What are the reasons that make it difficult to ejaculate

Patient's question:

Please sincerely ask everyone (doctors are preferred) to take a look at what causes the difficulty in ejaculation.

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 friction 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 or injuries such as diseases or surgical removal of the lateral brain lobes; damage or surgical removal of the lumbar sympathetic ganglia; spinal cord injuries caused by various reasons; and 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, primarily seen in hypofunction of the pituitary, gonads, thyroid, and peripheral nerve damage caused by diabetes.
The fourth major factor: pharmacological factors. Many drugs 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.

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