The brains of men with lifelong delayed orgasm (DO) might process sexual cues differently, according to recent research in the Journal of Sexual Medicine.
DO is a distressing condition that causes men to need more time to climax than they wish.
Experts aren’t certain what causes DO, but some studies have suggested that the central nervous system might have trouble processing sexual stimuli. Other factors, like anxiety, relationship conflict, and medications are also associated with DO.
This study used fMRI brain imaging to further investigate DO. Nine men – three with DO (average age 36 years) and six with normal orgasmic function (average age 35 years) – participated. One man in the DO group did not reach orgasm with his partner at all, but could do so during masturbation. For the other two, the average time to orgasm was 22.5 minutes with a partner and 16.7 minutes during masturbation. For the control group, the average times were 13.3 and 8.8 minutes, respectively.
Each man underwent fMRI, during which they watched three 50-second video clips: one depicting neutral content, one showing heterosexual intercourse, and one featuring humorous, but non-sexual, content. Between each clip, a 10-second gray fixation screen was shown. The sequence was repeated for 15 minutes.
In addition, each man completed the International Index of Erectile Function (IIEF), the Male Sexual Health Questionnaire (MSHQ), and an additional questionnaire concerning their experiences during the fMRI.
After analyzing the fMRI results, the researchers found that two brain areas had increased activation in the DO group during the sexual content, but not in the control group: the right fusiform gyrus of the occipital lobe and the right hippocampus.
This finding suggests “possible differences in neural activation while processing sexual stimuli in men with DO,” the authors noted.
They added that the right fusiform gyrus of the occipital lobe is linked to processing facial features. It’s possible that the men in the DO group might have focused more on faces during the sexual video clip than the men in the control group did.
“This observation and hypothesis require further validation but may explain why psychotherapy in men with DO has limited success,” they wrote.
In addition, the increased activity in the hippocampus might stem from “previous fear or anxiety-related memories in the context of sexual encounters, with performance anxiety or fear present due to difficulties in achieving orgasm.”
Several neurotransmitter receptors were identified as well, including dopamine receptors and cannabinoid receptors.
“Given the high degree of neurotransmitter complexity in the brain, narrowing the focus of receptor subtypes in these distinct regions may narrow the focus of future investigations of pharmacologic therapy for these men,” the authors wrote.
They acknowledged that their sample size was small, so the findings should be considered exploratory.
The Journal of Sexual Medicine
Flannigan, Ryan, MD, et al.
“Functional Magnetic Resonance Imaging Detects Between-Group Differences in Neural Activation Among Men with Delayed Orgasm Compared with Normal Controls: Preliminary Report”
(Full-text. Published online: July 11, 2019)