For about a century male ejaculatory disorders were considered to be caused mainly by psychological disturbances. However, since the 1990s, daily SSRI treatment has become very popular to delay ejaculation in men with lifelong PE. In addition, research has shown that it is likely that the persistent occurring very short ejaculation times of less than 1 minute in lifelong PE are related to neurobiological dysfunction in the central nervous system. On the other hand, epidemiological studies have shown that “complaints” of PE may not only occur in men with very short intravaginal ejaculation latency times (IELTs) but also in men with normal and even long ejaculation latency durations of, for example, 20 minutes. As their complaints are probably highly psychologically determined, treatment by counseling, psychotherapy of other non-medical interventions have been suggested. Integration of drug treatment, psycho-education, counseling and psychotherapy increases the chances for better coping mechanism in men affected by ejaculatory and orgasm problems. For female orgasmic disorders, particularly anorgasmia, medication is not yet available. Primary female anorgasmia is difficult to treat as multiple factors are involved in its pathophysiology. Neurobiological and pharmacological research is needed to develop drug treatment for those women who would like to alter this state. But with or without drug treatment, counseling may be of great value and contribute to better coping styles.