Male Anorgasmia and Delayed Ejaculation

madman

Super Moderator

Alexander Pastuszak, MD, Ph.D., reviews the anatomy and physiology relevant to delayed ejaculation and anorgasmia, as well as the causes and diagnosis of these conditions. He also discusses psychosexual and behavioral coaching treatment approaches for these conditions and evidence for pharmacotherapy options.

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This is pretty interesting stuff. I started a thread last week about this very issue. It turns out my prolactin is high (26.3 (range 4.0-15.2)), likely from the Lyrica I take for neuropathic pain. I see in the materials above that the suggested starting dose for cabergoline is 0.25 BIW. Dr. Saya has prescribed cabergoline for me at 0.125 BIW, then retest prolactin in six weeks. I'm going to follow his advice and protocol, of course, but I'm wondering if 0.125 BIW is going to do much. DE/anorgasmia has been wreaking havoc my sex life with my wife since I started the Lyrica, and I'm getting a bit desperate to get it under control. She's a good sport, but she doesn't always enjoy how long it takes me to climax.
 

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A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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