HomeAnswersUrologypoor ejaculationMy ejaculate does not come out and gets stuck during orgasm. Please advice.

Why does my ejaculate get stuck and not come out during orgasm?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At October 27, 2018
Reviewed AtSeptember 5, 2023

Patient's Query

Hello doctor,

I am 45 years old, male, and taking Dutasteride for ten years. Gradually, over the past two years, I have been seeing a change in my ejaculation. At the point of orgasm, the ejaculate no longer comes out. But this is definitely not retrograde ejaculation. The ejaculate gets stuck at the root of the penis. If I apply pressure with my finger at the outward facing root of the penis, and scoop upwards with my finger about 1 inch, the stuck ejaculate makes it round that bend and is expelled. If I time this right with orgasm, it can expel with normal force. What is this condition known as, what is the remedy, and is it related or unrelated to Dutasteride?

Answered by Dr. Karthik Rajan

Hi,

Welcome to icliniq.com.

I have gone through your query, I would like to know a few more details about your symptoms. How is your urinary flow, do you have to strain? Have you had any endoscopic procedure or catheterization done in your urethra? Are you only on Dutasteride or do you take alpha-blockers as well? Why were you prescribed Dutasteride at 35 years of age? The process of ejaculation requires a coordinated connection on the muscles surrounding the root of the urethra to expel the semen. Also, the quality of the erection needs to be evaluated in the clinic, because a fully rigid erection is required for a forceful expulsion of semen. I cannot be certain, but it appears that there is an issue in the same in your case. There is no specific name for the condition though. Also, 35 is a very early age for you to have prostatic enlargement large enough to be on Dutasteride. Though ejaculation problems are not attributed to it, it may be worthwhile to withhold the drug for a few weeks. If it is still persistent, then further testing can be performed.

Patient's Query

Thank you doctor,

To answer your questions, the flow is strong. However, some urine does get stuck in the same way the semen does. I, therefore, have to do the same scoop manoeuver after urinating to expel the rest. I learned this after it would leak out if I did not. No, I have not undergone any endoscopic procedure or catheterization in urethra. I was on Propranolol beta blockers 80 mg ER until four months back, for many years, for anxiety. Actually for male pattern baldness, and as my father had prostate enlargement, but mainly for the hair loss. It worked miraculously. My erection is strong and no weaker than it used to be.

Answered by Dr. Karthik Rajan

Hi,

Welcome back to icliniq.com.

Dutasteride is more likely to be associated with a global sexual dysfunction like a decreased sexual drive due to drop in the active form of testosterone. The dosage required for treating hair loss is much less than that for prostatic symptoms. But Dutasteride does not come in the reduced dose form, so you must be on full dosage and can be stopped or you can switch to Finasteride that has a 1 mg reduced dose for treatment of baldness. Secondly, since you mentioned that you have the same problem with urination as well, it would be necessary to get yourself examined by a urologist and if necessary do some radiology tests to rule out any pouches or diverticulum in the urethra which can lead to the symptoms that you mention.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Karthik Rajan
Dr. Karthik Rajan

Urology

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