Functional anejaculation?

For men, if they unfortunately suffer from functional anejaculation, it will not only cause great harm to their physical and mental health, but also affect fertility for women. Aejaculation not only destroys a perfect family, but also affects men's physical health. Men's functional anejaculation must be actively treated. Usually, you can give them more massages and stimulation to allow the patient to ejaculate outside the body.

The cause of anejaculation is that during sexual intercourse, the sexual organs (mainly the glans penis) sense sexual impulses, which are transmitted through afferent nerves to the spinal cord spermatorrhea center and ejaculation center, and then through efferent nerves to control effectors (vas deferens, seminal vesicles, ampulla, bladder neck and prostate), inducing ejaculation and accompanied by pleasure. This ejaculation reflex is controlled by the brain. If there is functional or organic disorder in any link of the ejaculation pathway, it may lead to ejaculation disorder.

1. Functional anejaculation

(1) Psychological factors are common causes. Dissatisfaction with the spouse, disharmony in the relationship between the couple, great mental pressure, and a bad sexual environment can all cause the man to adopt a restrained attitude towards sex, which can lead to anejaculation in the long run.

(2) Lack of sexual knowledge: Both husband and wife lack sexual knowledge and do not know how to have sex, or they have a fear of sex (such as the woman is afraid of pregnancy or pain) and restrict the man from thrusting in a large and rapid manner, making it impossible for the man to reach the threshold of ejaculation, leading to anejaculation.

(3) Sexual fatigue or ejaculation failure. Frequent sexual intercourse or masturbation can easily cause dysfunction of the spinal ejaculation center and lead to anejaculation.

(4) Long-term masturbation Long-term masturbation may cause anejaculation. Because the intensity of sexual stimulation during masturbation is often greater than that during sexual intercourse, the ejaculation center is accustomed to the strong stimulation of masturbation and may not reach the ejaculation threshold during sexual intercourse. On the other hand, due to the influence of traditional concepts, masturbators usually have a sense of guilt and shame, which can also inhibit ejaculation.

2. Organic anejaculation

(1) Nervous system diseases and injuries, such as lateral lobe lesions and spinal cord injuries, can cause anejaculation.

(2) Iatrogenic factors such as thoracolumbar sympathectomy and retroperitoneal lymph node dissection can damage nerves and cause anejaculation.

(3) Local lesions of the urogenital system such as hypertrophy of the spermatophore, phimosis or excessive foreskin with stenosis of the foreskin opening, penile trauma, nodules, scars, fibrosis, severe hypospadias, etc. can cause anejaculation.

(4) Endocrine abnormalities such as diabetes, hypopituitarism, and hyperthyroidism can cause ejaculation disorders.

(5) Drug factors: Antihypertensive drugs, sedatives or adrenaline blockers, as well as long-term alcoholism or drug abuse can induce anejaculation.

Clinical manifestations

During sexual intercourse, the patient's penis can maintain an erection for a long time without becoming flaccid, but he cannot reach orgasm, there is no ejaculation, and no semen is discharged from the body. Depending on whether the patient has nocturnal emissions and whether he can ejaculate through masturbation, anejaculation can be divided into functional anejaculation and organic anejaculation. Functional anejaculation accounts for about 90% of cases. Patients have no semen discharged during sexual intercourse, but can ejaculate during masturbation or have nocturnal emission during non-sexual intercourse. Organic anejaculation is the absence of ejaculation under any circumstances and may be accompanied by symptoms and signs corresponding to the primary disease.

examine

It includes sexual psychology assessment, blood sugar, endocrine hormone measurement, post-ejaculation urine analysis, urodynamic examination, and transrectal ultrasound, cystoscopy and CT examination if necessary.

The diagnosis of anejaculation is mainly based on the patient's medical history and is relatively easy to diagnose. The cause of the disease can often be determined by combining the physical examination and the results of the special examinations mentioned above. This disease should be differentiated from retrograde ejaculation and male erectile dysfunction.

treat

The treatment of anejaculation is mainly divided into psychological and sex education therapy, sexual behavior therapy, drug therapy, physical therapy (mechanical or electrical stimulation to induce ejaculation), surgical treatment and traditional Chinese medicine treatment. For those with a clear cause, timely treatment of the primary disease is the primary factor in treatment.

1. Psychological and sex education treatment

Mainly used for people with functional anejaculation. When treating this type of patient, it is necessary to teach both men and women about sexual organ anatomy, physiological knowledge, and sexual response, pay attention to sexual intercourse postures and methods, eliminate wrong ideas, and coordinate the relationship between husband and wife. The woman should cooperate with the man and help him eliminate sexual anxiety, so that he can have sexual intercourse in a fully relaxed and passionate psychological state, increase the intensity of stimulation, and enable the penis to receive more sexual stimulation, thereby achieving the purpose of treatment.

2. Sexual behavior therapy

It is mainly through concentrated sexual training that patients can gradually adapt to and become familiar with the sexual intercourse process, improve their own sense of sexual response, fully enjoy the pleasure of sexual intercourse, and reduce anxiety and fear of sexual intercourse. In addition, in order to enhance the stimulation of the penis, ejaculation can be further induced by masturbating beforehand, adjusting the frequency and time of sexual intercourse, changing body positions, and having the woman contract the perineal muscles after penetration by the man.

3. Medication

There are relatively few drugs for treating anejaculation, and their efficacy is still controversial internationally. Clinically, it has been found that oral administration of levodopa, ephedrine, etc. can promote ejaculation, but they are contraindicated in patients with hypertension, coronary heart disease, and hyperthyroidism. The latest research found that more than 50% of patients can ejaculate after taking midodrine orally.

4. Physical therapy

It mainly includes mechanical and electrical stimulation to induce ejaculation. Physical therapy combined with assisted reproductive technology is an effective method for treating infertility caused by anejaculation.

5. Surgery

It is mainly aimed at diseases of the penis itself. For example, patients with excessive foreskin and phimosis accompanied by narrow foreskin opening can be treated surgically. Removing the foreskin to expose the glans can increase its sensitivity to stimulation and facilitate ejaculation.

6. Traditional Chinese Medicine Treatment

Traditional Chinese medicine and acupuncture treatment have certain effects on anejaculation. Currently, traditional Chinese medicine treatment is mostly used as an auxiliary means in clinical practice.