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Evidence-Based Supplement Research
Evidence-Based Supplement Research

Pharmacological interventions in primary or secondary male anorgasmia: A systematic review.

  • 2025-11
  • Actas urologicas espanolas 49(9)
    • M P Gómez-Bueno
    • A M Diaz-Hung
    • H A García-Perdomo

Study Design

Type
Systematic Review
Sample size
n = 234
Population
men older than 18 years with primary or secondary anorgasmia
Methods
systematic review according to the recommendations of the Cochrane Collaboration and following the PRISMA Statement; search in MEDLINE (OVID), EMBASE, LILACS, and CENTRAL from inception to present

Objective

To determine the effectiveness and safety of pharmacological therapy in men older than 18 years with primary or secondary anorgasmia in terms of induced orgasm, improvement of the International Index of Erectile Function (IIEF), or Arizona Sexual Experience Scale (ASEX).

Methods

we conducted this systematic review according to the recommendations of the Cochrane Collaboration and following the PRISMA Statement. We designed a search strategy in MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to the present. We assessed the risk of bias based on the STROBE statement for observational studies and the Rob 2.0 tool for clinical trials.

Results

234 patients were included, and 232 were treated with pharmacological therapy in seven studies. Some pathologies reported were a history of prostatectomy, hypogonadism, psychiatric disorders, and use of antidepressants. Cabergoline was the most frequently administered treatment, followed by yohimbine and bupropion. The cabergoline improved orgasm in 66% of the population and yohimbine in 55%. The change in IIEF orgasmic function improved significantly with cabergoline and bupropion (P = <0.001 and P = 0.002). The ASEX improved with pycnogenol and was maintained in months 2,3 and 4 (p ≤ 0.05). The side effects reported were mild in three studies. Amantadine required discontinuation due to depression.

Conclusion

Pharmacological therapy with cabergoline, yohimbine, bupropion, and pycnogenol can have a positive effect on the orgasmic function of patients with primary or secondary anorgasmia.

Research Insights

  • The ASEX improved with pycnogenol and was maintained in months 2,3 and 4 (p ≤ 0.05).

    Effect
    Beneficial
    Effect size
    Small

Adverse Events Reported

  • PineOverall tolerability

    The side effects reported were mild in three studies.

    Finding
    Reported
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