Hello David, Male Sexual Anhedonia usually refers to ejaculatory andehonia (no pleasure of orgasm), but can also refer to lack of sensation or pleasure during masturbation or intercourse. Whilst there are some physiological issues which can cause this condition it is most usually connected to a psychological or emotional issue. As with most sexual problems which are related to emotional/ psychological issues Sexual Anhedonia is often a response to trauma, emotionally difficult childhood experiences/ upbringing, or sexual repression. It can also be linked to obsessive compulsive behaviour or depressions, bot of which can bring about general anhedonia (lack of joy in many areas of life, which extends to sexual experience). It is very useful for people with this condition to consult a Psychosexual Therapist, who can both make appropriate medical referrals and help with the psychological and emotional roots of the condition. Whilst it is often tempting to try to deal with the problem alone reaching out for professional help can in and of itself be therapeutic, as experienced or self-enforced emotional isolation and lack of intimacy can sometimes be a contributing factors in Sexual Anhedonia. For more information on the matter or to discuss this, or any other psychotherapy/ psychosexual based issue, please e-mail me through my website www.gyanchand.org or directly at shanta@gyanchand.org Best Regards Shanta Gyanchand Psychosexual and Relationship Therapist