I replied to this question from a lovely reader privately, but he kindly gave me permission to reproduce his question for the column as I suspect there are lots of people who could benefit from this advice. He asks:

Any ideas for a cis guy who can’t reach climax? I experience a loss of sensation due to my ongoing illness and the medication I have to take. Sometimes using a high-powered vibrator like my wife’s Doxy helps, but only occasionally. I still enjoy sex and try not to worry too much about orgasm, but you can understand this is very frustrating. Sometimes I just don’t want to bother. There’s so much information out there about premature ejaculation, but not much about loss of sensation or inability to climax for men.

This is such a great question, and one that is so rarely talked about. As you correctly identified, there’s tonnes of information for cis guys who orgasm too quickly, but very little for those who struggle to get there in the timeframe they’d like… or at all.

First, I’m going to give you the obvious but necessary advice. Try, if possible, to relax and not stress about it. For a lot of people, making climax the express goal of sex or masturbation stresses them out so much that it makes it even MORE difficult to get there. And remember, you can still have loads of sexy fun without orgasm and even without a hard penis.

Secondly, if you haven’t already, please talk to your doctor. I don’t know what medication you’re on, but anorgasmia and difficulty orgasming is a hugely common and problematic side effect of many medications, including common antidepressants such as SSRIs. (Ask me how I know!) Sadly, many medical professionals don’t take sexual side effects seriously. But sex is an important part of life for many people, doctors need to take these side effects seriously. There may not be another medical solution, depending on the specifics and what your condition is. But it’s an avenue worth exploring if you haven’t already.

Third, I’m going to make a couple of toy suggestions for you. You mentioned using the Doxy wand can sometimes bring you to orgasm. How are you using it? If you’re just pressing it against your cock, that’s awesome for a lot of men but you might also wish to try using an attachment. My partner absolutely loves the Hummer. The advantage of an attachment like this is that it transmits the vibrations all over the penis, rather than concentrating them in the one spot where the toy is sitting.

I also highly recommend you check out the Pulse by Hot Octopuss. Unlike the Doxy, this “guybrator” is actually not a vibrator at all. It uses PulsePlate technology, an oscillating mechanism based on proven medical research. It’s the same medical technology that is used to help men with spinal cord injuries to ejaculate. It can be used on either a flaccid or erect penis. Tests have shown that it can induce climax even while the penis is flaccid! Of course, no toy is perfect for everyone, but given that this one was based on devices designed for those with little or no sensation, I think there’s a very real possibility it will be a great option for you.

This sounds like a really frustrating situation for you. I really hope some of this advice is helpful. I also really hope that seeking further medical advice specifically around the sexual side effects of your medication gives you some answers.

Today’s advice column is kindly supported by Hot Octopuss. Using any of the affiliate links in this post to purchase toys sends a small commission my way and helps support my writing and sex education work.