A shameful problem in men - lack of ejaculation.

Lack of ejaculation - causes

Three systems are responsible for inducing an erection: Endocrine, Nervous and Vascular. It occurs as a result of stimulation of parasympathetic neurons located in the lateral sacral segments of the spinal cord. Ejaculation (or ejaculation), on the other hand, is a neurophysiological process. It involves the escape of ejaculate, or a portion of semen, from the urethra. Lack of ejaculation causes great discomfort and difficulties in interpersonal relationships. Of great importance in erectile dysfunction may be:

  • Atherosclerosis - the most common cause of erectile dysfunction;
  • testosterone deficiency;
  • hyperprolactinaemia
  • hypothyroidism
  • trauma or surgical injury to the spinal cord;
  • antidepressants, antipsychotics and for hypertension and arrhythmia;
  • multiple sclerosis;
  • diabetic nerve damage;
  • peripheral arterial vascular disease;
  • surgical procedures on the perineum and pelvis (e.g. prostate surgery);
  • psychological trauma, for example the discovery of infidelity, marital problems, arguments;
  • fear of unwanted pregnancy;
  • guilt associated with a restrictive religious upbringing;
  • lack of adequate sexual stimulation;
  • Decline or lack of interest in the partner, latent homosexual orientation;
  • masturbatory conditioning, for example habituation to strong tactile stimuli.

Ejaculation problems can be associated with various disorders of the body, such as retrograde ejaculation, delayed ejaculation or aspermia.

Reverse ejaculation

During retrograde ejaculation, semen retreats into the urinary bladder instead of escaping into the genitourinary tract. The semen mixes with the urine in the bladder and then escapes unnoticed during normal urination.

Reasons for this phenomenon include prostate surgery, diabetes or the use of prostate-regulating, antihypertensive or antidepressant drugs. Unfortunately, retrograde ejaculation interferes with fertility, i.e. it prevents the man from delivering semen into his partner's reproductive tract. In medicine, it is also referred to as a dry orgasm.

Delayed ejaculation

Delayed ejaculation is a disorder with not entirely clear causes. The man is then unable to achieve ejaculation or has great difficulty doing so, despite adequate sexual stimulation, erection and conscious desire. Biological predisposition and psychological factors can play a major role here. Stress, fatigue, anxiety, difficulties in the male-female relationship, feelings of guilt - all of these translate into problems with ejaculation.

Delayed ejaculation can be divided into two types: generalised and situational. The first occurs in all forms of sexual activity and with all partners. The second - depending on the situation and place, partner/partner or form of sexual activity.

Aspermia

Aspermia is the complete absence of ejaculation, or ejaculation of semen. Causes of this disorder can be:

  • prostate cancer;
  • androgen deficiency;
  • mechanical injury;
  • abnormal structure of the reproductive system;
  • surgical procedures within the reproductive organs;
  • bacterial infections, such as urinary tract infections;
  • obstruction of the ejaculatory duct;
  • stress;
  • diabetes.

Aspermia is usually treated pharmacologically or surgically. The patient must also change his lifestyle to a more peaceful and balanced one, introduce a healthy diet and give up stimulants (alcohol, cigarettes, legal highs). If therapy does not work, IVF can be implemented. This gives the woman a better chance of becoming pregnant.

Lack of ejaculation - research

If you experience a lack of ejaculation or erectile problems, you should immediately see a doctor (for example, a sexologist or psychiatrist), who will determine the causes of the disorder, make a diagnosis and propose appropriate treatment. The specialist will take a medical and sexological history and, if necessary, order additional blood tests (biochemical and hormonal), psychological and neurological examinations and consultations with an urologist or cardiologist.

Lack of ejaculation - treatment

Depending on the cause, doctors mainly recommend psychotherapy, pharmacotherapy or surgical treatment. A combination of several methods is also possible. Among the psychotherapeutic methods are:

  • individual or couples therapy,
  • masturbation training,
  • electrical stimulators or vibrators,
  • education and guidance.

In the case of retrograde ejaculation, which can be caused, for example, by damage to the muscles and nerves of the pelvic floor, surgery or electrostimulation is used. It is also possible to recover sperm directly from the urine passed after orgasm . If the problem has arisen with the medication in question, the medication can be discontinued or changed after consultation with the doctor. For aspermia that was caused by a bacterial infection, antibiotic therapy is used.

Substantive consultation: Dr Robert Gizler - specialist gynaecologist-obstetrician, medical director of the InviMed clinic in Wrocław.

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