Ejaculatory Dysfunctionanejaculation-inability-to-ejaculate

Anejaculation is a condition when the sperm/semen doesn’t exit the body when a man orgasms. At the climax, usually every man ejaculates a few million sperms along with some liquid that supports the life of sperms. Here, you should note that ejaculation and orgasm are two different things. Every orgasm need not lead to ejaculation and every ejaculation need not cause an orgasm. Though the combination is the most common thing that happens, in some men there may be just one thing happening.

The condition of not feeling the orgasm is called ‘anorgasmia’. In medical terms, this is defined as a condition when  there is absence of orgasm or when the feeling is less intense.

Should you be worried if sperm is not coming out?

The answer to the question depends on whether you are trying to get your partner pregnant. If you are planning to get your partner pregnant, then you need to ejaculate inside her body, through the vaginal opening. (Of course, there are alternative medical procedures to get your wife pregnant, but the natural way is the best route.) 

If you are not able to ejaculate after reaching climax in such a scenario, you must see a good sexologist or andrologist near you. If you are not planning to get your partner pregnant, anejaculation shouldn’t actually bother you as long as you are enjoying the act and feeling the orgasm. The Opinions of other medical experts may differ but it’s your choice whether to see a doctor or not in such a case as there is no harm in it. That statement should be taken with a pinch of salt because anejaculation can be due to an underlying cause that needs evaluation.


What causes anejaculation?

Physical conditions that cause anejaculation

  1. Erectile dysfunction is a condition where a man isn’t able to get an erection to perform penetrative sex. Even if they get an erection, they may lose it very quickly before actual ejaculation happens.
  2. Diabetes – This is not just a case of increased sugar levels in your blood. Blood vessels are also damaged by higher sugar levels. 
  3. Medications taken to treat other medical conditions (Depression or high blood pressure).
  4. Damage or injury to nerves in the abdomen or pelvic region.
  5. Injury to the spinal cord.
  6. Cancer treatment that involves radiation, surgery to remove any tumour in the abdomen region or lymphadenectomy. 

Psychological conditions that can cause anejaculation

  1. Stress, anxiety and depression. Stress is a monster, you name the symptom, stress can be behind it in most cases. Extreme stress can cause depression.
  2. Tokophobia – fear of pregnancy. 
  3. Relationship problems with your partner. This may not even lead to sex but when it does, you may face an unknown resistance to ejaculate or climax.

Are there different types of anejaculation?

If you are not able to ejaculate right from day one, the condition is called primary anejaculation. If the condition occurred to you at some point in life, it is called secondary anejaculation.

Types of anejaculation include:

  1. Situation based anejaculation – this is more of a psychological thing. Some people may be able to ejaculate fine during masturbation but not able to ejaculate during actual intercourse. You may be able to ejaculate comfortably at home but not in any other place.
  2. Total anejaculation – No ejaculation at all irrespective of place or person or act.
  3. Orgasmic anejaculation – No ejaculation occurs even when you can feel the orgasm. This can be attributed to nerve damage or other underlying physical condition.

How is retrograde ejaculation different from anejaculation?

Retrograde ejaculation is a condition when the sperms come out of the testicles and then instead of exiting the body, they return to the bladder. You can feel the orgasm but you won’t see any liquid coming out of the body. From the outside, the condition may sound similar to anejaculation but what happens inside the body is different in each case.

Should you see a doctor for anejaculation?

As I have mentioned, you don’t need to see a doctor if you are not planning to get your partner pregnant. You can just enjoy your orgasm and leave it there. Before you take that, I recommend checking with a good sexologist or andrologist (that’s the doctor who can treat anejaculation) to make sure that there is no underlying injury or damage.  If you haven’t met with any trauma or undergone surgery or radiation therapy, you should be good.

What are some options to take sperm out of the body?

If you are suffering from anejaculation and you or your doctors want to treat the condition, here are some options.

  1. Penile Vibraroty Stimulation (device) – It is kind of a vibrator for men. When applied at the tip of the penis, the stimulation caused is carried to the spinal cord resulting in ejaculation. 
  2. Electroejaculation – An electronic probe is pushed through the rectum to stimulate the nerves near the prostate. This induces orgasm with the electric pulses leading to ejaculation. The procedure is done at the doctor’s clinic while you are put under full body anaesthesia. 
  3. Micro TESE – Microscopic Testicular Sperm Extraction – a procedure where your doctor cuts open the testicles to look for the presence of sperm hot spots and extracts a small tissue with sperms from the area. Read more on Micro TESE here.

Once the sperm is taken out of your body, it can be used to perform IVF or IUI to get your partner pregnant.

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