Patient's question:
I have been married for over a year and have not had any children because I always feel that no sperm is released when I am with my wife. Moreover, it is very difficult for me to reach orgasm each time, and sometimes it is hard to achieve sexual climax. Later, I was diagnosed with anejaculation.Doctor's answer:
Hello,⑴ Psychological and emotional factors, also known as psychogenic retrograde ejaculation, are the most common in clinical practice. The causes are all related to psychological and mental aspects, such as frequent masturbation before marriage, which leads to insufficient intensity during marital intercourse and failure to achieve ejaculation; being taught from a young age to view sex as vulgar, dirty, or obscene; dissatisfaction with a spouse, loss of interest in the opposite sex, reduced libido, and avoidance of sexual intercourse; or fear of pregnancy after marriage, leading to long-term suppression of sexual activity and the formation of a conditioned reflex for retrograde ejaculation.
⑵ Lack of sexual knowledge: Incorrect sexual positions or improper techniques, such as the penis being inserted into the vagina and remaining stationary without friction or with insufficient friction, failing to stimulate or reach the required intensity for the ejaculation center, often results in retrograde ejaculation.
⑶ Female factors: The female may fear pain during intercourse, worry about pregnancy or sexual desire, and restrict the male's thrusting; poor physical condition or aversion to sexual activity may frustrate the male's sexual arousal.
⑷ Medication-related factors: Primarily due to the use of drugs that affect sympathetic nerve tension, such as guanethidine and reserpine for treating hypertension; or drugs like librium and thioridazine for treating neurasthenia or insomnia, and monoamine oxidase inhibitors. Excessive use of bitter and cold Chinese herbal medicines, as well as alcoholism, can also cause retrograde ejaculation.
(5) Anatomical factors: Excessive foreskin length, causing unbearable itching in the glans during vaginal friction; phimosis with pain, forcing intercourse to be interrupted; severe prostatitis leading to atrophic changes, rendering it ineffective in participating in the ejaculation process.
(6) Other factors: Frequent intercourse, excessive fatigue from work, excessive use of bitter and cold Chinese herbal medicines, and alcoholism can also cause retrograde ejaculation.