Patient's question:
Main symptoms: No ejaculation during sexual intercourse, no abnormal physical symptomsOnset time: Over a month
Laboratory test results: Not examined
Doctor's answer:
Hello, non-ejaculation can be divided into two categories: psychological and organic. Psychological non-ejaculation can be identified in sexual counseling through mental factors. Organic non-ejaculation is more commonly seen in congenital urinary and reproductive system developmental abnormalities, spinal cord injuries, vas deferens obstruction, certain cranial brain lesions, overly loose female vaginas, and the use of certain medications, among others. It is less common than psychological non-ejaculation. Non-ejaculation affects reproductive health and can lead to male infertility. Additionally, due to the lack of sexual climax during intercourse, sexual interest is significantly reduced, often accompanied by decreased libido, and emotional crises may arise between partners. Therefore, it is important to seek medical attention proactively. The treatment of non-ejaculation must distinguish between different causes and adopt etiological treatment. Functional non-ejaculation often has a history of genetic factors and ejaculation outside of sexual intercourse. For example: (1) Lack of sexual knowledge. (2) Psychological factors. (3) Ejaculatory failure syndrome. ② Congenital developmental defects of the urinary and reproductive systems or inflammatory stimuli, such as relaxed bladder neck, hypertrophic prostata, penile nodules, penile trauma, severe hypospadias, prostatitis, and seminal vesiculitis, etc. ③ Endocrine dysfunction, such as hypopituitarism, hyperthyroidism, acromegaly, and myxedema, etc. ④ Some medications can also cause non-ejaculation, common ones include guanethidine and reserpine for treating hypertension, Librium for treating neurasthenia, and thioridazine, etc. If a non-ejaculation patient wishes to have children, it is best to identify the cause of their condition and provide symptomatic treatment, such as psychological counseling, acquiring sexual knowledge, discontinuing medication that affects ejaculation, and treating related diseases, etc. Once the ability to ejaculate is restored, normal fertility can be achieved.