Difficulty Achieving Orgasm
Question
It is very difficult for me to achieve climax during sexual intercourse. In rare cases of reaching climax, the volume of semen is very small. I experience no erectile dysfunction. I am 73 years old, physically very active and in very good health. Prostate examination and test during the past couple of years have shown no abnormality. I have noticed this problem for quite a number of years, but it has become a lot more pronounced during the last three or four. Is this condition indicative of disease or merely one of age? Can the problem be treated?
L
Answer
Last Updated: December 2, 2014
L,
Let’s take the second question first. There are three components to the ejaculate: Prostate fluid (about 60%), seminal vesicle fluid (the other 40%), and sperm (less than 1%). As men grow older their prostates interiorly develop a benign tumor called an “adenoma”. As this adenoma enlarges it not only reduces the ability of the prostate to produce its component of the ejaculate by compressing it but it squeezes the ductal drainage system of the seminal vesicles and reduces its contribution and/or diverts some of the ejaculatory fluid into the bladder. The result is diminished ejaculatory volume.
The first question: Ejaculation is a complex mechanism in men. Without going into the complex neurological and physiological explanation of the event let me just say this: There is a voluntary component to ejaculation—the man must relax and “let go” or it won’t happen. So…if there are psychological factors or barriers interfering with the person’s ability to “let go”—if there is a real “control problem” here—then it just won’t happen. The medications that are used to help men achieve orgasm essentially allow him to relax and let nature takes its course.
Dr. Gregory Polito
Let’s take the second question first. There are three components to the ejaculate: Prostate fluid (about 60%), seminal vesicle fluid (the other 40%), and sperm (less than 1%). As men grow older their prostates interiorly develop a benign tumor called an “adenoma”. As this adenoma enlarges it not only reduces the ability of the prostate to produce its component of the ejaculate by compressing it but it squeezes the ductal drainage system of the seminal vesicles and reduces its contribution and/or diverts some of the ejaculatory fluid into the bladder. The result is diminished ejaculatory volume.
The first question: Ejaculation is a complex mechanism in men. Without going into the complex neurological and physiological explanation of the event let me just say this: There is a voluntary component to ejaculation—the man must relax and “let go” or it won’t happen. So…if there are psychological factors or barriers interfering with the person’s ability to “let go”—if there is a real “control problem” here—then it just won’t happen. The medications that are used to help men achieve orgasm essentially allow him to relax and let nature takes its course.
Dr. Gregory Polito
Answered By:
Gregory Polito, MD
Gregory Polito,MD, KM, Past President of CANFP, retired from a urologic practice, with a sub-specialty in vasectomy reversal
