I know how perfect orgasms should feel. They should be based on great desire, and pass through steadily increasing arousal. Then I should feel orgasmic certainty. This means that I should have arrived on a plateau from where the climb to the peak is as easy as managing a stairways of 5 to 10 steps. Or, in other words, a few more determined strokes, and I will explode.

More than anything else, it is the control of the plateau phase that makes the difference between a good and a so-so orgasm. For a perfect orgasm, I want to stay 5 to 10 minutes on such a plateau phase several times during a lovemaking session. I want to be tense, but I want to be able to hold back. I want to be totally focused. And if I were to make a few determined moves, 1-2-3, I shoot.

My lovemaking sessions last for hours. I am well beyond 50 now, but they have never been better. And I owe this to the pharmacological interference with practically every aspect of my love life. If I don't have my medications, I am not worth much as a lover, and lovemaking sessions are a disappointment: not much interest to start with, an erection that has a tendency to break down if not utilized to the full within several minutes, an orgasm that typically is too much labor, and a degree of satisfaction that is far below excellent.

Erections alone are meanwhile easy to engineer. Pfizer's Viagra, or a generic equivalent, will do the job.

But a sildenafil (Viagra)-only erection is rather technical, sort of like a morning erection, caused by the urge to urinate. And what's worse: Viagra alone will, in me and among many others, work against orgasm intensity. The pre-orgasmic plateau isn't as high on Viagra alone as it should be to give an orgasm the character of an explosion.

Some dopaminergics drugs such as cabergoline, bromocriptine, apomorphine, and pergolide work on various libido and excitement-related parameters. And so does the Southeast Asian herbal tongkat ali. While all of the above-mentioned dopaminergics drugs can be used in the treatment of Parkinson's disease or pituitary tumors, they cannot just be substituted one for another when it comes to sexual function. One of the drugs will primarily allow better control of the pre-orgasmic plateau phase, the other will primarily shorten the refractory period between multiple orgasms. One is ideal for a kick right at the onset of a lovemaking session, the other is suited for a long-term strategy.

But apart from phosphodiesterase inhibitors such as Viagra, and apart from dopaminergics and tongkat ali, there are a few medications that can be used to manipulate orgasm timing.

I have personally tested both: medications that shorten the road to the orgasm, and medications that prolong the pre-orgasmic journey. And while medications that make orgasms happen faster and easier are needed by many women to achieve an orgasm at all, drugs that delay orgasm are a pharmacological tool primarily for men. As a matter of fact, the annoying condition named "premature ejaculation" is one of the sexual function parameters that is the easiest to treat and to overcome.

Premature ejaculation, or, more specifically, premature orgasm, is a problem mostly of young men. It doesn't occur in women. The opposite problem, difficulties in taking the last step from the plateau to the peak, is more common in women then in men. They can hang on and on and on. Involuntarily, that is. "Almost, my darling, almost, I am almost there, go on, my darling, a little bit longer, continue, please continue, I am almost there, almost… I'm so sorry. Again, I didn't make it. I was almost there. Just a little bit more, only a very little bit more. The next time, for sure."

The medication works for men and women alike. The precise action of this medication is to make the last step to the peak an easier one. It does so by having a chemical, neurological trigger effect.

OK, I am a man. But I am beyond 50. Orgasms don't come as easily any more as they used to in my 20s or 30s.

But I like my lovemaking sessions to last for two hours. I can manage an erection that lasts that long by taking my Viagra or generic equivalent. I can mange to stay focused with a cocktail of dopaminergics or tongkat ali extract. And I can make sure that even though I could have my climax easily after 10 minutes, it will still be easy after two hours, entirely at the point of my choosing.

To make me trigger-happy, orgasm-wise, is the only effect of this medication. It will not work for desire or erections, nor will it increase ejaculatory load or sperm fertility. But it's worth it for the well-oiled trigger function. It's the drug for the orgasmic finish.