Patient's question:
Please kindly take a look at what could cause the difficulty in ejaculation. (It would be best if doctors could take a look.)Doctor's answer:
During sexual activity, men will experience ejaculation. If ejaculation does not occur, there must be a reason. The first major factor: penile diseases such as excessive foreskin or narrowed foreskin orifice can lead to entrapment during intercourse, causing pain and interrupting the act. Phimosis, where the foreskin covers the glans, reduces the friction-induced stimulation, making it difficult to reach the "ejaculation threshold." Additionally, penile glans inflammation, allergies, and other conditions can lead to discomfort from repeated friction, preventing ejaculation.The second major factor: neurological disorders and injuries. Diseases or surgical removal of the lateral lobe of the brain; damage or surgical removal of the lumbar sympathetic ganglion; spinal cord injuries caused by various reasons; pelvic surgeries, such as prostatectomy or radical resection, rectal cancer surgery, etc., can cause neurological damage, disrupting ejaculation function.
The third major factor: endocrine abnormalities. This is commonly seen in hypofunction of the pituitary, gonads, thyroid, or peripheral nerve damage caused by diabetes.
The fourth major factor: drug-related factors. Many medications can cause ejaculation dysfunction, such as tranquilizers and sleeping pills, which reduce neural excitability and suppress sexual arousal. Adrenergic receptor blockers (e.g., guanethidine, phenothiazines); anti-androgen drugs (e.g., cyproterone acetate), can all inhibit ejaculation.