Anejaculation: Symptoms, Causes, and Treatment Options

Introduction

Anejaculation is a rare male sexual dysfunction, because of which a man cannot ejaculate despite adequate sexual stimulation or even after experiencing orgasm. In many cases, this type of dysfunction has been found to affect couples’ ability to have children and their emotional health. Since the causes of this dysfunction may stem from physical, psychological, or a combination of both factors, prompt evaluation by a medical professional is extremely important for prescribing the correct treatment and directing individuals toward the best possible chance of resolving the issues leading to this disorder.

What is Anejaculation?

Anejaculation is a condition that affects men and is characterised by the inability to ejaculate either through masturbation or sexual intercourse, despite achieving an erection. Anejaculation represents a significant but infrequent form of male infertility, and can develop due to psychological issues such as performance anxiety or through physical causes such as nerve damage.

There are essentially two primary categories of anejaculation: primary anejaculation, which exists from puberty and is usually attributed to developmental or neurological problems; and Secondary anejaculation, which occurs later in life as a consequence of an illness, medical treatment, physical injury, or psychological trauma. Understanding whether a man has primary or secondary anejaculation helps to determine the best course of treatment.

Symptoms of Anejaculation

Individuals with anejaculation usually have continual issues with sexual activity even after adequate stimulation. Symptoms of anejaculation include the following:

• No ejaculation at any time during sexual activity - whether this be during sexual intercourse or masturbation.
• Erections and orgasms are normal, but there is never any semen produced.
• May feel nervous or anxious about their performance, frustrated, or distressed about the lack of orgasm/semen.
• May have concerns they are infertile because there is no semen deposited.
• If they are involved in a long-term relationship, their partners have been unable to get pregnant after having regular unprotected intercourse.

How Does Anejaculation Affect Male Fertility?

Anejaculation has a direct impact on male fertility. It's so, as semen fails to reach the vagina, making natural conception difficult or impossible. However, the majority of men with this condition continue to produce sperm normally; it is the inability to ejaculate that presents an issue, not the production of sperm. As such, reproductive assistance through technology offers options for men with anejaculation. Sperm retrieval and then insemination by either IUI or IVF allow couples to conceive even when the man is unable to achieve natural ejaculation.

Diagnosis of Anejaculation

A combination of physical evaluation and laboratory tests is done on the advice of the doctors to identify the cause of anejaculation. After thoroughly reviewing medical history and sexual concerns, specialists may recommend the following diagnostic approaches:

• Post-orgasm urine analysis for the presence of retrograde ejaculation.
• Collection of the patient's semen while observed by a medical professional.
• Blood tests to measure hormone levels of testosterone and other related hormones (i.e. Prolactin, FSH, LH).

Treatment Options for Anejaculation

In men with anejaculation, the cause can be a physical, psychological, or neurological etiology, which will dictate their treatment options. The goal of treatment is the restoration of ejaculation and/or assist conception through medically prescribed methods and may include:

• Medications to make the ejaculation reflex better.
• Anxiety and/or stress management by way of sexual or psychological therapy.
• Vibratory stimulation or electroejaculation for spinal cord injury.
• Surgical sperm retrieval methods like TESA or PESA are used if sperm is intended for use in IUI or IVF.
• Treatment of medical conditions causing ejaculatory dysfunction (for example, hormone imbalance or diabetes)

Lifestyle & Self-care Tips for Men with Anejaculation

For men who experience anejaculation, adjusting their lifestyle along with seeking proper medical treatment can promote their physical and mental health, and maintain stable hormone levels. The following are self-care practices that may benefit men with anejaculation:

• Maintaining healthy insulin/hormone levels is a must
• You can reduce stress through yoga, meditation, or therapy
• Avoid smoking cigarettes, drinking alcohol, and using illegal drugs
• If needed, seek the help of a therapist or someone you can talk to who is supportive of you
• Be sure to follow through on your physician's recommended health regimen.

Conclusion

While it is not a frequent occurrence, it is very important that a doctor determines the reason for an individual’s anejaculation. Whether this is due to hormonal or neurological issues, psychological issues, or medications. With modern diagnostic methods and treatments, including medications, counselling, advanced sperm retrieval methods, and assisted reproductive technologies, the majority of persons will experience a significant improvement in their condition and have the potential to achieve parenthood again.

With proper therapy and treatment from an expert at Indira IVF, men with anejaculation will regain confidence in their ability to be sexually active. They will have the opportunity to become parents.