Merck Manual

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Inability to Ejaculate

By

Irvin H. Hirsch

, MD, Sidney Kimmel Medical College of Thomas Jefferson University

Medically Reviewed Mar 2022 | Modified Sep 2022
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The cause is usually prostate surgery because

  • The nerves between the spinal cord and the penis may be damaged during pelvic surgery.

  • Removal of the prostate and seminal vesicles during surgery for prostate cancer eliminates the ability to produce semen (these glands are involved in semen production).

Other conditions that damage the nerves of the penis, as well as some mental disorders and some drugs that are used to treat mental disorders, may also affect the ability to ejaculate.

Depending on the cause, anejaculation may occur with or without orgasm. A doctor bases the diagnosis of anejaculation on the man's symptoms, results of an examination, and, if orgasm is possible, a urine test. Absence of sperm in a urine sample obtained after an orgasm indicates anejaculation, whereas presence of many sperm indicates retrograde ejaculation Retrograde Ejaculation Retrograde ejaculation is a condition in which semen is ejaculated backward into the bladder rather than out through the penis. (See also Overview of Sexual Dysfunction in Men.) In retrograde... read more .

Treatment depends on the cause and may include stopping any drugs that may be causing the problem, psychotherapy, or helping trigger ejaculation using oral drugs such as pseudoephedrine and/or imipramine. If the goal of therapy is to obtain semen for insemination, the man can use a penile vibrator or his doctor can apply an electric signal to the rectum to activate the nerves responsible for ejaculation (electroejaculation therapy). There is no treatment when anejaculation is due to removal of the prostate and seminal vesicles.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Contac Cold 12 Hour, Dimetapp Decongestant, Drixoral, ElixSure Cold, ElixSure Congestion, Entex, Genaphed , KidKare , Myfedrine, NASAL Decongestant, Nasofed, Nexafed, PediaCare Infants' Decongestant, Pseudo-Time, Silfedrine, Sudafed, Sudafed 12 Hour, Sudafed 24 Hour, Sudafed Children's Nasal Decongestant, Sudafed Congestion, Sudafed Sinus Congestion, Sudogest, Sudogest 12 Hour, Sudogest Children's , Tylenol Children's Simply Stuffy, Zephrex-D
Tofranil, Tofranil-PM
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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