|This article relies largely or entirely upon a single source. (April 2013)|
Sexual anhedonia, also known as pleasure dissociative orgasmic disorder, is a condition in which an individual cannot feel pleasure from an orgasm. It is thought to be a variant of hypoactive sexual desire disorder.
Normally, a human being is able to feel pleasure from an orgasm. Upon reaching a climax, chemicals are released in the brain and motor signals are activated that will cause quick cycles of muscle contraction in the corresponding areas of both males and females. Sometimes, these signals can cause other involuntary muscle contractions such as body movements and vocalization. Finally, during orgasm, upward neural signals go to the cerebral cortex and feelings of intense pleasure are experienced. People who have this disorder are aware of reaching an orgasm, as they can feel the physical effects of it, but they experience very limited or no sort of pleasure.
It is thought that people who suffer from this disorder suffer from a dysfunction in the release of the chemical dopamine in the nucleus accumbens, the brain's reward center. This part of the brain is thought to play a role in pleasurable activities, including laughter, addiction, and music. Additionally, it is thought that depression, drug addiction, high levels of prolactin, low testosterone, and uses of certain medications might play a role in inhibiting dopamine. A spinal cord injury or chronic fatigue syndrome might also occasionally cause this disorder. Age may also be a cause of this disorder.
A sudden-onset sexual anhedonia can also be a symptom of sensory neuropathy, which is most commonly the result of pyridoxine toxicity (e.g., from large doses of vitamin B6 supplements). In this case, the sexual dysfunction promptly resolves spontaneously once the B6 supplementation is stopped.
As sexual anhedonia is the source of considerable embarrassment among its sufferers, several treatment methods have been devised to help patients cope. Exploration of psychological factors is one method, which includes exploring past trauma, abuse, and prohibitions in the cultural and religious history of the person. Sex therapy might also be used as a way of helping a sufferer realign and examine his or her expectations of an orgasm. Contributing medical causes must also be ruled out and medications might have to be switched when appropriate. Additionally, blood testing might help determine levels of hormones and other things in the bloodstream that might inhibit pleasure. This condition can also be treated with drugs that increase dopamine, such as oxytocin, along with other drugs. In general, it is recommended that a combination of psychological and physiological treatments should be used to treat the disorder.
Other drugs which may be helpful in the treatment of this condition include dopamine agonists, oxytocin, phosphodiesterase type 5 inhibitors, alpha-2 receptor blockers like yohimbine hydrochloride.
- Csoka AB, Bahrick A, Mehtonen OP. Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors. J Sex Med. 2008 Jan;5(1):227-33.
- Courtois F, Charvier K, Leriche A, Vézina JG, Côté I, Raymond D, Jacquemin G, Fournier C, Bélanger M. Perceived physiological and orgasmic sensations at ejaculation in spinal cord injured men. J Sex Med. 2008 Oct;5(10):2419-30. Epub 2008 May 7.
- Soler JM, Previnaire JG, Plante P, Denys P, Chartier-Kastler E. Midodrine improves orgasm in spinal cord-injured men: the effects of autonomic stimulation. J Sex Med. 2008 Dec;5(12):2935-41. Epub 2008 Apr 15.
- Ishak WW, Berman DS, Peters A. Male anorgasmia treated with oxytocin. J Sex Med. 2008 Apr;5(4):1022-4. Epub 2007 Dec 14.
- Perelman, Michael A. (2011). "Anhedonia/PDOD: Overview". The Institute For Sexual Medicine. Retrieved 14 February 2011.
- Perelman, Michael A. (2011). "Anhedonia/PDOD: Causes". The Institute For Sexual Medicine. Retrieved 14 February 2011.
- Comprehensive Textbook of Sexual Medicine By Kar, page 18
- Perelman, Michael A. (2011). "Anhedonia/PDOD: Treatment". The Institute For Sexual Medicine. Retrieved 14 February 2011.
- Goldstein, Irwin. "Orgasmic Anhedonia/ PDOD: Treatment". The Institute for Sexual Medicine. Retrieved 15 July 2014.