Reasons for the absence of ejaculation in men, treatment of pathology

Health problems lie in wait for us at every turn. Poor ecology, chronic stress and overwork, insufficient physical activity and unhealthy diet - all this affects male strength and the ability to conceive. But such a violation as anejaculation, that is, the absence of sperm ejection during intercourse, is a common cause of male infertility and can lead to significant psycho-emotional disorders. Unfortunately, this disease is painless, therefore, representatives of the stronger sex usually rarely seek timely medical help.

What is "anejaculation" in men?

Anejaculation is a man's inability to end sexual intercourse with ejaculation (ejaculation), that is, ejection of a portion of sperm (for his own satisfaction or conception of a child).

Erectile dysfunction is the most common sexual health disorder in men. It covers a wide range of disorders, which can be divided into 4 main categories:

• premature ejaculation;
• delayed ejaculation;
• anejaculation;
• unsatisfactory sensations during ejaculation (for example, pain in the lower abdomen or anhedonia (inability to enjoy)).

Orgasm is a process that takes place purely in the brain and is characterized by the release of "mediators" responsible for the feeling of pleasure and pleasure. It usually, but not always, coincides with ejaculation. Therefore, anejaculation is divided into orgasmic and anorgasmic (accompanied by the absence of orgasm during sex).

It is important to urgently consult a doctor if you are unable to end sexual intercourse with ejaculation! The asymptomatic course of anejaculation during intercourse does not exclude the progression of the disease and can lead to serious problems, including complete infertility.

Pain can occur with prostatitis, inflammation of the bladder or urethra. The insidiousness of this disease lies in the fact that it does not affect the need for men for sex and libido as such. The frequency of intercourse may remain the same even in the absence of sperm ejection, and interest in the partner does not fade away. If the couple does not plan to have offspring, then the fair sex may even "ignore" the problem of her partner.

Reasons

In order to understand the causes of pathological disorders, you first need to understand the process itself. Ejaculation involves ejaculating semen, closing the neck of the bladder, and expelling semen through the urethra (ejaculation itself). The sympathetic nervous system and the sacral spinal cord control the release of semen. Many neurotransmitters in the brain such as serotonin, dopamine and norepinephrine play an important role in the physiology of ejaculation.

All the reasons that lead to anejaculation in men can be divided into two categories: physiological and psychological.

Psychogenic factors:

• insufficient sexual stimulation (mental and physical);
• reducing the sensitivity of the penis;
• mismatch between the reality of sex and the partner's preferred masturbatory fantasy;
• fear of intimacy;
• fear of pregnancy;
• problems conceiving;
• depression.

Physiological factors can be divided into several more subgroups

Neurogenic:

• multiple sclerosis;
• spinal cord injury.

Endocrine:

• hypogonadism;
• decreased thyroid function;
• increased production of the hormone prolactin;
• diabetes mellitus and its consequence - peripheral neuropathy, can lead to this disorder;

Congenital anatomical features of the structure:

• blockage of the ejaculatory duct;
• posterior urethral valves;
• complete or partial splitting of the urethra.

Surgical interventions on the pelvic organs:

• complete removal of the prostate;
• rectal surgery.

Infections:

• urethritis;
• tuberculosis of the genitourinary system;
• schistosomiasis;
• prostatitis;
• testicular inflammation.

Pharmacological inhibition with prolonged use of the following drugs:

• tricyclic antidepressants;
• monoamine oxidase inhibitors;
• antipsychotics;
• opiates;
• antiepileptic drugs;

Well, and the most "banal" - over time, all processes fade away, including anejaculation - complete or partial. There are also studies showing that excessive alcohol abuse can lead to illness.

Diagnostics

Unfortunately, there is currently no single gold standard for the diagnosis of anejaculation. Since many organic and psychological factors can be involved in pathogenesis, careful patient interviewing, a detailed medical history and appropriate physical examination can help the andrologist in making a diagnosis.

As mentioned earlier, ejaculation and orgasm usually happen together, but not always. The sensation of orgasm, that is, involuntary muscle contraction, in the absence of ejaculation, suggests an obstruction of the ejaculatory duct.

Anejaculation, especially the orgasmic variant, is usually indistinguishable from retrograde ejaculation in symptoms (seminal fluid flows in the opposite direction and enters the bladder, which leads to its inflammation). To separate these pathologies, urine analysis is performed: with retrograde ejaculation, sperm cells are found in the urine.

Treatment of anejaculation

Treatment approaches include pharmaceuticals, penile vibration stimulation, and electro-ejaculation. In the beginning, they resort to the medicinal method. Given the variety of drugs available for treatment, the question of which one to choose is decided on an individual basis by the attending physician.

Hormones are used: 2% testosterone solution is applied once a day, at the same time every morning, 16-24 IU of Oxytocin in the form of drops through the nasal passage during sex or under the tongue before intercourse. It is also possible to use dopamine reuptake inhibitors: Bupropion 150-300 mg / day orally in the morning and Amantidine as needed 200-400 mg orally 2 days before sex or systematically orally 30-50 mg 2-3 times a day. Often, substances similar to the neurotransmitter norepinephrine are used to stimulate ejaculation, which bind to the a1-adrenergic receptor, for example, Midodrine 1.5 hours before intercourse.

In case of hypogonadotropic hypogonadism, stimulating therapy with human chorionic gonadotropin is used.

The best method for obtaining sperm from men with spinal cord injury is to vibrate the penis. A vibratory stimulator is a flat-lipped device that is placed around the glans of the penis to stimulate it with vibration. If vibration stimulation fails, the sperm for fertilization of the egg are sometimes harvested by electro-ejaculation or surgically by skin aspiration of sperm or sperm extraction from the testicle.

Therefore, the choice of treatment should be tailored to the needs of the individual patient and the specific circumstances of each case. As a rule, drug treatment in advanced cases restores the relative function of ejaculation.

Sometimes, even with the elimination of the physiological cause of anejaculation, due to the neuroses that have arisen against the background of this problem, the ejaculatory function may not fully recover. Therefore, in order to prevent the transition of the disease into impotence, you should listen to your feelings and, if precedents arise, contact a psychologist.

In no case do not self-medicate, the presented methods of treating anejaculation are purely informative, the above drugs can be taken only after full-time agreement with a doctor.

Prevention

Lack of ejaculation is generally treatable, the main thing is to start it as early as possible. The main task is to determine the causes of the occurrence and search for subsequent effective options for solving the problem. For prevention, you should take good care of your health, be sure to treat chronic inflammation of the genitourinary system and prostate, avoid any trauma to the external genital organs.

In order not to miss anejaculation, it is necessary to regularly undergo preventive examinations in the hospital, determine the level of hormones in the blood, and regulate sex life. It is worth refraining from the use of anabolic steroids, since artificial testosterone supplied from the outside inhibits the production of its own and disrupts the hormonal balance of the body. Also, as a preventive measure, you can resort to herbal medicine and homeopathy.