From the Guidelines
Lack of ejaculation in men generally does not cause physical health problems, but it can pose a significant impediment to sexual satisfaction and may lead to relationship stress or marked trepidation about starting new relationships. Men who abstain from ejaculation, whether by choice or due to medical conditions, typically do not experience harmful physical effects, as the body naturally reabsorbs unused sperm and seminal fluid components 1. Some men may experience subjective discomfort like testicular heaviness or mild pelvic discomfort during extended periods without ejaculation, but these sensations are temporary and not medically concerning. However, if the inability to ejaculate is unwanted or sudden, it could indicate underlying medical conditions like retrograde ejaculation, certain medication side effects, or neurological issues that should be evaluated by a healthcare provider 1.
Potential Impacts on Sexual Satisfaction and Relationships
Psychological factors can also play a role in ejaculatory problems, potentially affecting sexual satisfaction and relationships. Disorders of the timing of ejaculation, including delayed ejaculation (DE), can cause significant distress for both men and their partners, and may lead to relationship stress or marked trepidation about starting new relationships 1. Men concerned about changes in their ejaculatory function should consult with a healthcare provider for proper evaluation and treatment if needed.
Treatment Options
According to the American Urological Association (AUA) and the Society for Men's Health (SMSNA) guidelines, clinicians should consider referring men diagnosed with lifelong or acquired delayed ejaculation to a mental health professional with expertise in sexual health, and advise men with delayed ejaculation that modifying sexual positions or practices to increase arousal may be of benefit 1. Behavioral interventions, such as incorporation of alternative sexual practices, scripts, and/or incorporation of sexual enhancement devices, are a low-risk option that may help some men with DE enhance arousal and trigger orgasmic response 1.
Key Considerations
It is essential to note that the perception of rarity of ejaculatory disorders may stem from the frequency with which other disabling disorders of sexual function, primarily erectile dysfunction (ED), are present in men with comorbid disruption of ejaculation 1. Therefore, a comprehensive evaluation and treatment plan should be developed to address the underlying causes of ejaculatory problems and improve overall sexual satisfaction and relationships. Men with delayed ejaculation should be advised to modify sexual positions or practices to increase arousal, and consider referral to a mental health professional with expertise in sexual health 1.
From the Research
Ejaculatory Disorders in Men
- Ejaculatory disorders, including premature ejaculation, delayed ejaculation, and anejaculation, are common male sexual dysfunctions that can cause distress for the individual and their partner 2.
- Delayed ejaculation, also known as inhibited ejaculation, is a condition where a man has difficulty ejaculating or is unable to ejaculate despite adequate stimulation 3, 2.
Potential Problems Associated with Lack of Ejaculation
- Lack of ejaculation can be a symptom of an underlying condition, such as delayed ejaculation or anejaculation, which can negatively impact a man's sexual relationship and overall well-being 3, 2.
- In some cases, lack of ejaculation can be caused by psychological factors, such as anxiety or depression, which can require treatment and counseling 4.
- Certain medical conditions, such as diabetes, hypertension, and penile trauma, can also increase the risk of male sexual dysfunction, including ejaculatory disorders 5.
Treatment Options
- Treatment for ejaculatory disorders, including lack of ejaculation, depends on the underlying cause and may involve pharmacotherapy, behavioral therapy, or a combination of both 3, 5, 2.
- In some cases, education, patient reassurance, and revised sexual techniques may be sufficient to manage the condition 2.