I also suffer from sexual disfunction. I can get arroused but I am unable to orgasm. I have to work so hard at it that it becoames an issue with my spinal issues. One time I got an occiptial neuralgic event where my entire upper body spasmed after sex in the push up position. The stress on the arms and neck just put me into crisis. I could not move my entire upper body, it hurt so bad I was screaming to my wife and crying. The pain slowly subsided after 20 minutes and the pain appeared to radiate from the T-4 level. Well to get onto the subject of the no orgasim, as I stated I get rock hard but no ejaculation and if I do I have to work for it to a point where sometime I either give up or fake it. Now as I stated in the article on Sympathetic reflex Dystrophy, I suffered a severe accident. I have spinal issues, spondylolisthesis S1/L5, taking methadone for pain management, receive epidural injections, have Addison's Disease, Ejection Fraction was 45 ging up with the use of coreg, on Lisinopril and Hydorcortisone for Addisons. What is wrong with me that i cannot ejaculate??? I am only going on 49. My wife also orgasims first since its or method of birth control is pulling out, so I usually have to wait and concentrate not to orgasm so she can go first. Could this be the issue. Well prior to masturbating I found that not it because I had to work it just like when having sex with my spouse. Whats happening here? Why cannot I orgasm?? Why do i have to work for the pleasure ???