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In a separate study, the same author group evaluated the prevalence of sexual dysfunction among 2437 men with mean age 51.9 years and reported a 4.4% rate of DE and/or DO . However, orgasm and ejaculation represent fundamental aspects of male sexual function, and ejaculatory and orgasmic dysfunction are highly prevalent and tremendously impact on quality of life [7,8,9]. Male sexual dysfunction occurs with disruption of any of these processes and encompasses decreased libido, erectile dysfunction (ED), ejaculation disorders, and orgasmic dysfunction . In Utilitarianism John Stuart Mill relevantly distinguishesbetween excitement and tranquillity as two sources of contentment, thefirst allowing us to tolerate pain and the second the absence ofpleasure (1971, Ch. II, ¶13). Plato had his Socrates argue that the dependence of some pleasureson the simultaneous presence of painful appetites, needs, or drivesshows that pleasure and pain are not related as contraries ordimensional opposites each of which simply excludes the other to theextent that it is present, but more complexly and interdependently— so that pleasure cannot simply constitute our lives as good sofar as we have it while pain similarly makes them bad. We must be willing todiscover that the diverse phenomena our subject studies have less incommon than we have been led by the common concept and the simplepicture of pleasure to suppose. These presumably involve brain areasand connections storing and linking specific information, whilemesolimbic dopamine and other neuromodulator systems supplynonspecific gain or error signals selectively strengthening, binding,and consolidating very recently activated representations in circuitscompeting with others to control attention, motivation, and action. 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