Ejaculation Issues During Intimacy: A Urology Perspective

Q: Ejaculation Issues During Intimacy: A Urology Perspective

Hello, sir： I would like to respond to your question and provide the following suggestions： 1. <br>Generally speaking, based on your description, your inability to achieve orgasm and the issue of anejaculation during masturbation is only partially related to your ex-girlfriend, b

Inability to ejaculate during sexual intercourse?

I usually achieve orgasm and ejaculation when I masturbate while watching adult films.
However, recently, when I had intercourse with my new girlfriend, I found that I was unable to reach orgasm and ejaculate, even though I had an erection and penetrated her vagina.
Five years ago, when I was with my ex-girlfriend for about six months, we had intercourse around twenty times, but I only reached orgasm and ejaculated twice.
I'm not sure why this is happening.

GEO, 30~39 year old female. Ask Date: 2008/03/19

Dr. Lin Hexing reply Urology

Hello, sir: I would like to respond to your question and provide the following suggestions: 1.
Generally speaking, based on your description, your inability to achieve orgasm and the issue of anejaculation during masturbation is only partially related to your ex-girlfriend, but the problem is more pronounced with your current girlfriend.
The primary issue may stem from psychological factors, as you are not yet married and have concerns about potentially causing your girlfriend to become pregnant.
Therefore, the underlying problem is not inappropriate sexual behavior, but rather the psychological pressure and burden that result from it, which may suppress the sympathetic nervous system, leading to difficulties in achieving orgasm and ejaculation.
If both partners consent and you engage in sexual activity without such concerns after formalizing your commitment, these symptoms should improve.
Finally, I wish you peace and happiness~~

Reply Date: 2008/03/19

More Info

Ejaculation issues during intimacy can be a complex and multifaceted problem, often influenced by psychological, physiological, and relational factors. From a urology perspective, understanding the underlying causes of these issues is crucial for effective management and treatment.

Firstly, it is important to differentiate between the ability to achieve an erection and the ability to ejaculate. In your case, you mentioned that you can achieve an erection and reach orgasm during masturbation, but experience difficulty with ejaculation during intercourse. This discrepancy can be attributed to several factors:
1. Psychological Factors: Anxiety, stress, and performance pressure can significantly impact sexual function. The fear of not being able to perform or the pressure to satisfy a partner can create a cycle of anxiety that inhibits sexual arousal and ejaculation. This is particularly relevant in new relationships where the dynamics and expectations are still being established.

2. Physiological Factors: There may be physiological reasons for the difficulty in ejaculation. Conditions such as retrograde ejaculation, where semen enters the bladder instead of exiting through the penis, can occur. Additionally, certain medications, particularly those affecting serotonin levels (like some antidepressants), can lead to delayed ejaculation or anorgasmia.

3. Relational Factors: The emotional connection with a partner can also play a role in sexual performance. If there is a lack of comfort or intimacy, it may hinder the ability to relax and fully engage in the sexual experience, which can affect ejaculation.

4. Previous Experiences: Your history of sexual experiences may also contribute to your current situation. If you have had limited success with ejaculation in the past, this may create a mental block that affects your current performance.

To address these issues, consider the following steps:
- Open Communication: Discuss your feelings and experiences with your partner. Open dialogue can alleviate pressure and foster a supportive environment, which may enhance intimacy and reduce anxiety.

- Consult a Specialist: If the problem persists, it may be beneficial to consult a urologist or a sexual health specialist. They can conduct a thorough evaluation to rule out any underlying medical conditions and provide tailored advice or treatment options.

- Therapy: Engaging in therapy, particularly cognitive-behavioral therapy (CBT), can help address performance anxiety and improve sexual function. A therapist can work with you to develop coping strategies and enhance your sexual confidence.

- Relaxation Techniques: Practicing relaxation techniques, such as mindfulness or deep breathing exercises, can help reduce anxiety and improve your overall sexual experience.

- Exploring Different Techniques: Sometimes, experimenting with different sexual techniques or positions can help. Focusing on the overall experience rather than solely on ejaculation may also alleviate pressure.

In summary, ejaculation issues during intimacy can stem from a combination of psychological, physiological, and relational factors. Understanding these aspects and addressing them through communication, professional guidance, and relaxation techniques can significantly improve your sexual experiences. If the problem continues, seeking help from a healthcare professional is advisable to explore further treatment options.

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