anonymous on September 12, 2011

What causes lack of sexual pleasure for men?

My husband is 22 years old and has never felt physical pleasure during masturbation or sex. Oral sex gives him a little pleasure, but only on the penis head and testicles. He can get an erection and ejaculate – but, again, it’s not pleasurable. Is there something physically or psychologically wrong with him?

answered by David Sobel, MD, JD on September 12, 2011

Thanks so much for sharing your concern with us. Based on what you have shared, it’s hard to say whether your husband’s lack of sexual enjoyment is physical or psychological in nature... both are possibilities that I’m happy to explore with you.

Lack of sexual pleasure might be a physical problem related to a disease or the way his penis developed…or it could be a side effect of medication or drugs. Anxiety and certain beliefs can also influence the way a person experiences sex. For example, sometimes religious beliefs can make a person feel guilty about sexual activity and sexual expression.

To find out for sure what’s causing this problem for your husband, I would encourage him to see his doctor or urologist who can do some tests to determine if there’s a physical problem. His doctor should also be able to help your husband with psychological resources if needed.

What does a doctor look for if someone doesn’t experience pleasure with sex? To begin, the doctor will likely visually examine the penis and testicles. The doctor may also take urine or blood samples, and possibly give your husband a prostate exam.

Some physical conditions that can influence a man’s enjoyment of sex include diseases such asPeyronie’s disease, lesions, an issue with the foreskin, a problem with the prostate, hormone deficiencies and certain medications...among other possibilities.

How can a therapist help a man who doesn’t find sex pleasurable? If your husband checks out fine, physically, a therapist might assess his psychological reaction to sex by discussing what he’s feeling emotionally during sexual activity. For example, if a man expresses anxiety, guilt, or a past experience with abuse or injury, then a therapist may be able to help him understand and overcome these feelings. And, with time, your husband may find pleasure in sex.

Thanks again for writing, and I wish you both good luck as you support each other toward developing a more pleasurable sex life.

Related info:

David Sobel, MD, JD

Dr. Sobel is a Colorado-based urologist and Director of the Denver Center for Men’s Health. His areas of expertise include men's sexual health and all areas of urology, including urologic oncology, treatment of benign prostatic hypertrophy, stone disease and incontinence. Dr. Sobel was educated at the University of Michigan Law School and the University of Illinois at Chicago College of Medicine, and completed his residency at the Rush University Medical Center in Chicago, IL.

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