Abstract
Anorgasmia (AO) and delayed orgasm (DO) is both prevalent and very bothersome among men. Several centrally acting neurotropic medications such as selective serotonin inhibitors have been associated with DO. The mechanisms underlying AO and DO are poorly understood, however, the associations to centrally acting medications provide a strong rationale for aberrant neural signalling being a potential mechanism. Neuroimaging studies have characterized normal sexual function but little data exists among pathologic conditions such as DO and AO. The objective of this study is to use neuroimaging techniques to investigate differential neural signalling among men with DO and AO. One subject with a history of normal erectile function but DO was compared to two men with normal erectile, ejaculatory and orgasmic function that served as controls. Subjects were given an international index of erectile function (IIEF), and male sexual health questionnaire – ejaculatory domain questionnaires. Subjects underwent a 3 Tesla functional magnetic resonance imaging (fMRI) study while watching 3 video conditions: a neutral control, a positive (comedy) emotional control, and a sexual condition. Each condition was played for 50seconds, and each condition was presented using 5 unique clips in a pseudorandomized fashion. fMRI data was then analysed using SPM12 software in a block-designed analysis.
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