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Erectile Dysfunction (ED)

Erection but no ejaculation



Dear Sir:

There have been several times over the past year or so that my fiancee has not reached the point of ejaculation. In fact he has not done so in any of our last 4-5 instances of intercourse. He has no trouble achieving or maintaining an erection and says that our sexual encounters are exciting and stimulating for him but he doesn`t reach the necessary level of stimulation and after awhile, it feels to him as if sensation diminishes(but without losing the erection). As it is now, we spend up to an hour and a half having sex before we both finally give up without the desired result.

My fiancee is only 29 years old. He is in good health: not overweight, no diabetes, no blood pressure/cholesterol issues, etc. He takes only vitamins, no prescription medications. We currently live in different states and therefore have intercourse a maximum of 4 times per month.

Can you please give us some idea of what might be causing this and what we might do to remedy it. This has been so difficult for us both, with me feeling inadequate as if I`m unable to satisfy him and him feeling inadequate as well.


There are several causes of delayed ejaculation. First medication related- the antidepressants known as the SSRI`s cause orgasm to be delayed or absent in men and women. However, this does not seem to be the case with your finacee. Second, are neurological causes. Usually there would be some other neurological symptom associated with difficulty ejaculating or some decrease in sensation. Urologists perform a test known as biothiesimetry to determine if their is a sensory loss to the penis. Unfortunately, these neurological problems are often difficult to treat. Thirdly, are a whole array of psychological problems from something as simple as performance anxiety inhibiting your finance from achieving orgasm to serious psychological inhibitions. If he is able to ejaculate under other circumstances, like by himself, with hand or mouth stimulation by you, this variability suggests a psychological basis and he might consider being evaluated by a competent sex therapist.

Good luck.

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Response by:

Allen D Seftel, MD Allen D Seftel, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University

Stanley E Althof, PhD Stanley E Althof, PhD
Professor of Urology
School of Medicine
Case Western Reserve University