What are the symptoms of impotence and how is it treated?

Patient's question:

Hello doctor; Sometimes when I have sex with my wife, I always feel weak and unable to perform. During the process, sometimes my penis becomes soft and even fails to complete the act (meaning I don't ejaculate and just stop). My wife heard from others that if a man doesn't ejaculate during sex and ends it, it's harmful to his health. Is there any medical evidence to support this?

Doctor's answer:

Hello:
Ejaculatory dysfunction includes the following three aspects:
1. Central Ejaculatory Dysfunction: Primarily caused by abnormal brain function, leading to enhanced inhibitory effects on sexual arousal, especially on the ejaculatory center. Patients experience no sexual climax or ejaculation. In some cases, it may be due to sensory organ disorders, emotional issues, intellectual impairments, or other factors.
2. Spinal Central Ejaculatory Dysfunction: Refers to the dysfunction or failure of the ejaculatory and erection centers within the lumbar and sacral spinal cord, which can result in weakened or complete inability to achieve penile erection, as well as delayed or complete inability to ejaculate.
3. Psychological Ejaculatory Dysfunction: This type of dysfunction does not involve organic disorders of the reproductive organs but is purely caused by psychological factors.
Ejaculatory dysfunction can be classified into the following three types:
(1) No Ejaculation Activity: Despite prolonged sexual intercourse or even reaching a certain form of climax, ejaculation does not occur.
(2) Retrograde Ejaculation: Normal sexual intercourse duration, but no normal semen is expelled during climax. Semen and fructose are found in the urine after intercourse.
(3) Anejaculation: Experiencing climax but without the emission of semen after ejaculation.
This condition is relatively easy to diagnose, and treatment should follow the following approach:
1. Symptomatic Treatment: Includes circumcision, increased physical exercise, improved nutrition, physical strengthening, enhanced overall health, and abstaining from smoking and alcohol. Maintaining a joyful mind and body is crucial, and most importantly, harmonizing the marital relationship.

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