Loss of Ejaculatory Pleasure: the Causes and Solutions

Q: Loss of Ejaculatory Pleasure: the Causes and Solutions

People without sensation： Hello, you shouldn't be so pessimistic. <br>Generally, spinal injuries, particularly in the lumbar region, are more likely to cause sexual dysfunction. <br>I believe your issue may stem from habituation, meaning that long-term DIY or fixed patterns of se

Lack of ejaculation sensation?

Hello Doctor: I have been troubled by an issue for almost a year! During sexual intercourse or masturbation, I have noticed that the sensation during ejaculation is not as intense as it used to be (only about one-third of the normal sensation).
Previously, I would feel a burning sensation before ejaculation, and I could sense the semen being expelled! Now, I only realize that I am about to ejaculate, but the sensation is less than half of what it used to be.
This has been consistent in all sexual activities or masturbation! Even during masturbation, the ejaculation lacks force, only reaching a few centimeters or just flowing out (previously, it would reach 20-30 centimeters)! Recently, over the past month, it seems to be getting worse, with even less pleasure! During orgasm, there is hardly any semen expelled; I have to squeeze my penis to get a little out! For the past year, I felt that the volume of ejaculation was only half of what it used to be, but now it seems almost nonexistent! What could be the problem? My erections now require watching adult films or engaging in intercourse to occur; previously, I could achieve an erection just by fantasizing during masturbation.
The duration of intercourse remains the same as before; the only issue is the lack of sensation during ejaculation! I do not drink alcohol, smoke, or have any drug use or other internal medical conditions.
I have been working rotating shifts for 15-16 years! In the past 2-3 years, I have also felt more easily fatigued.
A couple of years ago, I had a blood test for liver function, which was normal! However, last year, I had an accident that caused compression in the 3rd and 4th vertebrae of my spine, which has not fully healed; I wonder if this could be affecting me! Thank you for your response!

Mei you gan jue de ren, 30~39 year old female. Ask Date: 2006/11/14

Dr. Xu Weikai reply Urology

People without sensation: Hello, you shouldn't be so pessimistic.
Generally, spinal injuries, particularly in the lumbar region, are more likely to cause sexual dysfunction.
I believe your issue may stem from habituation, meaning that long-term DIY or fixed patterns of sexual activity have led to a desensitization.
In other words, insufficient stimulation during sexual activity can also affect the firmness of erections and the intensity of ejaculation.
Suggestions: Consider increasing foreplay or trying different positions to enhance stimulation; this should help improve the situation.
Response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2006/11/14

More Info

Loss of ejaculatory pleasure can be a distressing issue, and it is important to understand the potential causes and solutions. Based on your description, it seems that you are experiencing a significant decrease in the sensation associated with ejaculation, as well as a reduction in the volume of ejaculate. This can be attributed to a variety of factors, including physiological, psychological, and neurological influences.

Potential Causes
1. Neurological Factors: Given your history of spinal cord injury, it is possible that the nerves responsible for the sensation of ejaculation have been affected. The spinal cord plays a crucial role in sexual function, and any injury or compression in that area can lead to altered sensations or even loss of pleasure during ejaculation.
2. Hormonal Changes: Hormonal imbalances, particularly involving testosterone, can impact sexual function and pleasure. Although you mentioned that previous blood tests showed normal liver function, it may be worthwhile to check your testosterone levels, as low testosterone can lead to decreased libido and altered ejaculation sensations.

3. Psychological Factors: Stress, anxiety, and depression can significantly affect sexual performance and pleasure. Working night shifts and experiencing fatigue may contribute to psychological stress, which can, in turn, impact your sexual health.
4. Medication Side Effects: While you stated that you are not taking any medications, it is important to consider that some over-the-counter supplements or herbal remedies can also have side effects that impact sexual function.

5. Age-Related Changes: As men age, changes in sexual function are common. However, since you are relatively young, this is less likely to be the primary cause unless there are underlying health issues.

6. Physical Health: General health conditions, including cardiovascular health, can impact sexual function. It is essential to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall health and sexual function.

Solutions and Recommendations
1. Consult a Specialist: It is crucial to consult a urologist or a sexual health specialist who can conduct a thorough evaluation, including physical examinations and possibly imaging studies to assess any nerve damage or other underlying issues.

2. Hormonal Assessment: Request a comprehensive hormonal panel, including testosterone levels, to rule out any hormonal imbalances that could be contributing to your symptoms.

3. Psychological Support: Consider speaking with a mental health professional who specializes in sexual health. They can help address any psychological factors that may be affecting your sexual pleasure.

4. Physical Therapy: If your spinal injury is contributing to your symptoms, physical therapy may help improve nerve function and sensation. A physical therapist specializing in pelvic health can provide targeted exercises.

5. Lifestyle Modifications: Focus on maintaining a healthy lifestyle, including regular physical activity, a balanced diet, and adequate sleep. Reducing stress through relaxation techniques, such as meditation or yoga, may also be beneficial.

6. Open Communication: If you are in a relationship, communicate openly with your partner about your experiences. This can help alleviate any pressure you may feel and foster a supportive environment for exploring solutions together.

In conclusion, the loss of ejaculatory pleasure is a multifaceted issue that can stem from various causes. A comprehensive approach involving medical evaluation, psychological support, and lifestyle changes can help address the problem effectively. It is essential to seek professional guidance to identify the underlying causes and develop a tailored treatment plan.

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