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Suggest Treatment For Impaired Ejaculation

Posted on Mon, 14 Dec 2015

Question: I am 35 years old married for the last 4 years. During intercourse I am unable to ejaculate to achieve orgasm even after passage of a considerable amount of time in sexual activity with my wife, though my erection is strong and hard. Many a times it has so happened that, after intercourse when I am asleep, I find that nightfall has occurred. To speak frankly, I have never tried masturbating on my own and hence unable to give my sperm sample for the sperm count test. I am currently taking Andriol Testocap 40 mg once a day, Tentex Forte two times twice daily and Penegra 100 an hour before intercourse. Can visiting an XXXXXXX solve the problem?

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
possibility of retrograde ejaculation is there

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

No ejaculation while intercourse and nightfall afterwards suggests possibility of retrograde ejaculation.

Common causes are:

- Diabetes

- High blood pressure and medicines for blood pressure (Phenoxybenzamine, thiazides, clonidine, alpha-methyl dopa)

- Medicines for psychiatric problems ( Paroxitene, fluoxetine, sertaline, thioridazine, chlorpromazine, haldoperidol, amitryptyline)

- Other medicines (Prostate pills-Alpha-blockers, imipramine; Anti-Inflammatories-Naproxen; Muscle relaxants- Baclofen; Other- Alcohol, Methadone, phentolamine, guanethidine sulfate)

- Any problem of urinary bladder or prostate

- Any surgery of urinary bladder , prostate, urethra or spine

- Spinal cord/column injury/problem

Testosterone not likely to cause such problem.

Your treatment of erectile dysfunction with penagra, testosterone and tentex forte may cause this problem.

- Since when problem is there?

- Is there any relation with your treatment of erectile dysfunction?

Revert back to me with answers and relevant information what I mentioned.

I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Chintan Solanki (17 minutes later)

My Wife and I visited a fertility clinic in the month of March 2015 from where the medicines mentioned above were prescribed. They also referred me to a psychiatrist since I was suffering from some time due to job stress and depression which prevented a normal physical relationship with my wife.

The Psychiatrist had prescribed Escigress 20, Shicobal, Oscigress and Nexito plus which I had taken for the last 4-5 months but now I have stopped them completely as I feel that I can take care of my mental well being myself.

The fertility clinic where we visited has recommended us to go for an ICSI-TESE procedure if we are ready for parenthood in the month of XXXXXXX 2015. But we decided to wait and try ourselves before taking the final plunge. Our sexual life has improved considerably after taking the medicines mentioned above and nowadays I even no not require to take Penegra 100 sometimes for sexual activity. It comes to me naturally at times. To speak frankly family pressure is now on us to bear a child as a lot of time has passed. It may be so that the sexual activity has now become like an exam rather than take it as a pleasure thing to enjoy. I have almost decided to go for an ICSI-TESE procedure in the month of XXXXXXX 2016 if nothing concrete happens now.

I have not undergone any surgery till now. I have decided to visit an XXXXXXX to get a final opinion in this regard and if the problem can be rectified. I have spoken my heart out to you and require your valuable suggestion

Answered by Dr. Chintan Solanki (2 hours later)

Brief Answer:
Pseudoephedrine may help, Urologist consultation will help

Detailed Answer:
Hi,

Thanks for follow up and information.

You have taken Escigress 20 and nexito plus means total 25 mg of escitalopram for 4-5 months. Ejaculation problem is common side effect of the same. You are likely suffering from the same. It will take 4-6 weeks when this side effect will be reversed.

You are not using penegra that is very good thing.

You are also suffering from pressure for becoming father. This psychological factor can affect ejaculation. I suggest try to enjoy sex without such thoughts. Do not think about erection or ejaculation while doing sex.

If you are sure that there is night fall and semen is there after few hours of sex no need to go for hormonal check-up.
Pseudoephedrine or phenyephrine before sex may help in ejaculation in your case. I recommend consulting urologist for evaluation rather than XXXXXXX as your problem is not related with hormones.

If there is no semen at all and there is anejaculation then hormonal profile with local ultrasound should be done to check spermatogenesis in testicles is going or not. In that case biopsy may be indicated. XXXXXXX can help in this regard.

Feel free to discuss further.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad