Ejaculation Difficulties: Causes and Solutions for Couples

Ejaculatory dysfunction

Hello Dr.
Lin,
I have a question I would like to ask for your opinion on.
My husband is 32 years old and his daily life is quite normal.
He occasionally drinks a little alcohol, but every time we have intercourse, he has difficulty ejaculating.
This mismatch in our sexual experiences is quite troubling for me.
Regardless of whether he has been drinking or not, he is unable to ejaculate, even though we have sufficient foreplay and a good atmosphere.
We have communicated about this, and he insists it is not a matter of feeling.
For example, out of 10 times we have intercourse, he is unable to ejaculate 9 times.
Each time lasts a long time, and we both end up very tired! I am unsure what might be causing this issue and which specialist we should consult.

P.S.
We have currently ruled out issues related to feelings and alcohol.

Please provide us with your advice.
Thank you,
Joyce

Joyce, 20~29 year old female. Ask Date: 2004/10/10

Dr. Lin Wenxu reply Urology

Dear Ms.
Joyce,
Thank you for your letter.
I apologize for the delay in my response.
Indeed, your husband's case of sexual dysfunction is relatively uncommon in clinical practice.
Possible causes may include congenital issues related to sperm production, anatomical abnormalities of the vas deferens, or acquired psychological factors; urinary tract infections leading to gland obstruction; the use of certain medications; previous pelvic or urinary tract surgeries; and even tumors in the genital area could contribute to such issues.
I recommend that you both visit a urology clinic for further evaluation and, if necessary, additional testing.

Reply Date: 2004/10/10

More Info

Dear Joyce,
Thank you for reaching out with your concerns regarding your husband's ejaculation difficulties. This is a common issue that many couples face, and it can indeed be frustrating and concerning for both partners. Understanding the underlying causes and exploring potential solutions can help improve your sexual relationship.

Ejaculation difficulties can stem from a variety of factors, both physical and psychological. Since you mentioned that your husband is otherwise healthy and that alcohol consumption has been ruled out as a contributing factor, we can consider other possible causes.

1. Physical Factors:
- Hormonal Imbalances: Testosterone levels play a significant role in sexual function. Low testosterone can lead to difficulties with ejaculation.

- Neurological Issues: Conditions affecting the nervous system, such as diabetes or multiple sclerosis, can interfere with the signals that trigger ejaculation.

- Medications: Certain medications, particularly antidepressants and medications for high blood pressure, can have side effects that affect sexual performance, including ejaculation.

- Chronic Health Conditions: Conditions such as obesity or metabolic syndrome can also impact sexual function.

2. Psychological Factors:
- Anxiety and Stress: Performance anxiety can create a cycle where the fear of not being able to ejaculate leads to increased anxiety, making it even harder to achieve ejaculation.

- Relationship Dynamics: Sometimes, underlying issues in the relationship can manifest as sexual difficulties. Open communication is essential, and it seems you have already taken steps in this direction.

- Past Trauma: Previous negative sexual experiences can lead to psychological barriers that affect current sexual performance.

3. Lifestyle Factors:
- Diet and Exercise: A healthy lifestyle can improve overall sexual health. Regular exercise and a balanced diet can enhance blood flow and hormone levels, which are crucial for sexual function.

- Sleep: Poor sleep quality can affect hormone levels and overall energy, impacting sexual performance.

Given the complexity of this issue, it would be beneficial for your husband to consult with a healthcare professional. A urologist or a sexual health specialist would be ideal, as they can conduct a thorough evaluation, including a physical examination and possibly blood tests to check hormone levels. If physical causes are ruled out, a referral to a psychologist or sex therapist may be helpful to address any psychological factors contributing to the issue.

In the meantime, here are some strategies that may help:
- Open Communication: Continue discussing your feelings and experiences with each other. This can help alleviate some of the pressure and anxiety surrounding the situation.

- Relaxation Techniques: Encourage your husband to practice relaxation techniques, such as deep breathing or mindfulness, which can help reduce anxiety during intimate moments.

- Focus on Foreplay: Instead of concentrating solely on ejaculation, try to enjoy the intimacy and connection during foreplay. This can help reduce performance pressure.

- Explore Different Techniques: Sometimes, changing positions or trying new things can help create a more relaxed atmosphere.

It's important to approach this situation with patience and understanding. Sexual difficulties can be challenging, but with the right support and communication, many couples find ways to navigate these issues together. I wish you both the best in finding a resolution that works for your relationship.

Warm regards,
Doctor Q&A Teams

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