Ejaculation Issues: Causes and Solutions for Men - Urology

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Ejaculation issues, particularly the inability to ejaculate during sexual intercourse, can be a source of concern for many men. Your situation, where you experience difficulty ejaculating despite having a regular sexual routine with your girlfriend, raises several important points to consider.
Firstly, it's essential to understand that sexual performance can be influenced by a variety of factors, including psychological, physiological, and situational elements. Given that you have a limited number of days each month to engage in sexual activity, performance anxiety may play a significant role in your experience. The pressure to perform well during those few days can lead to anxiety, which can inhibit arousal and ejaculation. This is a common phenomenon known as "performance anxiety," where the fear of not being able to perform can create a cycle of stress that further complicates the situation.

In addition to psychological factors, physiological aspects should also be considered. Hormonal imbalances, particularly involving testosterone, can affect libido and sexual function. Although you mentioned that your health check-ups have shown normal indicators, it might be worthwhile to specifically assess hormone levels, including testosterone, to rule out any underlying issues.
Another potential factor is the technique and duration of sexual activity. If you find that you are engaging in prolonged sessions without ejaculation, it could lead to a condition known as "ejaculatory incompetence." This can occur when the body becomes desensitized to stimulation over time, making it harder to reach orgasm. It might be beneficial to vary the duration and intensity of sexual activity, allowing for breaks or changes in stimulation to see if this affects your ability to ejaculate.

Regarding your concern about not being circumcised, while there is some debate in the medical community about whether circumcision affects sexual function, most studies suggest that it does not have a significant impact on ejaculation. However, if you feel that the presence of the foreskin is causing discomfort or affecting your sexual experience, discussing this with a healthcare provider may provide clarity.

If these issues persist, it would be advisable to consult a urologist or a sexual health specialist. They can conduct a thorough evaluation, which may include a physical examination, hormone testing, and possibly psychological assessments to determine if there are any underlying conditions contributing to your ejaculation difficulties.
In the meantime, consider implementing relaxation techniques before engaging in sexual activity. Practices such as deep breathing, mindfulness, or even discussing your feelings with your partner can help reduce anxiety and create a more relaxed atmosphere, which may facilitate better sexual performance.

In summary, ejaculation issues can stem from a combination of psychological and physiological factors. Addressing performance anxiety, exploring variations in sexual activity, and consulting with a healthcare professional for a comprehensive evaluation can help you understand and potentially resolve these concerns. Remember, open communication with your partner about your experiences and feelings can also enhance intimacy and reduce pressure during sexual encounters.