Lifelong anorgasmia: This means you've never experienced an orgasm; Acquired anorgasmia: This means you used to have orgasms, but now experience difficulty reaching climax; Situational anorgasmia: This means you are able to orgasm only during certain circumstances, such as during oral sex or with a certain partner. Most women can't reach orgasm through vaginal penetration alone. In fact, most women don't consistently have orgasms with vaginal penetration alone. Plus, orgasms often change with age, medical issues or medications you're taking.
When pharmacotherapy for delayed ejaculation is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics).
Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation