What is Anejaculation? Solutions for a More Enjoyable and Intimate Experience

Anejaculation is a condition where a person is unable to ejaculate semen from the penis during sexual activity. We may also define it as the inability to ejaculate during sexual intercourse. 

• While it is not a life-threatening condition, anejaculation can cause emotional distress and difficulties with fertility.
• It affects around 3-6% of men and can impact fertility and sexual satisfaction.

Types of Anejaculation

According to the Journal of sexual medicine :

On the basis of orgasm anejaculation is classified as:

• Orgasmic Anejaculation: This type occurs when a man experiences orgasm but cannot ejaculate semen. This is often caused by physical issues like nerve damage, surgery, or hormonal imbalances.
• Anorgasmic Anejaculation: This type is less common and refers to the inability to reach orgasm or ejaculate semen during sexual activity while awake.

On the basis of situation anejaculation is classified as:

• Total Anejaculation: This is the complete inability to ejaculate semen in any situation, regardless of masturbation, sexual intercourse, or stimulation.

• Situational Anejaculation: This type refers to the ability to ejaculate in some situations but not others. Examples include:

• Clinic Anejaculation: Can ejaculate at home but not in a medical setting.
• Periovulatory Anejaculation: Can ejaculate on most days but not around a partner's ovulation.
• Unexpected Anejaculation: First-time failure to ejaculate on the day of ovulation despite past success.
• Masturbatory Anejaculation: Can ejaculate through masturbation but not during intercourse.
• Intercourse Anejaculation: Can ejaculate during intercourse but not through masturbation.

Symptoms of Anejaculation

1. No Fluid Release: No seminal fluid is released during orgasm.
2. No Sperm Release: No sperm are released from the body.
3. Infertility: Difficulty conceiving due to lack of sperm.

Causes of Anejaculation 

Neurological disorders

• Conditions like multiple sclerosis, spinal cord injuries, or diabetes can interfere with the nerve pathways responsible for ejaculation.
• A study published in the Journal of Sexual Medicine in 2016 looked at the prevalence of anejaculation among men with spinal cord injury. The study found that 28.6% of men with spinal cord injury reported anejaculation.

Medications

•  Hirsch & Pastuszak, in 2018 reported prevalence anejaculation as a side effect of SSRI (Antidepressant)  from 2.7% to 18% among men taking SSRIs.
• Antidepressants, antipsychotics, and blood pressure drugs, can sometimes cause anejaculation as a side effect.

Psychological factors

• A study presented by (Soykan & Mulhall, 2023)  showed Stress, anxiety, or past traumatic experiences can sometimes contribute to anejaculation.

Surgical procedures

• Surgeries involving the prostate, bladder, or pelvic area can potentially lead to anejaculation in some cases.

Diagnosis of Anejaculation 

To diagnose anejaculation, healthcare providers typically perform a physical examination and take a detailed medical history. 

Diagnostic tests for anejaculation may include

1. Semen analysis: This test evaluates the presence and quality of semen.
2. Neurological evaluation: Tests like nerve conduction studies or imaging may be performed to assess potential neurological causes.
3. Hormone testing: Measuring hormone levels can help identify any underlying hormonal imbalances.

Treatment Options for Anejaculation 

The treatment approach for anejaculation depends on the underlying cause. Some potential treatment options include:

1. Medication adjustments: If anejaculation is caused by certain medications, switching to alternative drugs or adjusting dosages may help.
2. Assisted reproductive techniques: For individuals seeking fertility, procedures like intracytoplasmic sperm injection (ICSI) or testicular sperm extraction (TESE) may be recommended.
3. Counseling or therapy: For cases related to psychological factors, counseling or sex therapy can be beneficial.
4. Vibratory stimulation: In some cases, using a vibrator or other devices can help induce ejaculation.
5. Surgery: In rare cases, surgical interventions may be considered to address underlying anatomical issues.

It's important to consult with a healthcare professional to determine the most appropriate treatment plan

 based on individual circumstances.

Frequently asked questions about anejaculation include

1.Is anejaculation is treatable???

Yes, anejaculation is treatable, and the appropriate treatment can help individuals lead fulfilling and healthy lives.

2.Anejaculation ICD-10??

In the International Classification of Diseases (ICD-10), anejaculation is classified under code N53.14, which falls under the broader category of male erectile dysfunction.

3.Anejaculation after Radiotherapy??

Radiation therapy for cancers in the pelvic area, such as prostate cancer, can sometimes damage nerves or muscles responsible for ejaculation, leading to anejaculation.

4.Anejaculation with Tamsulosin ???

Tamsulosin, a medication used to treat benign prostatic hyperplasia (BPH), has been associated with anejaculation as a potential side effect in some patients.

6.Anejaculation and Diabetes ??

Diabetes, especially if poorly controlled, can lead to nerve damage (neuropathy) and affect the nerves responsible for ejaculation, resulting in anejaculation in some cases.

7.Situational Anejaculation ??

Situational anejaculation refers to cases where a person experiences anejaculation only in certain situations or contexts, such as during sexual activity with a partner but not during masturbation,

8.Anorgasmic Anejaculation ???

Anorgasmic anejaculation is a condition where a person experiences both an inability to ejaculate (anejaculation) and an inability to achieve orgasm (anorgasmia) during sexual activity.

9.Psychogenic Anejaculation ??

Psychogenic anejaculation refers to cases where psychological factors, such as stress, anxiety, or past traumatic experiences, are the primary cause of the inability to ejaculate.