All about anejaculation

Ejaculation is the expulsion of 2 to 5 ml of semen followed by orgasm. When sperm cannot be expelled, it is called anejaculation. What are the different types, causes and treatments of this condition?

The different types of anejaculation

Anejaculation is the inability to expel sperm outside of the sexual channel. It can be primary or secondary. It is said to be primary when it is present from the beginning of the patient's sexuality. When ejaculation occurs after a period of normal sexual activity, it is called secondary. There are several major types of anejaculation:

• Retrograde ejaculation (semen goes back to the bladder);
• Orgasmic anejaculation or orgasm without ejaculation (no ejaculation or less than 0.5 ml);
• Ejaculation without orgasm;
• Asthenic anejaculation or slobbering ejaculation (semen expelled as a flow and not as a strong jet).

Causes of anejaculation

Organically, anejaculation can be due to

• A failure in the sperm propulsion mechanism due to a neurological disorder
• Trauma to the spinal cord or damage to the nerves that control ejaculation
• An abnormality in the excretory pathway and mechanical disorders
• Impairment in the sperm production process.

Anxiety, disgust, fear or guilt reactions, and interprofessional factors in the couple are causes of anejaculation. The use of certain medications and addiction to certain toxic substances such as tobacco, alcohol, marijuana, heroin, cocaine, and amphetamines can have an impact on ejaculation. 

Treatment of anejaculation

If the anejaculation has psychological causes, the patient will be treated by a psychotherapist. If the condition is due to hypogonadism, a testosterone-based treatment can be proposed by the doctor. For persistent retrograde ejaculation despite prostate surgery, surgical removal of the prostate is possible. But this does not prevent the patient from having children. The patient can either use sperm storage in a sperm bank before the operation or artificial insemination.