What's the best natural high in life? I think almost every guy would answer an orgasm. Well, not every guy: it turns out that lot of men have found that an orgasm isn't always an orgasm. Men think of poor orgasms as a woman's issue, but trust me - it is quite common among us males as well. In fact, a fairly high percentage of men actually dread the Big O believe it or not, because it leads to embarrassment or even debilitation. Researchers have even developed a term for this: "orgasmic dysfunction." And so this isn't a page on how to improve your orgasm if you are young and healthy, but rather how to improve it if something has gone wrong along the way.
have already covered Anorgasmia in Men. However, there are a host of related problems that I want to cover on this page instead, many of which I have seen on the The Peak Testosterone Forum. Below are Five Common Orgasmic Dysfunction Conditions:
1. Weak Orgasms. One reader wrote in with the following description:
"still having mild libido (compared to before), erections in bed with gf are there but sometimes I lose them and not so strong, mild orgasms, but I still can orgasm no problem and I have a morning erection once every week or so, but it fades by the time I stand up, before they would last minutes. but I noticed when I wake up in the later hours of the night I have a full erection" 
Men in this category often describe orgasms as almost boring believe it or not.
SOLUTION (FOR SOME MEN): I have found that low testosterone men often regain powerful orgasms once they go on a well-managed HRT (testosterone therapy) program. High and low estradiol can also make for weak orgasms, so a good protocol run by knowledgeable physician is critical. 
2. Debilitating Orgasms. This is a strange one, but a few of our posters have found orgasms almost incapacitating. For example, look at this description from one of senior members (with long term low testosterone):
"Ok guys a bit of a weird topic here and not something I would normally discuss, but fairly profound for me so I though I would share to see if anyone else has experienced something similar. Most of my adult life I have avoided masturbation because afterwards I would get extremely tired and God forbid I did it twice I would be basically catatonic. I probably started to experience this in my early thirties the most and in business I had to make sure I didn't masturbate the day before meetings or I always felt off." 
I am not sure exactly what causes this but assume it is some sort of neurotransmitter depletion in the brain, especially in a low testosterone environment.
SOLUTION (AT LEAST FOR THIS SPECIFIC POSTER): I can tell you that this specific individaul was greatly improved through HRT (testosterone therapy. Of course, HRT does not always work this smoothly for a hypogonadal man, but it is important to point out just what a pivotal role a man's T plays in an orgasm.
3. Delayed Orgasms. One man with Hashimoto's (autoimmune hypothyroidism) and low testosterone said he "always had problems achieving orgasm."  Of course, this is similar to anorgasmia, where a man cannot achieve an orgasm at all. It can be due to many factors, but low testosterone, high estradiol and elevated prolactin are common culprits.
4. Unpleasurable Orgasm. "First I started to notice that my penis became numb according to Morgentaler, one of the low T symptoms. Then GRADUALLY I lost libido, and also gradually I lost orgasmic sensation. I could maintain erection, have sex, but ejaculation did not result in orgasm. Plus on the top of that I started to experience premature ejaculation. The intercourse was under 1 minute and this is it. I had no control over it."  T of 325 
5. "Dead D ck". The reader in #4 referred to Dr. Morgentaler, who is probably my favorite urologist on planet earth: all us guys on HRT owe him a big debt. He stated that in a state of low testosterone "men may experience other symptoms, such as more difficulty achieving an orgasm, less-intense orgasms, a smaller amount of fluid from ejaculation, and a feeling of numbness in the penis when they see or experience something that would normally be arousing."  High and low estradiol can also take the wind out of one's sails.
We've already covered what a dramatic difference that testosterone can make in orgasms - although it certainly doesn't always! so check out this low testosterone man description after being on HRT:
"Not quite like being a kid, but WOW. I haven't felt this good in YEARS. My sleeping is all screwed up from the Australia trip, but with only three hours sleep yesterday I got up before 6am and did my full work out, and THEN after work I dug out a huge garden bed all by myself. Finished the night with sex that ABSOLUTELY felt more like it did when I was younger. My whole body was alive, and the orgasm was incredibly strong. It just usually doesn't work that way anymore. I'm a T believer!" 
Of course, not everyone experiences this dramatic of a turn around with HRT. Some guys write in after three months asking when they will feel anything at all! Furthermore, I remember one man wrote in and said that he was able to achieve an erection and orgasm with testosterone levels at 158! So there are many exceptions to the rule. One of the reasons is that estradiol and prolactin also often play a major role.
But what if all of these hormones are respectable and yet you still are having orgasmic dysfunction? Below I list some other Possible Culprits for Lousy O's. And remember: one of my prime directives on this site is to make you a certified Orgasmatarian. What is an Orgasmatarian? Simply someone who is healthy enough to achieve an orgasm and erection, because these are such key indicators of general health in us males.
Here are some solutions that have worked either on the forum or in the research and, yes, all of them should be cleared by your doctor first!
1. Medications and Recreational Drugs. Prescriptions drugs are notorious for causing orgasm issues. For example, one man wrote in and said that "Paxil has been wonderful except that I can't orgasm with it. If I only take half a pill, I can, but then my anxiety starts to creep up."  We have had the same commentary for Propecia and Epistane. Of course, virtually any recreational or prescription narcotic or painkiller can make it to where a man cannot orgasm. Alcohol in excess can do the same as well. (Moderate drinking can be a vasodilator and help actually.) So one of the first places to check is with your doc and your pharmacist.
NOTE: Do your research, but, if you have orgasmic dysfunction from Propecia, reportedly men have often been helped with progresterone. 
2. Yohimbine. This extract did very well in a study on men with orgasmic dysfunction (20 mg per day).  Researchers noted that "of the 29 patients who completed the treatment, 16 managed to reach orgasm and were able to ejaculate either during masturbation or sexual intercourse." Curing over half of the patients with one supplement is pretty impressive considering the gravity of their issue. On the forum, Yohimbine HCL has the reputation for being more safe than yohimbe itself and with less of the common side effects such as light headedness, palpitations, elevations in blood pressure etc.
CAUTION: Always check with your doctor first, especially if you are on any medications: yohimbine is an alpha blocker and thus can lower blood pressure and increase blood flow. This sounds good, but it can also lead to priapism and potentially dangerously low blood pressure, etc. Any erection over a couple of hours should be treated in the E.R. immediately.
3. Clomid. Many men boost their testosterone nicely using Clomid in order to preserve fertility. However, they don't realize how powerful the estrogenic effects of Clomid are and how they can mute or dampen one's O's.
4. Optimize Your Nerve Function. Obviously sensitivity can play a role and a little neuropathy is not going to help things. See my pages on Neuropathy and Erectile Dysfunction for more information. (A related disorder can be Retrograde Ejaculation and Low Semen Volume.)
5. Boosting Nitric Oxide. There is definitely an NO component often in orgasmic issues and men with orgasmic and erectile dysfunction issues from antidepressants can get a lot of help from Viagra for example.  Of course, I emphasize Natural Ways to Boost Your Nitric Oxide instead. Prelox, an herbal No booster, helped one of our posters, who stated that "after a few weeks I notice benefits, particularly in pleasure of orgasm. (The manufacturers claim the two ingredients work synergistically.)" 
6. Dopamine. Strategies that boost dopamine will likely help with orgasmic dysfunction as well. We had one poster take a dopamine-boosting drug (used for erectile dysfunction by some) with some success.  He discontinued because of side effects from this drug (Zyprima), but it just goes to show the power of dopamine: For a more holistic approach, you may want to look at my links Natural Dopamine Increasers and Sleep and Dopamine for some starter information.
11) Asian Journal of Andrology, May 2007, 9(3):403 407, "Yohimbine in the treatment of orgasmic dysfunction"
12) The American Journal of Psychiatry, November 01, 2001, 158(11), "Efficacy of Sildenafil Citrate for the Treatment of Erectile Dysfunction in Men Taking Serotonin Reuptake Inhibitors"