Ejaculation is a complex physiological process in which the nerve endings and central excitation are two important parts, but the former is more important. Non-ejaculation is the inability to ejaculate during normal intercourse or the absence of sperm and fructose in the post-coital urine examination. According to its cause, it can be divided into two categories, functional and organic: if ejaculation has never occurred in the waking state, it is called primary ejaculation; those who have a history of ejaculation in the vagina and then have no ejaculation are called secondary ejaculation. The primary non-ejaculation is due to insufficient nerve endings excitement, the key is too high stimulation threshold, and the intensity of stimulation is relatively too low, unable to cross the “threshold”. The secondary ejaculation is mostly due to psychological factors that strengthen the central inhibition, and the treatment is based on eliminating the inhibition of the nerve center on ejaculation.
The causes of ejaculation problems are diverse. It can be divided into two categories in general.
I. Primary ejaculation
Patients who have never ejaculated in the waking state have primary absolute ejaculation, which can be caused by sexual ignorance or sexual inhibition, and may or may not have ejaculation in general. Patients who can ejaculate during masturbation or with non-coital stimulation by the female partner, such as by hand or mouth, are called primary selective ejaculation. This is due to unconscious resistance, an incorrect view of intravaginal ejaculation, or insufficient stimulation of nerve excitation during sexual intercourse, so that the ejaculatory reflex is not “on” or does not reach the strength of the reflex. Patients can first stimulate the female partner to produce sexual excitement and pleasure, and later use self-masturbation to achieve the purpose of ejaculation. Sometimes the female partner can assist in ejaculation, but sometimes the female partner’s participation will inhibit ejaculation, only by their own masturbation. The reasons for this are as follows.
(1) sexual ignorance. Before the newlywed both parties do not know what sexual intercourse is all about, the whole lack of sexual knowledge, and do not know what the other party requires, or even have fear of sexual relations, or out of shyness, never had intercourse for months after marriage, some people do not know that the penis during intercourse to be in the vagina for the frequency of fast, large amplitude of continuous friction, and even do not know that intercourse will ejaculate.
Sexual intercourse is not in the right position, and individuals do not even know the part of the vagina. Prolonged intra-anal or intra-urethral intercourse. During sexual intercourse, the desire to urinate (mostly for the male), interrupting intercourse for fear of staining the wet sheets, penis weakness after urination, intercourse can not continue.
(2) mental and emotional factors. Ideologically have some kind of “taboo” on intercourse, the sex life as a beast, mostly because of the education received from childhood to distort sex into a dirty, dirty, obscene things. Or unsatisfied with the current spouse, fond of the old lover; hostile spouse, suspect that the wife has an affair; or the woman had been raped or had a sexual experience, the husband is haunted by this; or married with more debt, the pressure of thought, sexual desire suddenly reduced; because of the newlywed nervousness, sexual life after a few failures, by the wife cold and resentment, the formation of sexual malignant stimulus, and gradually lose interest in the opposite sex, sexual desire, avoiding sexual intercourse, and even lead to the couple rebellion.
(3) the female factor. The woman is afraid of painful intercourse, fear of rubbing the vagina, fear of cervicitis, cystitis and restrict the male side of the pumping; the woman’s poor physical fitness, bored with sexual activities, so that the male sexual impulse frustrated.
(4) objective factors. Such as narrow housing, several families living in the same room, noisy environment, the formation of sexual inhibition; the two sides work different, different commuting time, sexual activity is not coordinated; the male side of the work is too strenuous, etc..
(5) Anatomical factors. The foreskin is too long, rubbing in the vagina, the head of the penis itchy; foreskin embedded, painful, forced to interrupt sexual intercourse; severe seminitis so that atrophic changes occur, can not effectively participate in the ejaculation process.
(6) Gay men, who marry women because of family and social pressure, cannot get an erection during sex after marriage, or although they can get an erection after stimulation, they cannot ejaculate because of their aversion to sexual intercourse with men.
Second, secondary non-ejaculation
There was ejaculation after marriage, but the ability to ejaculate was lost under the influence of other reasons.
(1) After the first marriage, the sexual urge is unusually intense, and ejaculation can be achieved during intercourse even though there is no pumping, but after this peak period, ejaculation cannot be achieved later due to improper methods. After marriage, due to a variety of factors or a strong career temporarily do not wish to have children, using in vitro ejaculation. Condoms and other measures to prevent pregnancy. To be intended to have children, but by some psychological influence and do not ejaculate.
(2) Masturbation or improper sexual activity is discovered and chastised, resulting in mental trauma; unmarried cohabitation and pregnancy is criticized, bringing fear of pregnancy and non-ejaculation after marriage; frequent masturbation before marriage is strongly stimulated and influenced by various false propaganda about the dangers of masturbation, and non-ejaculation in the same room after marriage; feelings are hurt or discord, and there is fear of ejaculation; abnormal sexual psychology, when having an affair can In the literature, according to the results of ejaculation, there is no ejaculation during intercourse with the wife, which is secondary to incidental ejaculation; both parties do not cooperate.
In the literature, ejaculation can also be divided into functional and organic ejaculation according to the causes of ejaculation. Functional ejaculation is the most common type of ejaculatory disorder, accounting for about 90% of cases or more, and it includes.
(1) Central ejaculation disorder. This is mainly due to abnormal brain function, which strengthens the inhibition of sexual excitement, especially the inhibition of the ejaculatory center, and the patient has no orgasm and ejaculatory action. There are also a few cases of non-ejaculation due to sensory organs, emotional and intellectual disorders, etc.
(2) Spinal central ejaculation disorder. Dysfunction or failure of the ejaculatory and erectile centers in the lumbosacral medulla can lead to weakened erection or even complete inability to erect the penis and delayed ejaculation or even complete inability to ejaculate.
(3) Psychogenic ejaculation disorder. This type of ejaculation disorder has no organic disorders of the reproductive system, but is purely caused by psychological factors.
Functional ejaculation can be further divided into the following three types.
(1) Absence of ejaculatory activity, after prolonged intercourse or even some form of orgasmic exhaustion.
(2) Retrograde ejaculation, where the duration of intercourse is normal, but there is still no normal ejaculation after orgasm, and there is sperm and fructose in the urine after intercourse.
(3) Non-ejaculation, which refers to the absence of semen discharge after orgasm and ejaculation.
Organogenic non-ejaculation mostly has a history of neurological or endocrine disease or surgery or trauma. There can be the following problems leading to organic non-ejaculation.
1, neurological lesions and injuries: diseases or surgical removal of the lateral lobes of the brain; injury or surgical removal of the lumbar sympathetic ganglion; spinal cord injury due to various causes; pelvic surgery, such as prostate removal or radical treatment, radical rectal cancer surgery, etc., which causes damage to the nervous system and makes ejaculation dysfunctional and non-ejaculatory.
2, endocrine abnormalities: mainly seen in the pituitary gland, gonads, hypothyroidism and peripheral nerve damage caused by diabetes.
3, the penis itself disease: foreskin is too long, foreskin mouth narrow so that sexual intercourse embedded, resulting in pain and interrupted intercourse. The foreskin covers the glans, so that the stimulation generated by friction is weakened and does not reach the “threshold” of ejaculation. In addition, inflammation of the glans penis, allergies, etc. can not tolerate the friction back and forth and not ejaculate.
4, drug factors: many drugs can cause ejaculatory dysfunction, such as sedatives, sleeping pills to reduce the excitability of nerves, sexual excitement is also inhibited, adrenergic receptor blockers (guanethidine, phenothiazines). Anti-androgenic drugs (cyproterone acetate, etc.). All can have an inhibitory effect on ejaculation, which affects the degree of ejaculation with the size of the drug and the duration of the drug, the larger the amount of drug and time, the greater the impact, but most of the drug can be reversed after discontinuation.
5, toxic factors: chronic alcohol poisoning, nicotine poisoning and morphine, cocaine, codeine poisoning, etc. can make the poisoned person low sexual ability and cause non-ejaculation.
The reason for this is that Chinese medicine believes that the causes of ejaculation are caused by labor and weariness, internal injury, poor diet, internal blockage of blood, and depression of Fu Zhi, which causes failure to open the jingguan and jingqi. The causes are as follows.
(1) Labor weariness and internal injury: excessive intercourse, or frequent masturbation when young, or erotic indulgence, resulting in damage to the kidney qi; or after a long illness, damaging the yin and yang of the kidney; or weakness of the body, congenital kidney qi deficiency, resulting in the inability to ejaculate or the inability to discharge sperm.
(2) Dietary indiscretion: vegetarian spicy food, alcohol and thick taste, easy to form damp-heat internal knots, blocking the seminal tract, resulting in the inability to ejaculate.
(3) Blood stagnation and internal obstruction: Blood stagnation is caused by poor emotional and moral conditions and liver qi obstruction; or the sperm is held back from ejaculation during intercourse, resulting in internal obstruction of sperm; or blood stagnation is formed due to other internal organs and tissues lesions that are not treated, resulting in sperm obstruction and intermittent sperm.
(4) Qingzhi factors: ① more thoughts and delusions, desire fire, so that the phase fire is hyperactive and can not ejaculate. (2) disharmony between husband and wife, or fear of pregnancy, or emotional factors such as the desire not to send the liver qi stagnation, dysfunctional drainage, loss of sperm shutdown, and inability to ejaculate. (3) sudden fright during intercourse, the kidney qi reverses, the sperm pass meets abnormally, resulting in ejaculation disorder.