Patient's question:
Hello expert, I have a friend, male: currently 42 years old, married for 18 years. Recently, he often cannot ejaculate during sexual intercourse with his wife, which has led to unsatisfactory sexual life. Could you please tell me what might be the cause of this? Is there any good way to solve this problem? Thank you!!!First question supplement: His erection is normal, but he doesn't reach climax and doesn't ejaculate after lasting too long. Could you please tell me what might be the reason? Thank you!!!
Doctor's answer:
Hello, I suggest you refer to the following materials appropriately:The causes of anejaculation are diverse and can be broadly categorized into two types.
I. Primary Anejaculation
Patients who have never ejaculated in a state of consciousness are diagnosed with primary absolute anejaculation, which is caused by sexual ignorance or sexual inhibition but are still experiencing nocturnal emissions. Those who can ejaculate during masturbation or through non-coital stimulation (e.g., by a partner's hand or mouth) are classified as having primary selective anejaculation. This is due to unconscious resistance, incorrect perceptions about intravaginal ejaculation, insufficient neural excitement during intercourse, failure to "connect" the ejaculation reflex, or not reaching the intensity required to trigger the reflex. Patients can first stimulate their partner to achieve sexual arousal and pleasure, followed by self-masturbation to achieve ejaculation. In some cases, the partner's assistance may facilitate ejaculation, while in others, the partner's presence may inhibit ejaculation, leaving the patient to rely solely on self-masturbation. The underlying causes include:
（1）Sexual ignorance. Before marriage, both parties may be unaware of what intercourse entails, lacking sexual knowledge and understanding each other's needs. Some may even harbor fear or shame regarding sexual relationships, leading to months of no sexual activity after marriage. Some individuals may not realize that during intercourse, the penis must engage in rapid, forceful friction within the vagina, or may even be unaware that ejaculation occurs during intercourse (one female college graduate visited for a check-up three days after marriage, unsure why there was "water" in her vagina).
Incorrect sexual positions, and in rare cases, individuals may be unaware of the location of the vagina. Long-term practice of anal or urethral intercourse. During intercourse...