Patient's question:
After sex, why can't I always cum?Doctor's answer:
Hello!Ejaculatory dysfunction refers to a condition where the penis can become erect and hard during sexual intercourse but fails to ejaculate or cannot ejaculate into the female vagina, thereby failing to reach sexual climax. The erect penis gradually softens and returns to normal after a period of time. It is one of the male sexual dysfunctions. Primary ejaculatory dysfunction means that the erect penis has never been able to ejaculate into the vagina. If there was previously the ability to ejaculate during intercourse but it is now lost, it is called secondary ejaculatory dysfunction. Clinically, primary ejaculatory dysfunction is more common than secondary dysfunction.
The organic causes of ejaculatory dysfunction are mostly congenital anatomical abnormalities of the reproductive system, spinal cord damage, lumbar sympathetic ganglion injury, or the use of drugs that affect sympathetic nerve tension (e.g., guanethidine, thiazide-like drugs). Most cases of ejaculatory dysfunction remain psychological in nature. From an early age, individuals may have been subjected to strict religious or feudalist asceticism, mistakenly believing that sexual activity is sinful and masturbation is evil. Other factors include hostility toward the female partner or specific psychological traumas (e.g., the female partner engaging in extramarital affairs or being raped) or fear of pregnancy, all of which create a heavy mental burden. A small portion of men with ejaculatory dysfunction lack sexual knowledge, or are "sexually illiterate," failing to thrust the penis in or thrusting it in the vagina with insufficient amplitude, frequency, or speed, thereby failing to reach climax and not ejaculating. This type of sexual illiteracy can be corrected once explained, and strictly speaking, it cannot be called true ejaculatory dysfunction—it is simply a lack of knowledge about the proper technique.