%0 Journal Article %T A Conceptual Approach to Understanding and Managing Men's Orgasmic Difficulties. %A Rowland DL %J Urol Clin North Am %V 48 %N 4 %D Nov 2021 %M 34602177 %F 2.766 %R 10.1016/j.ucl.2021.06.012 %X Premature ejaculation (PE) and delayed/inhibited ejaculation (DE) are 2 ejaculatory problems that may negatively affect the sexual relationship and cause distress. Although no specific cause explains these problems when they have been lifelong conditions, understanding both biological and psychological factors may be relevant to treatment choices, with options ranging from pharmacologic to psychobehavioral. Integrating treatment modalities may lead to better outcomes but may also require greater psychological and resource investment from the patient or couple.