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Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6190
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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I am a 59 year old male who cannot ejaculate when I try to

Customer Question

I am a 59 year old male who cannot ejaculate when I try to masturbate. I have had some intermittent success in the past, but recently cannot ejaculate at all. I sometimes have a problem with getting an erection, but usually when I do it will only last for a minute or less.
I have seen a urologist and he suggests that my type 2 diabetes or the blood pressure medications that I take could be the cause of this issue. I am not convinced since I have had some success in the past with ejaculating. Could this possibly be a psychological problem since I have been am separated from my wife for a year, but will be reuniting back in a few months? My wife also has been very uncooperative with supporting my need for intimacy in the past, and claims her reason is that I get too upset with my sexual disfunction (ed) and in turn blame her for it. I do get upset after not being able to ejaculate or get an erection, but I do not cast any blame, she just assumes that I am mad at her. Is there any treatment or medication that can help me with this problem? I am severely stressed out and wonder whether I will ever have a healthy sex life again.
Submitted: 9 months ago.
Category: Medical
Expert:  Dr Uzair replied 9 months ago.

Hi and thanks for the query.

This is not a simple issue. Ejaculation and erection are complex pathways that require a lot of evaluation before a cause can be identified. In brief, there are two types of problems, organic ones and inorganic. The inorganic are the psychological ones where a mechanical cause can not be identified. But the rule is to rule out all the organic problems first.

I would suggest that you have the Urologist evaluate your problem in detail. Diabetes and high blood pressure can inflict changes in the circulation and nerve endings of the penile area causing problems with both erections and ejaculation.

While, the urologist completes his/her evaluation you should also see a sex therapist and a psychologist to save your time and evaluate the psychological aspect side by side.
I do not suggest that you skip or leave your blood pressure medication in order to search for a cause, that might cause more harm than good.
The urologist can run tests like nerve conduction studies, spinal xrays, artificial erection test, ultrasound of the scrotum and prostate etc to see where the problem really is. Central or in the apparatus itself.

Let me know if you have any queries regarding this.

Please do rate the answer as that is the only way I get compensated for my time here.

Best.

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