Ejaculation disorder, also known as inability to ejaculate, refers to having normal sexual desire, normal penile erection, being able to maintain erection and intercourse in the vagina for a period of time, or even a long time, but no orgasm occurs, and inability to ejaculate. According to the survey of western famous sexologists Masters and Johnson, among 450 male sexual dysfunction patients, 17 of them were not ejaculating, accounting for 8%; a study in Shanghai reported that among 2087 cases of male infertility, 32.39% were not ejaculating; more than 70% of these people were caused by lack of sexual knowledge and incorrect methods of intercourse.
Brief description of the disease
Ejaculation, also known as inability to ejaculate, refers to having a normal sexual desire, normal penile erection, being able to maintain erection and intercourse in the vagina for a period of time, or even for a long time, but no orgasm, and being unable to ejaculate.
This disease is caused by the dysfunction of a link in the sexual physiological reflex process in which the central nervous system, peripheral nervous system, endocrine system and reproductive organs participate together, so that the stimulation of sexual excitement is not enough to produce the ejaculatory reflex.
Disease classification This disease is divided into primary and secondary ejaculation according to the nature of the disease.
Primary ejaculation, which is characterized by never having ejaculation, whether in the waking state or in sleep, is mostly caused by congenital organic disease; this condition is less common.
Secondary ejaculation is more common and usually occurs in two ways: one is when one has experienced ejaculation in the vagina and for some reason is currently unable to ejaculate in the vagina; the other is when one is unable to ejaculate in the vagina and can ejaculate by masturbation or other means.
There are many causes of ejaculation and they are mainly divided into two categories: functional and organic.
The main causes of functional non-ejaculation are as follows.
(1) Mental and emotional factors, also known as psychogenic ejaculation disorders, are the most numerous clinically. It is mainly the result of sexual dysfunction, strengthening of the inhibition of the ejaculatory center and the inability to get excited. Sometimes ejaculatory premonition may occur, but it is extinguished instantly. The causes are from the psychological aspect, such as frequent masturbation before marriage, so that after marriage, sexual intercourse does not reach sufficient strength and not ejaculate; education received from childhood distorts sex into a dirty, dirty, obscene thing; or dissatisfied with the spouse, loss of interest in the opposite sex, decreased libido, avoiding sexual intercourse; some are afraid of wife pregnancy after marriage, long-term restraint of sex, forming the conditioned reflex of non-ejaculation.
(2) Lack of sexual knowledge: incorrect sexual position, or improper method, stagnation after penile insertion into the vagina, no friction or insufficient friction intensity, not aroused or not reached the required intensity of ejaculatory center excitement often leads to non-ejaculation.
(3) Female factor: The female partner is afraid of painful intercourse, fear of pregnancy or sexual desire, limiting the male partner’s pumping; the female partner’s poor physical condition and boredom with sexual activity frustrate the male partner’s sexual impulse.
(4) Drug factors: mainly because of taking drugs that affect sympathetic tone, such as guanethidine and reserpine for hypertension; Librium, methiodiazide, phenothiazines, monoamine oxidase inhibitors for neurasthenia or insomnia, etc. Excessive use of bitter-cold Chinese medicine and alcohol abuse can also cause non-ejaculation.
(5) Objective factors: such as narrow housing, noisy environment, the formation of sexual inhibition; the two sides work different, different commuting time, sexual activities are not coordinated, etc.
(6) anatomical factors: long foreskin, friction in the vagina, itchy penis head; foreskin embedded, painful, forced to interrupt sexual intercourse; severe seminitis so that atrophic changes occur, can not effectively participate in the ejaculation process.
(7) Other factors: too frequent sexual intercourse, work too hard, excessive use of bitter cold Chinese medicine, alcoholism and other reasons can also cause non-ejaculation.
The main causes of organic non-ejaculation are as follows.
(1) Genital anatomical abnormalities: congenital defects of the genitourinary tract, such as congenital lack of seminal vesicles, congenital absence of the vas deferens; obstruction of the vas deferens, seminal vesicles, epididymis and other genital tracts caused by injury or inflammation.
(2) Neurological system lesions: such as lateral lobe disease and resection, spinal cord injury, lumbar sympathectomy, and post-pelvic radical surgery.
(3) Endocrine hypofunction: such as pituitary, gonadal, thyroid and other lesions.
Clinical manifestations
1.Normal sexual desire and normal penile erection.
2.No orgasm and pleasure during sexual intercourse, i.e. no paroxysmal twitching sensation of genitalia at all times during sexual intercourse.
3.No random ejaculatory action during sexual intercourse, no semen ejaculation.
4. There is ejaculation in functional non-ejaculation and no ejaculation in organic non-ejaculation.
Differential diagnosis
1. Retrograde ejaculation: The same as non-ejaculation is that no semen is ejected from the urethral orifice during intercourse. However, retrograde ejaculators have normal intercourse time, have orgasm during intercourse, and also have ejaculatory movements, and have white flocculent material in the first urine after intercourse, and a large number of sperm and fructose are visible on microscopic examination.
2.Azoospermia: normal intercourse, ejaculation and orgasm, semen discharge, no sperm on laboratory test.
3, abnormal penile erection: the penis is continuously erect for more than 6 hours or even up to several days, and does not become soft even after ejaculation, accompanied by penile pain.
Disease treatment general treatment
① Sexual knowledge education and psychotherapy: correcting wrong sexual concepts, coordinating the relationship between husband and wife, encouraging the female partner to take the initiative to cooperate and assist the male partner in treatment.
②Create good habits, quit frequent masturbation; quit smoking and drinking; increase nutrition, strengthen the body and improve the quality of the whole body.
③ strengthen physical exercise, you can use traditional fitness therapy, such as qigong, taijiquan, etc., to maintain a happy body and mind.
④Improve the living room environment and create a good sexual environment.
⑤ Circumcision in case of excessively long foreskin.
Drug treatment
1.Western medicine treatment: use ephedrine, levodopa, Stilbene, neostigmine, etc.; use testosterone propionate, human chorionic gonadotropin and other drugs for endocrine abnormalities.
2, Chinese medicine treatment: need to dialectic prescription according to the specific circumstances of the patient. Most of those who do not ejaculate generally have low semen volume, so eat more sperm-producing foods or drugs on a regular basis.
Head acupuncture with acupuncture treatment head acupuncture frontal side three lines is the main; with Daher, Sanyinjiao, partial real plus Tai Chong, Zhongji through Qu bone; partial deficiency plus Tai Xi, Guan Yuan through Zhongji. Acupuncture is performed once a day or every other day, and 10 times is a course of treatment.
Electric vibration and electrical stimulation therapy uses electric massagers to stimulate the glans tether to induce ejaculation, which can often obtain better results. There are also reports of results obtained with electrode insertion therapy in the rectum.
1, non-ejaculation can not only lead to infertility, but long-term existence can even lead to changes in libido and erectile dysfunction. Therefore, it needs to be taken seriously and treated actively.
2, the treatment of non-ejaculation requires the understanding and cooperation of the patient’s wife. Therefore, the wife should be sympathetic to the husband, more relief, it is advisable to seek medical help together with the couple, collaborative treatment.
3, both husband and wife should fully understand the anatomy and physiological function of the sexual organs, the process of sexual response and other knowledge, master the correct sexual intercourse posture and method, so that the ejaculation center is subject to sufficient sexual stimulation.
4.Behavioral therapy: during sexual intercourse, the frequency and amplitude of penis thrusting in the vagina should be increased continuously, while the female partner can control the contraction of the vaginal sphincter to increase the friction and the intensity of stimulation of the penis, and use her hand to hold up the scrotum to press the male partner’s pubic symphysis to promote the arrival of male orgasm to achieve the purpose of ejaculation. If you still can’t reach ejaculation, you can first set the penis out of the vagina and have the female partner use her hand for strong stimulation. When there is a sense of urgency to ejaculate, then reinsert the penis into the vagina and raise the thrusts substantially with high frequency until ejaculation. If the above method still cannot achieve intravaginal ejaculation, you can masturbate by yourself or with the help of the female partner and use the most stimulating sexual method to induce extra-vaginal ejaculation and experience the feeling of ejaculation, then gradually transition to intravaginal ejaculation with the above method.
5, functional non-ejaculation, Chinese medicine treatment has better efficacy. However, the specific prescription and treatment plan need to be based on the patient’s specific evidence, and cannot be treated with a fixed herbal prescription. For those who have not been able to cure ejaculation for a long time, you may want to try Chinese medicine therapy.