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

Question

Hello doctor,

I am 45 years old, male, and have been 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?

Answer 1

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.

I hope this information helps you.

Feel free to ask further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Dutasteride is more likely to be associated with a global sexual dysfunction, such as a decreased sexual drive due to a 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, which 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.