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Ejaculatory Inhibition - Causes, Types and Risk Factors

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Ejaculatory inhibition, often known as anejaculation, is one of the most overlooked male dysfunction. This article explains what ejaculatory inhibition is and how to overcome it.

Medically reviewed by

Dr. Raveendran S R

Published At May 24, 2022
Reviewed AtJuly 27, 2023


Ejaculation inhibition is one of the least frequent, least investigated, and least understood male sexual dysfunctions. Both the male and his partner are likely to experience a loss of sexual fulfillment due to this disorder. In addition, men who cannot ejaculate and reach orgasm have various psychological effects, including worry, distress, and a lack of confidence in their sexual interactions. Ejaculation inhibition is a phrase used to describe a change in the pattern of ejaculation and orgasm that includes retrograde ejaculation, variable delays in ejaculation latency, and complete inability to ejaculate (anejaculation). This group also includes reductions in the volume, force, and sensation of ejaculation.

What Causes Ejaculatory Inhibition?

The etiology of ejaculation inhibition is frequently multifaceted, coming from many biological or psychogenic variables affecting the man's biologic ejaculatory latency in varying combinations throughout his life.

Psychological Reasons

Many psychological and relational factors have been traditionally implicated as confounding factors in the etiology of ejaculation inhibition, including

  • Fear of pregnancy and problems with fertility.

  • Fear of being castrated and dying.

  • The fear of annihilation linked to the loss of sperm.

  • The fear of losing control.

  • Fear of coming out or being exposed and, as a result, feeling ashamed about the problem.

  • Abandonment or rejection fears.

  • Intimacy phobias and a loss of autonomy.

  • Fear of injuring or defiling one's relationship.

  • Fear of being retaliated against by the female or other males.

  • Fear of achieving success (success phobia).

Physiological Reasons

  • Penile sensitivity has decreased (hypothesized).

  • Response system that is inherently sluggish or muted.

  • The ejaculatory threshold is high.

Pathophysiological Reasons

  • Medication can be an iatrogenic cause.

  • Trauma or pelvic surgery (for example - spinal cord injury, prostatectomy, resection of the prostate).

  • Neuropathy is a condition that affects neural functioning (diabetes, and other diseases affecting the nervous system).

  • Endocrinology (hypogonadism, hypothyroidism).

  • Age-related.

Religious Beliefs and Orthodoxy

  • Strong auto sexuality (masturbation).

  • Reduced sexual desire.

  • Sexual arousal or excitement is insufficient.

  • Anxiety about sexual performance.

  • The relational disparity in sexual dysfunction between fantasy partners.

Infections or Inflammations

  • Urethritis (urethral inflammation).

  • Genitourinary tuberculosis (urinary tract infections caused by tuberculosis bacteria).

  • Schistosomiasis (a disease caused by parasitic worms).

  • Prostatitis (prostate gland infection).

  • Orchitis (infection of the testes).

  • Orchialgia in testis cancer survivors (deep testicular pain in cancer survivors).

Does Masturbation Cause Ejaculatory Inhibition?

Another well known pathophysiological cause for ejaculatory inhibition is "autosexual" orientation, which refers to males who prefer masturbation to partnered sex. Many men with ejaculatory inhibition engage in self-stimulation that differs from what they would do with a partner in terms of the pace, pressure, duration, and intensity required to produce an orgasm. As a result, they prepare themselves for the possibility of having problems achieving orgasm with a partner, and as a result, they develop acquired ejaculatory inhibition.

What Are the Different Types of Ejaculatory Inhibition?

Ejaculatory inhibition can be categorized into four categories as follows:

  • Lifelong Ejaculatory Inhibition - A retrograde inhibition or incompetence present from puberty.

  • Acquired Ejaculatory Inhibition - After a time of normal sexual function, acquired ejaculatory inhibition develops.

  • Generalized Ejaculatory Inhibition - Ejaculatory suppression is not restricted to specific sex partners or types of stimulation.

  • Situational Ejaculatory Inhibition - Only in particular instances situational ejaculatory suppression occurs.

What Are the Factors That Increase the Risk of Ejaculatory Inhibition?

Risk factors are those whose presence increases the likelihood of the condition. For example, a few risk factors for ejaculatory inhibition are:

  • Age - Men's physique and sexual responses alter as they grow older. Ejaculatory inhibition is more common in older patients who have more concurrent conditions. In older patients, depression, peripheral vascular disease, diabetes, late-onset hypogonadism, higher BMI (body mass index), and psychological disorder appear to contribute to ejaculatory inhibition.

  • Lifestyle - Smoking, obesity, alcohol consumption, inactivity, and loneliness (such as the loss of a spouse) are all known to be potent inhibitors of ejaculation and overall sexual function and satisfaction.

  • Sexual Attitude, Anxiety, and Sexual Skills - Ejaculatory inhibition can be caused by discontent, performance anxiety, and discomfort. When coping with ejaculatory inhibition in infertility situations, distress grows, which can have negative implications in relationships. Suppressed anger, fear of pregnancy, fear of "defiling" a partner by ejaculation, or unwillingness or inability to embrace pleasure are some of the proposed psychological roots of ejaculatory inhibition.

What Happens if You Do Not Address Ejaculatory Inhibition?

  • Ejaculatory inhibition can occur due to underlying pathological conditions such as inflammation of reproductive organs or distortion of ducts, which needs medical attention.

  • It is difficult to generalize, but sexual dissatisfaction caused by ejaculatory inhibition can result in increased anxiety, low self-esteem and sense of self, body-image difficulties, and a sense of worthlessness in both sexual partners.

  • Sex can boost communication and feelings of connection for certain people. People who do not feel like they have enough sex due to ejaculatory inhibition may worry that something is wrong with their relationship or that their partner is losing interest in them, leading to severe relationship issues.

Is It Possible to Overcome Ejaculatory Inhibition?

Workup and treatment are tailored to the underlying concerns based on the etiology of ejaculatory obstruction. Ejaculatory inhibition treatments include the art of balancing the physiological, psychological, social, and behavioral factors that contribute to the disease can be broken down into medication, penile vibratory stimulation, psychological (sexual therapy, masturbation retraining).

  • Pharmacotherapy - The removal of pharmaceuticals that have been shown to increase ejaculatory inhibition, such as hypertension drugs and the administration of drugs and hormone supplements like oxytocin, have been shown to treat the disease.

  • Penile Vibratory Stimulation (PVS) - Electro ejaculation treatments such as penile vibratory stimulation (PVS) have been utilized to treat ejaculatory difficulties in neurogenic patients for many years. Ejaculation can be obtained by stimulating the pudendal nerves, which helps to activate the ejaculatory reflex in patients with ejaculatory inhibition. Therefore, when PVS is used with medical therapy, the efficacy of ejaculatory inhibition treatment improves.

  • Sex Therapy - Increased genital specific stimulation, sexual education, roleplaying alone and in front of his spouse, masturbatory retraining practices, anxiety reduction on ejaculation and performance, and recalibrating the mismatch of sexual fantasies with arousal are some of the psychological treatments that can help to treat ejaculatory inhibition.


Ejaculation physiology is quite complicated. Ejaculatory inhibition, unlike premature ejaculation, is a rare clinical condition with no consensus on its etiology or therapy. Patients with ejaculatory inhibition are assessed using a comprehensive medical history, physical examination, and laboratory tests to guarantee a correct diagnosis. However, many ejaculatory inhibition patients are successfully treated with tailored psychological therapy.

Frequently Asked Questions


At What Age Do Males Stop Ejaculating?

Generally, there is no specific age at which men stop ejaculating. However, according to some studies, men 50 and older may experience difficulty ejaculating and having orgasms. Around 15 % of men face this problem in their early 60s, 20 % of men in age 65 to 74, and 33 % of men aged 75 or more than that.


How to Strengthen the Ejaculatory Muscles?

Pelvic muscle exercises can be performed to strengthen the ejaculatory muscles. These exercises are known as kegel or pelvic exercises and are considered the first line of treatment for the conditions like erectile dysfunction. These exercises help strengthen muscles such as the ischiocavernosus and bulbocavernosus in the pelvic area, which surrounds the penis and plays a crucial role during an erection.


For How Long Can a Man Have an Erection?

Normally, an erection can last from a few minutes to about half an hour. This duration is highly varied among men; seven to thirteen minutes is the ideal duration of erection before ejaculation. Anything that lasts longer than three to four hours is considered a medical emergency.


How Many Times Should a Man Release Sperm?

There is no specific number mentioned for how many times a man should ejaculate, and there is also not enough evidence that failure to ejaculate causes health problems. Moreover, ejaculating frequently can have various health benefits, such as reducing the risk of getting prostate cancer. But does not mean men should start ejaculating more often due to its health benefits.


Can Ejaculating Decrease With Age?

It has been found that with age, the amount of semen released during ejaculation also decreases. According to various studies, it has been found that men older than 55 years experienced the most significant reduction in the quantity and volume of semen as compared to young adults. A 20 % decrease in the volume in a 50-year-old man has been reported compared to 30 year old.


Is It Normal to Finish Early in Bed?

Many men have unrealistic expectations that they will last longer during intercourse, but that's not always true. A man who ejaculates within a few minutes is considered normal as it depends on intimacy and excitement. However, people who finish within a few seconds and cannot keep the erection can be linked with a medical condition, and medical assistance must be taken.


Does Erectile Dysfunction Ever Go Away?

Erectile dysfunction is when the patient cannot keep an erection for sexual intercourse. It is one of the common conditions faced by men between the ages of 40 and 70. The treatment of erectile dysfunction depends on its cause. In some cases, it is easy to cure; in others, it can stay for months or years. 


What Are the Fast Ways to Cure Erectile Dysfunction?

The treatment of erectile dysfunction usually depends upon the cause; some of the following steps can be done to treat this condition which includes -
- Lifestyle changes include quitting smoking, losing weight, or exercising regularly.
- Medications can be taken orally or directly injected into the penis.
- Using vacuum devices or penis pumps to stimulate the blood supply to the penis.


What Happens if a Person Is Getting an Erection Every Day?

Getting an erection is a normal thing, even every day, whereas some others may not experience any. This usually depends upon the level of hormones or fluctuations in the level of hormones, which can happen with age, sexual maturity, sleep, or physical activity. Unless the frequent erections are causing any pain or discomfort, it is a matter of concern no matter how many a person gets in a day.


Is Erectile Dysfunction Psychological?

Erectile dysfunction can be caused by psychological issues or less physical activity. This is also termed psychological impotence. Some men face the problem of performance anxiety that may lead to erectile dysfunction, which can be triggered by stress, guilt, negative body image, sleep disorders, and mental health concerns.


How to Test for Erectile Dysfunction at Home?

Some of the following tests can be done at home to check for erectile dysfunction which includes -
- NPT (nocturnal penile tumescence) Test - A roll of stamps are used in this test, and they are stuck on the penile shaft overnight. As men without ED usually have erections in sleep, and that will lead to the breaking of these stamps around the penis, which may help in concluding erectile dysfunction.
- Sexual Health Inventory for Men (SHIM) - This is the more accurate way to diagnose ED. This includes a questionnaire that helps in diagnosing erectile dysfunction. This can be performed at home or at the doctor’s office.


What Nerves Control the Erection of the Penis?

A nervous system branch controls the erection function called the autonomic nervous system. Within this system, the process of erections is controlled. The dorsal penile (pudendal nerve) is responsible for reflex erections during physical touch with the penis.


What Should Be Done to Prevent Erectile Dysfunction?

Erectile dysfunction can be prevented by making some lifestyle changes which include -
- Exercise regularly.
- Manage diabetes or other chronic conditions with the help of a doctor.
- Stop smoking or consuming alcohol.
- Try to reduce stress.
- Get helps for conditions like depression or anxiety.
- Get regular checkups and medical screening done.
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Dr. Raveendran S R
Dr. Raveendran S R



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