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While having sex with my wife I have an errection but I have…

Customer Question
While having sex with...

While having sex with my wife I have an errection but I have problems ejaculating the last two times we had sex I just can’t ejaculate

Doctor's Assistant: Is this your first time reaching out for information about this? In general, how would you describe your overall health?

Yes

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I had hep c but I have been cured with harvoni

Submitted: 4 months ago.Category: Medical
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Answered in 5 minutes by:
3/10/2018
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,778
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

What is your age?

What are your present medications?

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Customer reply replied 4 months ago
65 none just milk thistle probiotics n tumaric
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Customer reply replied 4 months ago
This really concern me I’m healthy I exercise I run I try to ear right why is this happening
Customer reply replied 4 months ago
Are you there doctor
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Absence of orgasm is called Anorgasmia. The causes are usually divided as following;

1) psychogenic

2) caused by certain medications (you are on none).

3) decreased penile sensation owing to impaired pudendal nerve function. Most commonly, this occurs in diabetics with peripheral neuropathy. Men who experience anorgasmia in association with decreased penile sensation should undergo vibratory testing of the penis and further neurologic evaluation as indicated.

The ejaculatory mechanisms consist of three stages: emission, ejection, and orgasm. All of these mechanisms have different physiological and anatomical control which work in integration. The foremost to control this is a good sensation on the penis, especially at glans. This sensation causes central nervous system activation of the sympathetic nervous system, which in turn activates the working of secretions from seminal vesicles, prostate, and bulbourethral glands (EMISSION); and emission is ejaculated out of the urethra by the contractions of the bulbocavernosus and levator ani muscles. Problem at any level can DELAY the EJACULATION. Nerve pathways that use serotonin and 5-HT receptors regulate the speed of ejaculation.

Following is the protocol for the work up;

1) Stimulation of the penis with a vibrator or other stimulatory device to determine for any underlying physical (neurological) problem.

2) A neurological examination; to determine other nerve problems.

Treatment entails;

1) Sex therapy sessions; reduce performance pressure and focus on pleasure. About 20 sessions may be needed for the optimal outcome.

2) Hypnosis

3) Withdrawal of the medication; if one is considered the cause. In your case your herbs and supplements do not seem to be responsible.

4) Avoidance of the stress, anxiety, and other factors. Enjoying the sex, changing position for best glans stimulation and partner's effort also play an integral component in the positive results.

You may consult a urologist for an initial evaluation.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Were you able to read the detailed answer above?

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Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Was this information helpful to you? I would be glad to answer any further questions.

It is privilege assisting you.

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Stay blessed.

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