Patient's question:
I have been married for five years. In the past few years, I often felt energetic, so our sexual life was quite frequent. Since the beginning of this year, whenever we have sex, I often don't climax, but I can still reach orgasm. After that, I become limp, and we still haven't had a child. The couple often argues!Doctor's answer:
Hello: The majority of cases of anejaculation are caused by psychological factors. Patients may experience nocturnal emissions during sleep, and sometimes ejaculation can occur during manual stimulation. In most cases, sexual activity ends with a soft erection after a certain period. Some individuals may experience prolonged erections but still fail to ejaculate, often due to a lack of sexual knowledge, insufficient stimulation to the glans penis, or inadequate stimulation to reach the threshold required 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, pelvic fractures, and posterior urethral injuries. Many medications, such as those used to treat psychological disorders (e.g., chlorpromazine) or antihypertensive drugs (e.g., phenoxybenzamine), can also lead to anejaculation. Additionally, congenital or acquired testicular dysgenesis, vas deferens obstruction or ligation, inflammation, stones, or stenosis in the epididymis, seminal vesicles, or prostate, as well as inflammation, stones, or adhesions in the posterior urethra or verumontanum, may cause anejaculation or difficulty with ejaculation.