There may not be anything all that unusual about women faking orgasms. But what about men? It turns out some men vie for Oscars in the bedroom too.

Why would a man need to fake an orgasm? To understand, it may be helpful to look at the reasons women give for doing so. One of the best discourses on this topic, from the "Show me" School rather than the dry medical literature, is the scene from the classic movie When Harry Met Sally, in which actors Meg Ryan and Billy Crystal are sitting in a restaurant discussing Crystal's certainty that no woman has ever faked an orgasm with him. "How do you know?" asks Meg Ryan. "Most women have faked it at one time or another." She then proceeds to mimic an orgasm, complete with moans and shrieks, right at their table. When she is done, a middle-aged woman sitting nearby says to the waiter, "I'll have what she's having."

Why do women fake orgasms? A female colleague suggests "it's just a little white lie." Women, she explains, don't always experience orgasms with sex, but men may be disappointed if she doesn't have one. Faking an orgasm makes the guy feel he's done a good job as a lover, and also allows the activity to come to an end, which can be particularly useful with a partner determined to prove his manly mettle.

So, what does this have to do with guys? Aren't men always able to have an orgasm? After all, the single most common sexual dysfunction among men is that they come too quickly, with anywhere from 10-30% of men reporting premature or rapid ejaculation in various studies. Yet not all men are alike, and some men may actually be unable to reach The Promised Land. Ever. Big problem.

A more complicated story was provided by Jim (real names not used), a 33 year old software engineer who had been married for a little more than one year. Jim was happy in his marriage to Gloria, and the sex was fine, but there was a catch- he just couldn't achieve an orgasm during intercourse. He had no trouble having an orgasm with masturbation, mind you. It was only a problem during sex.

Neither Jim nor Gloria had been very active sexually prior to their marriage, leaving them with little to compare this to. At first Gloria considered Jim's inability to climax "A little weird," but soon she began to doubt her own feminine skills and started to ask Jim, "Am I doing it wrong?" and "You don't find me sexy, do you?" The pressure mounted (!), and soon Jim hit upon a solution- he started faking his own orgasm. This seemed to work, as Gloria seemed pleased with their sex life. Yet Jim still didn't understand what was happening to him.

There can be a number of reasons why men may have a difficult time achieving an orgasm during intercourse. Medications, particularly the SSRI antidepressants, are the most common cause. Neurologic conditions and diabetes can contribute, by decreasing genital sensation. And sometimes it's psychological. I had a patient once who was ambivalent about having children. Although he had nodded assent when his wife asked "So, you agree it's ok if I stop taking my birth control pills?" he really didn't feel prepared to take the giant leap of fatherhood. No wonder he withheld his magic seed.

In Jim's case, it turned out that his technique of achieving orgasm during masturbation was to lie prone and rub his body against the bed, something he'd learned as a twelve-year old. As pointed out by my colleague, Dr. Michael Perelman, some masturbatory practices, such as Jim's, bear little resemblance to the stimulation achieved during actual intercourse. This seemed to be Jim's problem. The goal of therapy in these men is a hands-on approach ( of course!) in which the men re-train the penis so that they can learn to have an orgasm with stimulation that is more like sex. Eventually, men like Jim should be able to have an orgasm from sex itself. I've referred Jim to an experienced sex therapist, and I hear he's making good progress. In the meantime, he enjoys sex with his wife, but continues to fake orgasms.

Is it OK for Jim to do this?  Is it really any different than a woman faking an orgasm, other than the missing "evidence" (more on that upcoming in Part 2)?   Whether it's right or wrong is hard for me to say, but I do find Jim's motivations instructive. Jim fakes orgasms to make his wife feel okay about their sex life, and her own lovemaking skills.  It really provides a different perspective on men, doesn't it?

Who says guys are just unfeeling louts who care only about themselves?

About the Author

Abraham Morgentaler, MD

Abraham Morgentaler, M.D. specializes in male reproductive and sexual health, and is a professor of urology at Harvard Medical.

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