While a firm definition exists for premature ejaculation (PE), such does not exist for delayed orgasm, also known as retarded orgasm/ejaculation and inhibited orgasm/ejaculation. Complete failure to achieve orgasm is known as anorgasmia, while complete inability to ejaculate is known as anejaculation (see Anejeculation algorithm). Delayed orgasm is one of the most poorly understood and pharmacologically recalcitrant sexual dysfunctions. A reasonable definition is “the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress.” There is no specific time frame, and as is the case with PE, time frame cannot be the sole factor defining the condition. As with PE, the condition can be lifelong (primary) or acquired (secondary). It may be global, that is, occurring in all sexual scenarios or situational, occurring only in specific sexual scenarios (e.g., with partner but not masturbation, or with one partner but not another). The most robust study addressing this condition (US National Health and Social Life Survey) cites an incidence of “inability to achieve orgasm” of 8 %, although this clearly under-represents the incidence of “difficulty achieving orgasm.” Delayed orgasm has been associated with significant reduction in health-related quality of life as well as self-esteem, anxiety, and depression and has been linked to reduced sexual satisfaction and relationship dissatisfaction and discord.