Patient's question:
Male, 27 years old. Married for 4 years. In the first 2 years, ejaculation was normal, but gradually it became difficult to ejaculate, and now he can't ejaculate at all.Doctor's answer:
Hello:The vast majority of cases of anejaculation are caused by psychological factors. The patient may experience nocturnal emissions during sleep, and sometimes ejaculation occurs during masturbation. In most cases, sexual intercourse ends with the penis becoming flaccid after a certain period. Some patients maintain a prolonged erection without achieving ejaculation, often due to a lack of sexual knowledge, insufficient stimulation to the glans penis, or failure to reach the required level of stimulation for the ejaculation reflex. Psychological anejaculation accounts for approximately 90% of all cases, while the remaining 10% are caused by certain urological or reproductive system disorders.
Organic causes of anejaculation include diabetic peripheral neuropathy, spinal cord injuries, and urethral damage following pelvic fractures. Many medications, such as those used to treat psychological disorders (e.g., chlorpromazine) and antihypertensive drugs, may also lead to anejaculation. Sometimes,