Men tend to have many different feelings about ejaculation, most of them positive. True, sometimes the timing of a guy’s ejaculation may be a little off, but in general men look forward to the experience with anticipation and glee. And, of course, aspects of ejaculation are tied into matters of penis health as well. All of which explains why a man who experiences ejaculation problems such as anejaculation may feel worried and anxious.

What is anejaculation?

When a man has anejaculation, he is unable to ejaculate, even when the penis is directly stimulated during either partner-based sex of masturbation. There are two different kinds of anejaculation, one of which has two further categories:

- Situational anejaculation. In this kind of anejaculation, a man is capable of ejaculating when he masturbates or having an ejaculation through nocturnal emission, but not through forms of partner-based sexual activity. This may mean no form of partner-based sex produces an ejaculation, or it may mean only specific forms are ineffective. For example, a man might not be able to ejaculate during vaginal sex but may through oral sex or through the partner’s physical manipulation of his penis.

- Total or complete anejaculation. As the name implies, with total or complete anejaculation, there is no ejaculation at all. There are two categories of importance here. One is orgasmic anejaculation, in which a man still experiences an orgasm even without ejaculation. The other is inorgasmic anejaculation, in which neither ejaculation nor orgasm is experienced, even when masturbating.

Exactly how common anejaculation may be is difficult to determine. However, one study that looked at various ejaculatory issues in men found that 37% of the men with ejaculatory problems included anejaculation among their issues.

It should also be noted that sometimes what is diagnosed as orgasmic anejaculation may in fact be retrograde ejaculation, a situation in which semen is rerouted into the bladder rather eliminated via urethral ejaculation. Measuring urine for semen content can verify the proper diagnosis.

What causes it?

Why might a man experience anejaculation? There can be numerous causes. It may be due to a psychological factor which causes discomfort that interferes with the penis’ ability to react. Sometimes it may be due to a partner not being able to provide stimulation in such a way as to bring about the desired effect; for example, they may be stimulating a less sensitive part of the penis, maybe be unable to enfold the penis in a snug enough manner, or the penis may have been de-sensitized due to rough handling.

There can be some specific physical causes, such as an obstruction in the ejaculatory duct that prevents the semen from flowing through. A spinal cord injury can also make ejaculation difficult and in some cases impossible, depending upon the severity of the injury. Or if there is damage to the autonomic nervous system, which regulates "unconscious" nervous system responses, this can impede ejaculation as well.

Some neurological diseases, such as Parkinson’s and multiple sclerosis, also can bring this about, as can diabetes. And in some cases, antidepressant or antipsychotic medications may be the culprit.

When the cause is physical or medicine-related, doctors can sometimes take management steps that can reduce or eliminate the problem. If the anejaculation is due to psychological factors, a man will need to undergo psychological counseling and/or sex therapy. Often cognitive-behavioral therapy is useful in identifying the psychological cause and determining how to overcome the problem.

Working out the reasons for and treatment of anejaculation is crucial. Things are made easier if steps are taken to keep the penis in good general health, such as regularly using a penis health creme (health professionals recommend Man1 Man Oil, which is clinically proven mild and safe for skin). Men should definitely seek out a crème that include L-carnitine, an amino acid shown to protect against peripheral nerve damage caused by friction, compression, and other common injuries, which can lead to reduced sensation or numbness. The crème should also include vitamin B5. Also called pantothenic acid, this vitamin is required for cell metabolism and maintenance of healthy tissue.