From a physiological point of view, orgasm is an intensified release of neurotransmitters and hormones under the control of the autonomic nervous system. Along with the euphoric feeling created by the released neurotransmitters in the brain, the orgasm also has a purely reproductive side – the intense contractions of the pelvic muscles help expel the ejaculate in men and facilitate its uptake by the reproductive tract in women. The physiological role of the male orgasm seems largely clear, since in most men orgasm is largely coupled with ejaculation, which is the climax of intercourse. In women, it is not so obvious, and for a long time it was not clear what exactly is the meaning and physiological meaning of orgasm in the fairer sex. Today, it is accepted that the movement of the pelvic muscles, and especially the movements of the cervix, which assist the penetration of the ejaculate into the uterus, are the main physiological goals achieved by orgasm in women. Different men give different descriptions of orgasm. In some it is a localized sensation in the groin, in others the sensation radiates to different parts of the body, and in others it can cover the whole body. In addition to the well-known differences between the male and female orgasm, there are also some lesser-known characteristics of the male orgasm. This is, for example, the ability of some men to achieve orgasm without ejaculation. For some, this is due to retrograde ejaculation, a medical condition in which semen is not pushed out of the body but into the bladder. This is usually due to weakness of the sphincter, which normally closes the bladder and prevents ejaculate from entering it during ejaculation. Surgical manipulations of the prostate or bladder can lead to this condition, as can nerve damage in diabetes, and the use of certain antidepressants and antipsychotics. As far as possible, the condition is affected pharmacologically. In other men, orgasm occurs before ejaculation. It is also possible that orgasm is not associated with ejaculation or occurs a few seconds after it. Although the physiological prerequisites for this are not yet fully understood, some sexologists make some distinction between the functions of the sexual and nervous systems, attributing orgasm to a greater extent to the nervous system and ejaculation to the sexual system. This distinction, however, is at best conditional because the entire process of sexual stimulation, obtaining an erection and ejaculation is under the control of the nervous system. Prepubescent boys can experience orgasm without ejaculating, as can older men. It is also possible for a man to experience several orgasms, and after the second, ejaculate is practically not expelled. Sometimes this is called a “dry orgasm”, although this term sometimes includes different things – retrograde ejaculation; the absence of prostatic secretion after prostate operations; failure to void due to medication or drug use,squeezing the urinary canal, etc. NEWS_MORE_BOX Ejaculation without orgasm is a condition known in the medical literature as ejaculatory anhedonia (literally, ejaculation without pleasure). Of the medicinal substances, some antidepressants and antipsychotics are frequent causes of this condition. Other causes include drug abuse, low testosterone or high prolactin levels, spinal cord trauma, or disruption of neurotransmission in the brain. While in cases of hormonal imbalance drug therapies are available with a high or satisfactory success rate (hormone replacement therapy in men, normalization of prolactin levels or pharmacological antagonism of its effects), nerve damage is much more difficult to influence. Another uncomfortable topic for many men is premature ejaculation. It must be clarified here that the concept of “premature” is largely conditional and refers rather to the cultural or individual understanding of what is “premature” and what is “timely” ejaculation. The reason for the visit to a specialist is not some real physiological dysfunction, but the dissatisfaction of one or both partners with their sex life. Most men find that this condition is overcome with time and experience. Meanwhile, many of them use various techniques to delay ejaculation – temporarily stopping sexual stimulation or holding the ejaculation by gently squeezing the penis. Condoms with a specially added local anesthetic can also be used. It is very rarely necessary to prescribe drugs for this “indication”, because, as has already become clear, it is not a disease in the classical sense of the word.that this condition is overcome with time and experience. Meanwhile, many of them use various techniques to delay ejaculation – temporarily stopping sexual stimulation or holding the ejaculation by gently squeezing the penis. Condoms with a specially added local anesthetic can also be used. It is very rarely necessary to prescribe drugs for this “indication”, because, as has already become clear, it is not a disease in the classical sense of the word.that this condition is overcome with time and experience. Meanwhile, many of them use various techniques to delay ejaculation – temporarily stopping sexual stimulation or holding the ejaculation by gently squeezing the penis. Condoms with a specially added local anesthetic can also be used. It is very rarely necessary to prescribe drugs for this “indication”, because, as has already become clear, it is not a disease in the classical sense of the word.