Answer:
by Annette Owens: (05/13/2004)
Under which circumstances can you not
ejaculate/climax? When you masturbate or when you
are with a partner or both? Have you had a colostomy
after your operation? Has anything else been going on in
your life?
I am trying to determine whether your problem has 1)
physical/organic (related to body function) or 2)
psychological roots (the way you perceive yourself and
possibly a relationship that you may be in).
1) Physical/organic roots:
One organic cause can be related to changes in
hormone levels (androgen deficiency), which can be
assessed by lab-testing at your doctor’s office.
Another organic cause could be if some of the nerves
important for the ejaculation process have been
severed during your operation. Since your erectile
function is unaffected, it is clear that many of your
nerves are still working fine, and I assume that this is
only a remote explanation.
Are you currently taking any medications? Some drugs
can cause so called “dry orgasms.” If so, check with the
doctor who prescribed the medication to you.
2) Psychological roots:
Psychological factors can often affect ejaculation in
various ways: early/fast/premature ejaculation or
delayed ejaculation as in your case. I recommend
reading “The New Male Sexuality” by Bernie Zilbergeld
for more information on this subject. You may get
some important insights from this book.
Finally, a sex therapist can specifically deal with your
ejaculation problems. You can contact The American
Association of Sex Educators, Counselors, and
Therapists (AASECT) at www.aasect.org for a list of sex
therapists in your area or try The American Board of
Sexology at www.sexologist.org. They have an on-line
listing of therapists in different states.
Good luck, and let me know if I can be of further help
to you.
Annette Owens, MD PhD
Reviewed by: Kathleen VanKirk DHS
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