Lesser-Known Ejaculation Disorders: A Guide for Guys

When it comes to men’s sexual health, most conversations seem to be about one of two things: erectile dysfunction or premature ejaculation. Are they important? Absolutely. But the conversation about men’s sexual health is much bigger than that. There are many lesser-known conditions that impact men’s intimacy, confidence, and even fertility. And (chances are) a lot of guys are dealing with them silently. So, it’s time to shed some light on these rarely discussed conditions. 

Today, we’re talking about conditions like anejaculation, retrograde ejaculation, and delayed ejaculation. No shame or judgment—just facts and support.

Anejaculation: When Orgasm Happens...But Ejaculation Doesn’t

Picture this – you’re having sex, experiencing desire, arousal, and the build-up to orgasm—except when it’s time to cross the finish line, nothing happens. That’s anejaculation, the inability to ejaculate semen during climax. There are two main types:

• Situational anejaculation: When ejaculation can only happen under certain conditions but not others (e.g., masturbation vs. sex)
• Orgasmic anejaculation: When orgasm happens, but without ejaculation
• Anorgasmic anejaculation: When there’s no orgasm or ejaculation 

What Causes It?

• Neurological Conditions: Diseases like multiple sclerosis or Parkinson's disease can affect nerve signals involved in ejaculation
• Spinal Cord Injuries: Spinal cord trauma can interfere with the pathways necessary for ejaculation
• Surgical Interventions: Procedures involving the prostate, bladder, or retroperitoneal lymph nodes can sometimes impact one’s ability to ejaculate.
• Medications: Certain antidepressants and medications can make it more difficult to ejaculate.
• Psychological Factors: Stress, anxiety, depression, or relationship issues can also play a role

How’s it Treated?

• Getting to the Root Cause: If it’s a medication issue, a doctor might tweak the prescription. If it’s nerve-related, more specialized medical care is usually needed
• Sex Therapy: When psychological factors are at play, therapy can make a huge difference
• Medical Intervention: In some cases, procedures like penile vibratory stimulation (PVS) or electroejaculation (EEJ) are used to treat anejaculation

The bottom line is that experiencing anejaculation can feel confusing, even isolating—but it’s more common than you might think, and it’s absolutely treatable.

Retrograde Ejaculation: When Semen Takes a Detour

Have you ever experienced an orgasm but didn’t notice any semen coming out? If so, did you notice your urine looking cloudy afterward? These are common signs of retrograde ejaculation. During a typical orgasm, a small muscle (the bladder sphincter) tightens to keep semen from coming out. During retrograde ejaculation, that muscle doesn’t close properly, so semen flows backward into the bladder instead.

What Causes It?

• Surgeries: Procedures on the prostate, bladder, or urethra can sometimes damage the muscles and nerves involved in ejaculation
• Medical Conditions: Diabetes is a major culprit—high blood sugar levels can damage the nerves that regulate ejaculation
• Medications: Some antidepressants, blood pressure meds, or drugs used to treat enlarged prostates can cause retrograde ejaculation

How’s it Treated?

• Medication Changes: If meds are causing retrograde ejaculation, swapping or adjusting the prescription might fix things
• Targeted Medications: In some cases, drugs that tighten the bladder neck muscles can help semen go in the right direction
• Fertility Support: If conception is the goal, sperm can be extracted directly from the urine or through other specialized procedures

Retrograde ejaculation doesn’t usually require treatment unless fertility is a concern—but if it’s affecting your self-esteem or intimacy, it’s worth bringing up with a healthcare provider.

Delayed Ejaculation: When Climax Takes (Way) Longer Than Expected

Let’s talk about another under-the-radar issue: delayed ejaculation. This is a condition where orgasm takes a long time to achieve (or sometimes doesn’t happen at all) even with plenty of arousal and stimulation. Most guys will experience a delay now and then (especially when stressed or distracted)—but when it becomes a consistent pattern, it can cause frustration and anxiety.

What Causes It?

• Emotional and Psychological Factors: Stress, performance anxiety, depression, or relationship problems often play a big role
• Medical Conditions: Diabetes, nerve damage, hormonal imbalances, and low testosterone can all contribute to delayed ejaculation
• Medication Side Effects: Antidepressants (especially SSRIs) are some of the biggest offenders here

How’s it Treated?

• Psychotherapy: Working with a sex therapist can help address psychological barriers to ejaculation and rebuild confidence around sex
• Medical Treatment: Bloodwork and exams can reveal underlying health conditions that need treatment, which might be the cause of delayed ejaculation
• Medication Management: If meds are part of the problem, your doctor might suggest alternatives or timing strategies
  
  

Let’s get one thing straight—delayed ejaculation isn’t about "not trying hard enough," and it’s not something you have to just live with. There are real, actionable ways to work through it.

Why Talking About It Matters

As anxiety-inducing as they can be, the reality is that many guys are experiencing (or have experienced) trouble ejaculating at some point in their lives. It’s more common than you think, even though it rarely gets the airtime it deserves. Sex and arousal are complicated—full stop. Your ability to climax or ejaculate isn’t just about physical stimulation; it can be influenced by things like your mental health, medications, past experiences, and even medical conditions you might not know you have.

Yet too often, these conditions aren’t talked about enough. But ignoring these issues doesn’t make them go away—it can just make them harder to deal with. If you’re experiencing symptoms like trouble ejaculating, significant changes in the way orgasm feels, a lack of semen during orgasm, or feelings of stress or tension around climax, know you’re not alone. Everyone deserves to feel confident and connected in their sex life. That’s why we’re always ready to step up to the plate and help shed some light on these lesser-known issues.

Final Thoughts

Sexual health isn’t just about performance—it’s about connection, confidence, and feeling good about yourself. So, the more we normalize conversations around conditions involving climax or ejaculation, we hope to erode some of the shame or stigma guys can feel around the topic. Ultimately, if something feels off, don’t wait. Listen to your body and reach out to get the answers and support you need. Remember, you deserve a sex life that’s satisfying, fulfilling, and joyful—free of shame or uncertainty.