Sexual Health Q&A

What is orgasmic anhedonia/pleasure dissociative orgasmic dysfunction?

The word “anhedonia” refers to the inability to experience pleasure from an activity that is normally considered pleasurable. People with orgasmic anhedonia (also called pleasure dissociative orgasmic dysfunction or PDOD) are unable to feel pleasure when they climax.

Orgasmic anhedonia/PDOD doesn’t affect sex drive. People with this rare condition still feel driven to have sex. Men still ejaculate. And women still know they’re reaching orgasm. The difference is that the pleasure is missing.

The situation can be quite frustrating for couples. People with orgasmic anhedonia/PDOD may be embarrassed or feel like they’re missing out. Partners may feel inadequate, like they are doing something wrong. Some partners are unaware of the situation.

Experts believe that orgasmic anhedonia/PDOD occurs because of a problem with neurochemicals in the brain, particularly dopamine. Patients may receive sexual stimulation, but there is a disconnect between the sensation and the part of the brain that recognizes that sensation as pleasurable.

It’s possible that the orgasmic anhedonia/PDOD is linked to psychological issues like depression or addiction. But it could also be connected to medications, high prolactin levels, low testosterone, or physical conditions like spinal cord injury.

If the cause of orgasmic anhedonia/PDOD can be identified, treating that issue may solve the problem. Sometimes, a combination of medical treatment and sex therapy is necessary.

People who do not feel pleasure during orgasm are encouraged to see their doctor.