WNHO -Indian Society Of Sex Medicine WhatsApp 9822006427. Male Orgasm. Orgasm and ejaculation, though co-occur are two separate entities. Orgasm can occur in the absence of ejaculation and vice versa. ETIOLOGY – causes. 1]Dislike for a partner, 2] Religious restrictions. 3] Masturbation Guilt 4] Guilt regarding nocturnal emission. 5] Fear of Pregnancy 6] Inadequate sexual stimulation. 7] Low libido. 8] Testosterone deficiency 9]Myopathy 10] Neuropathy 11} Spinal cord lesion. 12] Retrograde ejaculation 13]Drugs –Phenothiazines & amp; Guanethidine. 14] High threshold of ejaculatory reflex 15] Mental block. Treatment: - Sensate focus exercise [mutual pleasuring] is employed daily for the first three days. Since coitus is not allowed, it eliminates the pressure to perform. After the initial three days, when genital touching occurs, the woman stimulates the penis in whatever way he likes. Advise -inj. Testosterone once in 3 weeks for 3-4 injections.  (Testosterone increases the life span and fertilizing power of spermatozoa. It helps in the final maturation of spermatozoa during spermatogenesis. In hypogonadism, it stimulates libido and improves E.D. In normal individuals, it does not improve libido or erection.)  1. Testosterone ( Nuvir, Andriol) : 40 mg cap, T.D.S. with fatty meals for 3 weeks  2. Inj. Testosterone enanthate (Testoviron depot) : 100, 250 mg, deep intramuscular, 1ml every 2 weeks  3. Inj. Human chorionic gonadotropin or [Hcg] ( Profasi): 5000, 10000, 20000 I.U. Powder with diluent. Used for ovulation, spermatogenesis & amp; for undescended testis.  4. Levonorgestrel (Ecee2, Norlevo, I pill) : 750 mcg tab . Two tabs are taken together, preferably within 12 hours (no longer than 72 hours) after unprotected sex.  5. Tibolone ( Livial, Tibomax ): 2.5 mg tab O.D. for 3 months for menopause.,  6. Clomiphene citrate (Clomid, Fertyl): 25, 50mg tab.  Female: for ovulation. 50mg O.D. For 5 days (from the 5th to 9th day of the menstrual cycle. For 3 menstrual cycles.  Other hormone: if FSH or LH blood levels are low injections of these hormones may restore fertility and potency.  The sex center is in the limbic system near Hypothalamus in the brain.  The brain receives sensory signals and transmits messages to the muscles and blood vessels.  The sensory messages must be adequate to arouse sexually and produce an erection.  The sensory pathways especially from the five special senses-touch, sight, hearing, smell and teste – play an important role in the sexual arousal