This chapter reviews disorders related to ejaculation and orgasm, including premature ejaculation (PE), delayed ejaculation, anejaculation, and painful orgasm. Diagnostic criteria, psychosexual and pharmacologic interventions, and newer therapies are discussed. Recent European and Italian consensus documents emphasize that premature ejaculation should be classified as lifelong or acquired, with diagnosis based on a combination of intravaginal ejaculatory latency time, perceived control, and associated distress, and managed using evidence-based pharmacological and behavioral strategies as recommended by SIAMS and the European Academy of Andrology.