Why Men with ED Have Trouble With Orgasms

As if having erectile dysfunction were not challenging enough, a new study reveals that most men with ED have other sexual problems. More precisely, 65 percent fail to have an orgasm and 58 percent also have problems with ejaculation. The study from New York-Presbyterian/Weill Cornell Medical Center (NYP/WCMC) included more than 12,000 men and is the largest ever to evaluate problems with ejaculation and orgasm in men.

We may have become more comfortable talking about erectile dysfunction; after all, commercials on ED appear on prime time TV every day. Yet most men who have erectile dysfunction are also suffering with other sexual difficulties seldom mentioned. According to Darius Paduch, male sexual medicine specialist at NYP/WCMC and assistant professor of urology and reproductive medicine at Weill Cornell Medical College, although Viagra and other ED medications have helped many men, “our research suggests there are other common sexual issues that remain largely unaddressed.”

To arrive at their findings, the researchers followed 12,130 men with mild to severe erectile dysfunction. The data came from questionnaires given to an international cohort of men enrolled in 28 clinical trials for tadalafil (Cialis). The findings have led the researchers to rethink how to define qualify of life regarding sexual performance.

Paduch noted that “for the last few decades we have focused on penile rigidity…however, many patients say that problems with ejaculation—like decreased force or volume or decreased sensation of orgasms—are just as critical.” Other ejaculatory problems may include delayed ejaculation, inability to ejaculate, painful ejaculation, and retrograde ejaculation.

In other words, men are not just coping with not being able to have an erection: they are also worried about the quality of their sexual experience, but who knew? Paduch explained that “despite the frequency of these issues, non-erectile sexual dysfunction is underreported and undertreated due to social stigma and misunderstandings about the physiology of male sexual response and orgasmic dysfunction in particular.”

The findings of this study have put a spotlight on several important sexual problems affecting men who are also suffering with erectile dysfunction. They have also prompted both Dr. Paduch and Alexander Bolyakov, a co-author of the study and a research associate at Weill Cornell Medical College, to make plans to measure biological and subjective changes in men associated with orgasm and ejaculation.

“The high prevalence of both orgasmic and ejaculatory dysfunction warrants further clinical and translational research into new treatments to improve sexual health,” said Dr. Paduch in a release from Weill Cornell Medical College. Their additional research will hopefully prove fruitful for the millions of men with erectile dysfunction and the ejaculatory and orgasmic difficulties that too frequently accompany it.

Read more in our Erectile Dysfunction Health Center.


Paduch DA et al. Factors associated with ejaculatory and orgasmic dysfunction in men with erectile dysfunction: analysis of clinical trials involving the phosphodiesterase type 5 inhibitor tadalafil. BJU International 2012 Apr; 109(7): 1060-67