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Inability to Ejaculate

By

Irvin H. Hirsch

, MD, Sidney Kimmel Medical College of Thomas Jefferson University

Last full review/revision Jul 2020| Content last modified Jul 2020
Click here for the Professional Version

The cause is usually prostate surgery because

  • The nerves between the spinal cord and the penis may be damaged during pelvic surgery.

  • Removal of the prostate and seminal vesicles during surgery for prostate cancer eliminates the ability to produce semen (these glands are involved in semen production).

Other conditions that damage the nerves of the penis, as well as some mental disorders and some drugs that are used to treat mental disorders, may also affect the ability to ejaculate.

Depending on the cause, anejaculation may occur with or without orgasm. A doctor bases the diagnosis of anejaculation on the man's symptoms, results of an examination, and, if orgasm is possible, a urine test. Absence of sperm in a urine sample obtained after an orgasm indicates anejaculation, whereas presence of many sperm indicates retrograde ejaculation Retrograde Ejaculation Retrograde ejaculation is a condition in which semen is ejaculated backward into the bladder rather than out through the penis. (See also Overview of Sexual Dysfunction in Men.) In retrograde... read more .

Treatment depends on the cause and may include stopping any drugs that may be causing the problem, psychotherapy, or helping trigger ejaculation using oral drugs such as pseudoephedrine and/or imipramine. If the goal of therapy is to obtain semen for insemination, the man can use a penile vibrator or his doctor can apply an electric signal to the rectum to activate the nerves responsible for ejaculation (electroejaculation therapy). There is no treatment when anejaculation is due to removal of the prostate and seminal vesicles.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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Test your knowledge

Premature Ejaculation
Premature ejaculation is ejaculation that occurs too early, usually before, upon, or shortly after penetration. Which of the following is rarely a cause of premature ejaculation?
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