Nothing Cum-ing Out

I’m a 25-year-old healthy, white male, and I haven’t been able to ejaculate for two years. I can feel the rush and experience of orgasm, but nothing ever comes out. This started happening at a time when I was feeling quite good about my life. I came back from an international exchange and then didn’t masturbate for a month, because I didn’t feel like it. I was caught up in the joys of my life at the time. I guess I’m wondering, what might be going on and should I be concerned?

Before getting into your question I need to clarify something for this and future questions. While I’m well-educated on sexual health and sexuality issues, when it comes to most physical health questions, my answer will always be to go see a doctor.

As a sex educator, I have no medical training and can’t examine or diagnose anyone. Sure, I can speculate on what might be the cause, and I will in case something clicks, but that just makes me a slightly more comforting version of a Google search.

Providing a general overview of best- and worst-case scenarios can freak people out and there’s no way for me to follow up and know if someone found the solution they needed. In this case the main message to take away is to find a doctor, possibly an urologist, as there is
no substitute for a physical examination with a health professional.

I know it can sometimes be difficult to address sexual health issues but two years is a long time to have waited after such a significant change in your sexual response. Generally speaking, the sooner you tackle health issues, the more options you have and the lower your risk for long-term consequences.

Being unable to ejaculate, with or without the sensation of orgasm, is called anejaculation. There are different possible causes, both psychological and physical. Not having masturbated for a month is unlikely to have been the cause—ejaculation, thankfully, is not something you’ll lose by not doing it.

In terms of physical causes, the first thing to consider is if you are or were on any medication at the time. Many medications can have an effect on sex drive and sexual response, so you’ll want to start by looking into your medication’s side effects.

If you’ve ruled out medication, another possibility is a condition called retrograde ejaculation. This is when semen exits through the bladder instead of the urethra, often due to a weakened bladder sphincter. When you ejaculate, the bladder sphincter usually contracts to force semen out of the urethra, but if the muscle is weak, semen may flow into the bladder instead. This will usually result in a consistency or colour change in urine since there will be semen present, so keep an eye out for this.

While quite rare, some men also have decreased amounts of ejaculation due to an ejaculatory duct obstruction. This is a physical blockage of the ducts that carry semen to the urethra. However, in this case, it’s more common to have some ejaculation fluid since it’s rare for the ejaculatory ducts to become fully blocked.

You can do more research on these possibilities on your own, but I still urge you to make an appointment with a doctor as soon as possible. If this situation has been going on for two years already, it’s unlikely that it will go away on its own.

If you’re a Concordia student, you can get an appointment pretty quickly with Concordia health services by calling 514-848-2424 ext. 3565 for the Sir George Williams campus and ext. 3575 for the Loyola campus.

You can also call Info-Santé at 811 from any Quebec phone line for health information or to find a CLSC or walk-in clinic.

—Melissa Fuller @mel_full

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