Lack of ejaculation: causes and treatments

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

The problem of lack of ejaculation (scientific language is called anejaculation) is the absence of ejaculation while maintaining the rest of the attributes of normal intercourse. The problem is quite common and can occur at any puberty.

Signs of pathology

The main symptom of the disease is the absence of ejaculation (ejaculation) during intercourse. Moreover, the course of coitus itself is often normal.

A concomitant symptom is a weakening of orgasm. Sometimes complete anorgasmia (lack of orgasm) can also be observed. Then this symptom is considered concomitant for anejaculation. It is not considered an independent symptom.

There are the following options and combinations of symptoms:

• anejaculation with normal orgasm;
• lack of ejaculation and weakening of orgasm;
• lack of ejaculation and orgasm. In this case, both an unexpectedly long erection can be observed, and its weakening some time after the onset of coitus.

Most patients note that there is no ejaculation with preserved orgasm. But the time of coitus is increasing. Others note a complete loss of erection after pseudo-orgasm (incomplete and sometimes distinctive sensations). In the third variant, there is a lack of orgasm with a preserved erection and the ability to prolong coitus indefinitely.

It is clear that the first option does not force people to seek help (unless anejaculation interferes with planning pregnancy), while the remaining options for the development of pathology, if it is not transient, force patients to seek help. In both of these options, other symptoms appear over time, one of which is a decrease in potency. In pseudo-orgasm, this is associated with a decrease in the production of androgens according to the feedback principle.

With complete anorgasmia with preserved erection, a decrease in potency occurs as a defensive reaction in response to ischemia (lack of oxygen) of the cavernous bodies of the penis. As you know, an erection is achieved by stopping the outflow of venous blood from the cavernous bodies of the penis.

This leads to their overflow with blood, which causes an increase in the volume of the penis, an increase in the elasticity of its tissues. For normal coitus, the state of erection has no negative consequences. But during an unexpectedly long state of arousal, there is a deficiency of oxygen in the tissues with all the ensuing consequences.

Causes of anejaculation

The absence of ejaculation can have both acquired and congenital causes. But both are detected, as a rule, in sexually mature men, which is associated with the onset of sexual activity, when anejaculation can have any consequences.

Congenital causes are associated with abnormalities in the development of the vas deferens and / or organs of spermatogenesis (testicles). The first reasons account for more than 90%, since the pathology of the testicles most often leads to the development of impotence due to the reduced production of androgens.

During normal development, the replaceable testicular ducts drain into the common urethra below its outlet from the bladder. During an erection, the prostate gland compresses the urethra immediately after it leaves the bladder. This ensures a normal flow of semen during ejaculation.

If there are abnormalities in the development of these mechanisms, 2 options can be observed (depending on the nature of the congenital pathology):

• Violation of the movement of sperm in the upper sections of the testicular ducts. Because of this, sperm cannot enter the urethra. Or, sperm progression is difficult. Anejaculation is then noted, with or without an obliterated orgasm;
• Violation of the flow of semen through the urethra. Ejaculation occurs in the bladder cavity, which is why the urine becomes cloudy - sperm is present in it. This option gives the absence of ejaculation with a normal orgasm.

The acquired causes are associated with external influences, diseases suffered after birth. These are injuries, diseases of the genitourinary system, some systemic pathologies, intoxication.

Injuries to the pelvic organs can lead to a violation of the innervation of the genitals. As a result, all reflex changes accompanying an erection and sexual intercourse are disrupted. The most basic reason for the lack of ejaculation is impotence. Another common variant of the consequences of injuries is the complete loss of sensitivity of the penis. Then an erection occurs only as a reaction to psychological stimuli. And only for emotional people.

Another option for post-traumatic anejaculation is damage to the seminal ducts and / or urethra.

2 options are possible here:

• Complete cessation of the flow of sperm through the vas deferens and the throwing of ejaculate into the bladder. But often the symptoms of a violation of ejaculation are combined with signs of abnormalities in the work of the urinary system;
• Disease-induced anejaculation occurs as a result of complications. For example, due to the formation of strictures (narrowing up to complete overlap), the normal flow of sperm during coitus is disrupted. They can arise as complications of inflammatory diseases: urethritis, prostatitis, sexually transmitted diseases.

Chronic intoxication primarily refers to alcohol. Its role is to disrupt the functioning of neurons, as a result of which their activity decreases. And this most directly affects the course of reflexes during coitus. Finally, ethanol desensitizes peripheral receptors. Among the last in a number of reasons are psycho-traumatic factors. But they are the last only by tradition, since now they are rapidly beginning to occupy leading positions. These include: stress, chronic fatigue syndrome, long-term practice of artificially restraining ejaculation.

Age, as the reason for the lack of sperm output, is the only one that does not mean pathology. In persons over 50, not every intercourse ends with ejaculation. And this is considered the norm.

Treatment for anejaculation

First of all, you need to find out the reason for the absence of ejaculation during coitus. Only after that the treatment is started.

3 methods of therapy are possible:

• medication;
• surgical;
• non-drug (psychological).

There is also a mixed version. This is when several methods are combined.

The surgical method is indicated in the presence of developmental abnormalities or structural changes due to external influences (trauma). The goal of surgery is to restore the normally functioning structure of the genitourinary system.

Medical treatment, as a rule, is carried out for secondary anejaculations. The choice of drug depends on the specific reasons for the absence of ejaculation. So, for infectious diseases, drugs with antimicrobial action are shown. In case of urological problems (for example, prostate adenoma), appropriate medications are used.

The help of a psychotherapist is required to treat psychosomatic problems that have caused the lack of ejaculation. The urologist should refer the patient to this course, after excluding all other causes of anejaculation.

Prophylaxis

After the absence of ejaculation caused by congenital anomalies or trauma has been healed, the patient should visit the urologist periodically. In all other cases, under the age of 40, a visit to the doctor should be due to the relevant complaints.

There are no specific measures to prevent the development of anejaculation. All recommendations of urologists for the prevention of pathologies are reduced to the general principles of a healthy lifestyle.