is a case report on secondary male anorgasmia with cerebral infarction. Material and Method: The patient was a 55-year-old man who had suffered from male anorgasmia, acquired type. The patient had a normal erectile response, but ejaculated without any sensation of orgasm. The patient underwent an evaluation by a psychiatrist and an urologist trained in sexual medicine. Result: The results of physical, psychological, and laboratory examination were normal. Brain MRI revealed cerebral infarction at bilateral parietal lobes and frontal lobes. Conclusion: There is a possibility that these brain regions are related to male orgasmic dysfunction.
The deficit of male orgasm is an unusual clinical condition with unknown etiology. For difficulties in reaching orgasm, lifetime prevalence estimates a range of up to 34% in women [
A 55-year-old man visited our hospital in 2006 complaining of a history of loss of orgasmic sensation since 1991. The patient underwent an evaluation by a psychiatrist and an urologist trained in sexual medicine. He had had no family history of appreciable disease. He had had the past history of Vestibular neuronitis (1990), and Hypertension (1996-2006). He had been taking Betaxolol (beta-blocker) 20 mg/day since 1996. His sexual history was normal. He did not have a sexual partner at that time. His libido, erection, and arousal were normal. But he ejaculated without any sensation of orgasm. His penis, testicles, epididymides, prostate, sensory examination, bulbocavernosus reflex, and anal sphincter reflex were normal. The result of International Index of Erectile Function-5 was 24 points (normal range is between 22 and 25 points). The blood test including hormonal test was all normal. The psychological state that was evaluated by a psychiatrist was normal. The brain MRI revealed cerebral infarction at bilateral parietal lobes and frontal lobes (
Definition of anorgasmia is absence of orgasm experience, independent of whether or not any or all of the physiologic concomitants of ejaculation [
associated with the medial preoptic area and paraventricular nucleus [