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Question:
I'm a 21 year old male who has an interesting
problem. I usually masturbate fairly regularly, but when
I can't (for 5-7 days in a row), I normally have a
nocturnal emission. Twice in the last month and a half,
however, I have had a wet dream without an erection.
When I reach orgasm, I wake up with extreme pain in
my testicles and no semen has come out. The only way
I have found of relieving the pain is to achieve an
erection and masturbate to orgasm. Is this a serious
problem?
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Answer:
by Annette Owens: (05/15/2004)
I do not think that you have a serious problem.
Orgasm and ejaculation are two separate phenomena
which occur simultaneously most of the time. It is
possible to have an orgasm without ejaculation (as you
describe) and vice versa. This is normal and not to
worry about.
You did not mention whether you are currently taking
any medication. Some drugs can cause so called "dry
orgasms" (orgasms without emission and no apparent
evidence of backwards ejaculation into the bladder).
Just for your information, and not to alarm you:
Changes in the ejaculation pattern can sometimes
reflect early sexual symptoms of diabetes. If this
problem persists, or if you notice a difference in
ejaculation during masturbation, I would suggest having
your blood sugar checked in order to rule out diabetes.
You mentioned extreme pain in your testicles during
orgasm. The complex process of ejaculation is to my
knowledge not yet fully understood. It can be divided
into two separate stages: During stage one muscle cells
in the testes and a number of structures surrounding
them (epididymis, vas deferens, seminal vesicles) and
the prostate contract. I can only speculate that you
experience this stage involving muscle contraction as
painful. This all happens before stage two when semen
is transported out of the penis by rhythmic muscle
contractions (involving other muscles as during stage
one). Sorry about this very technical explanation.
Finally just a reminder: Testicles should never be
painful under ordinary conditions. Any change in size,
shape or sensation, particularly in one testicle should
be investigated for testicular cancer. In fact, it is a
good idea for all men to perform periodic self
examination of their testicles. Check for lumps or other
testicular irregularities.
Annette Owens, MD PhD
Reviewed by Sexual Health Editorial Team
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