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). In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy, mirtazapine, or nefazodone (withdrawn from the US market), which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do.
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sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation.
Anorgasmia is the medical term for regular difficulty reaching orgasm after ample sexual stimulation, causing you personal distress. Anorgasmia is a common occurrence, affecting a significant number of women.