Situational & Total Anejaculation – Understanding, Causes & Treatment

What Is Situational Anejaculation?

Situational anejaculation is a condition where men are unable to ejaculate during sexual activity despite having normal erections. However, they may still ejaculate during masturbation or experience nocturnal emissions (involuntary ejaculation during sleep).

Can It Be Treated?

Yes. Treatments for psychogenic (non-physical cause) anejaculation include:

• Sex therapy or counseling
• Vibrator-assisted stimulation
• Electroejaculation under medical guidance

What Is the Mechanism of Normal Ejaculation?

Normal ejaculation has two key phases:

• Emission phase: The vas deferens contracts to push sperm towards the base of the penis. At the same time, the prostate and seminal vesicles release fluids to create semen.
• Expulsion phase: Under somatic nerve control, rhythmic contractions expel semen through the urethra. Once the emission starts, ejaculation becomes involuntary.

Normal antegrade ejaculation is a coordinated process involving both the autonomic and somatic nervous systems.

What Is Total Anejaculation?

Total anejaculation is the complete absence of ejaculation during any form of sexual activity—whether intercourse or masturbation.

It is further classified into:

Anorgasmic Anejaculation

In this condition, the man is unable to reach orgasm at all and does not ejaculate. Possible reasons include:

• Psychological inhibitions or trauma
• Inadequate sexual stimulation
• Low testosterone levels
• Side effects of psychotropic medications

Orgasmic Anejaculation

Men with this condition reach orgasm but do not release semen. This can occur due to:

• Blockage in ejaculatory ducts
• Damage to ejaculatory nerves (e.g., due to diabetes)
• Post-surgical effects (prostate, bladder, or testicular cancer surgeries)

Important: This condition must not be confused with retrograde ejaculation, where semen flows backward into the bladder.

What Is Retrograde Ejaculation?

Retrograde ejaculation is when semen flows backward into the bladder instead of out through the penis. This occurs due to:

• Weakness or damage to the bladder neck muscles
• Medications like alpha-blockers (e.g., Flomax)
• Transurethral resection or laser prostate surgeries (TURP)

How Is Retrograde Ejaculation Diagnosed?

Diagnosis is made by analyzing a urine sample collected after orgasm. The presence of sperm in the urine confirms retrograde ejaculation. If no sperm is detected, it may indicate total anejaculation.

Struggling with ejaculation issues or seeking clarity? Book a confidential consultation at Androplus and receive expert diagnosis and treatment tailored to your condition.