Anejaculation

What is anejaculation?

Anejaculation means no ejaculation. When orgasm occurs but semen isn’t released from your penis, it’s called anejaculation.

Anejaculation is a type of male sexual dysfunction that can affect one’s ability to enjoy sex. It can also lead to male infertility.

What is ejaculation?

Ejaculation is the release of semen from your penis. It typically occurs when a person reaches sexual climax (orgasm) during intercourse or masturbation. The male reproductive system makes semen. This fluid contains sperm, which fertilizes eggs for conception and pregnancy.

Most people who have anejaculation still make sperm. But infertility can happen because they can’t ejaculate the semen that carries sperm.

Anejaculation vs. anorgasmia: What’s the difference?

Anejaculation is when orgasm occurs but no fluid leaves your body. Anorgasmia is when orgasms are absent or less intense — even after plenty of sexual stimulation.

How common is anejaculation?

An estimated 12,000 people seek treatment for anejaculation every year. The number of people who have the condition may be higher, as many don’t seek medical care.

What are the types of anejaculation?

Some people are never able to ejaculate (primary anejaculation). Others lose the ability to ejaculate for various reasons (secondary anejaculation).

Types of anejaculation include:

• Situational: You can ejaculate in certain situations, like while masturbating, but not during intercourse. Or you may be able to ejaculate only at home, but not in a hotel.
• Total: You’re unable to ejaculate while masturbating or having sex, regardless of the location or situation.
• Orgasmic: You can’t ejaculate while having an orgasm. Orgasmic anejaculation is often due to a physical problem like nerve damage.

Retrograde ejaculation is a similar condition in which semen goes back into your bladder instead of leaving your body. With retrograde ejaculation, orgasm occurs but no fluid escapes.

What causes anejaculation?

People with erectile dysfunction may not be able to get or keep an erection long enough to climax and ejaculate. But most people with anejaculation don’t have erection problems.

Potential causes of anejaculation include:

• Diabetes.
• Infections.
• Medications like antidepressants or alpha-blockers to treat high blood pressure or an enlarged prostate.
• Nerve damage from bladder surgery, prostate surgery, or pelvic injury or radiation.
• Nervous system disorders like Parkinson’s disease and multiple sclerosis.
• Spinal cord injury.
• Testicular cancer treatments, such as lymph node removal.

These factors may bring on situational anejaculation:

• Anxiety and depression.
• Fear of pregnancy.
• Relationship problems.
• Stress.

What are anejaculation symptoms?

The primary sign of anejaculation is the lack of ejaculate (fluid) during orgasm.

How is anejaculation diagnosed?

Your healthcare provider will review your symptoms and medical history and perform a physical examination.

If you’re able to orgasm, your provider may order a urine test (urinalysis) to take place immediately after you climax. No sperm (azoospermia) in a urine sample after an orgasm may indicate anejaculation.

If there are sperm in your urine sample, you may have a different type of sexual dysfunction called retrograde ejaculation. This condition causes semen to move back into your bladder (your urinary system organ that holds pee) during orgasm instead of leaving your penis.

How is anejaculation managed or treated?

Anejaculation doesn’t cause any long-term problems. Some people don’t seek or want treatment. Treatment (when desired) depends on the underlying cause. Psychotherapy (talk therapy), sex therapy and anti-anxiety medications can ease anxiety and stress that cause situational anejaculation.

Some people benefit from changing medications or better managing conditions like diabetes. There isn’t a treatment for certain causes like nerve damage.

Can a male with anejaculation have biological children?

Anejaculation makes it more difficult to conceive a child, but it’s not impossible. A urologist or reproductive medicine specialist can use different methods to retrieve sperm from your testicles. Your healthcare provider then uses infertility treatments to fertilize eggs with your extracted sperm. Examples include intrauterine insemination (IUI) or in vitro fertilization (IVF).

Sperm retrieval methods for males with anejaculation include:

• Penile vibratory stimulation (PVS): You apply a specially designed vibrator to the tip of your penis. Sensory nerves carry the vibrations to your spinal cord, causing ejaculation. As many as 6 in 10 men with anejaculation ejaculate with PVS. This therapy may take place at home or your provider’s office.
• Electroejaculation: If PVS doesn’t work, your healthcare provider may insert a probe into your rectum to directly stimulate the sensory nerves near your prostate. The probe sends mild electrical pulses that cause you to orgasm and ejaculate. This procedure may take place under general anesthesia (you’re asleep). About 9 in 10 men ejaculate with this method, but sperm quality may be poor at first. You may need to undergo the procedure several times to get a good sperm sample.
• Sperm extraction: During microscopic testicular sperm extraction, your provider surgically removes a small amount of tissue from your testicles and then extracts sperm from it. You’re asleep for this procedure.

When should I call the doctor?

You should call your healthcare provider if you experience anejaculation that:

• Affects your ability to enjoy sex or get or maintain an erection.
• Interferes with your ability to conceive a child.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What’s causing the anejaculation?
• Do I need treatment?
• What’s the best treatment for me?
• What are the treatment side effects?
• Can I conceive a child?
• Should I look out for complications?

A note from Cleveland Clinic

Not being able to ejaculate while having an orgasm can be upsetting to you and your partner. Don’t be embarrassed to talk to your healthcare provider about this issue. There are therapies that can help. It’s especially critical to talk to your provider if you want to conceive a child. There are procedures and fertility treatments that can help you start a family.