Substance-induced sexual dysfunction may occur only or predominantly during substance intoxication. For example, alcohol intoxication may cause erectile dysfunction or orgasmic disorders that resolve when the patient is not intoxicated. Clinicians must determine that the patient's sexual dysfunction is not better explained by another psychiatric disorder or a concomitant physical disorder. Because patients often do not associate their sexual dysfunction with use of substances, especially prescribed drugs, direct questioning by a clinician may be necessary to establish the etiologic link. A persistent or recurrent delay in or absence of orgasm after normal sexual arousal.
Depression is a common cause of orgasmic difficulty as well as decreased desire and arousal.
Problems with achieving orgasm are usually linked to difficulty in developing sufficient arousal. However, arousal may be sufficient to achieve partial or full erection but not to produce orgasm. Premature Ejaculation Orgasm and ejaculation with minimal sexual stimulation that persistently or recurrently occurs before, during, or shortly after penetration and before the man desires. The disorder is probably due to a combination of psychologic and physiologic factors. Regardless of cause, treatment with small doses of a selective serotonin reuptake inhibitor is usually successful.