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Question:
I am a 52 year old male with a problem regarding
failure to orgasm/ejaculate. The problem started
roughly a year ago, with the initial symptoms being an
increase in the time to reach orgasm. This happened
fairly infrequently at first. My wife seemed to think
that it was a lack of interest in her that caused it to
happen, although I have exactly the same difficulty if I
masturbate on my own. In recent months I have had an
affair, and although the relationship has been very
stimulating, I am still experiencing the same problem
only it seems to be much more frequent now. I have no
problem whatsoever maintaining my erection, and
seem to be able to go on for a very long time much to
my partner's delight. I do achieve a very heightened
arousal, however I really miss ejaculating/having an
orgasm. I am not taking any kind of drug, prescribed or
otherwise. Some years ago I had some checks done
regarding inability to provide a good stream, however
after these tests I found I was able to urinate normally
again. I don't appear to have any lumps in my testicles
etc, and my health generally is excellent. Could the
failure of orgasm/ejaculation have serious implications,
what are the chances of regaining my old abilities, and
what can I do to correct this?
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Answer:
by Annette Owens: (05/15/2004)
Your problem with delayed ejaculation can have
various causes:
1) One organic cause can be related to changes in
hormone levels (androgen deficiency), which can be
assessed by lab-testing.
2) Another organic cause could be if some of the nerves
important for the ejaculation process have been
somehow affected. Since you claim to be otherwise
healthy, this is probably unlikely in your case.
3) Could it be possible that you are ejaculating
backwards into your bladder? This could reflect early
sexual symptoms of diabetes. I would suggest having
your blood sugar checked in order to rule out diabetes.
4) You mention that you are not currently taking any
medications. Some drugs can cause so called "dry
orgasms" (orgasms without emission and no apparent
evidence of backwards ejaculation into the bladder).
But again, this seems not to be the case for you.
5) Have you had a recent prostate exam? If not, I
recommend to have one done. You mentioned
problems a few years ago (inability to provide a good
stream), that could have been related to an enlarged
prostate.
6) You mentioned that the problem started a year ago,
and that your wife originally thought that it was due to
lack of interest in her. You have since started an affair.
I suggest that you get counseling in order to resolve
your situation. Your problem with delayed ejaculation
can very well be related to marital or relationship
concerns. A sex therapist can specifically deal with
your ejaculation problems, but any other counselor can
also be helpful in resolving your issues. The fact that
you still have the problem when masturbating or when
being with your lover does not rule out that your
problem has psychological roots.
The chances for regaining your old abilities will depend
on the cause. I suggest that you have your androgen
levels, blood sugar, and PSA (prostate-specific antigen)
tested at your doctor’s office, together with a digital
prostate exam. I also strongly recommend getting
counseling in order to try to resolve your relationship
issues. If the origin of your problem is psychological, it
could improve much with sex therapy/counseling.
Finally, I am glad that you have checked for lumps in
your testicles. It is a good idea for all men to perform
periodic self examination of their testicles, checking
for lumps or other testicular irregularities.
Good luck, and let me know if I can be of further help
to you.
Annette Owens, MD PhDReviewed by Sexual Health Editorial Team
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