Why am I having trouble ejaculating?

Dear Reader and Frustrated, 

These are valid questions to ponder. There are a few reasons that may impact a person’s ability to ejaculate, such as a condition called delayed ejaculation (DE). Delayed ejaculation, as the phrase implies, is typically identified when a person finds it difficult to ejaculate during most or all sexual encounters, with the issue happening over a long period of time. Some causes of DE are psychological, such as having performance anxiety, inability to relax during sex, having fears of abandonment or separation, or having trouble distinguishing between emotions and sensations. DE might also be associated with infertility, prostatitis, anxiety or depressive disorders, or use of selective serotonin reuptake inhibitors (SSRIs). Masturbation and porn are also thought to be associated with DE because people who masturbate or consume porn frequently might have higher expectations of sexual satisfaction or need more sexual stimulation to orgasm. Some people theorize that sexual fantasies which aren’t reflective of sexual reality could desensitize people and keep them from climaxing. However, studies have not proved if these factors truly cause DE. 

In regard to your toes numbing during masturbation or passing semen during a bowel movement, these could be due to peripheral neuropathy. This is a condition which is related to numbness, digestion, and urination. It’s also possible that fluids coming out from the penis during bowel movements could be due to application of pressure on the bladder and releasing urine, though precum and semen are also possible since they all come out of the urethra. If these symptoms persist or you’re worried about having children in the future, it might be good to speak with a health care provider such as a urologist. 

Here are a few questions you might ask yourself to get to the bottom of why this might be happening to you or why your partner may be experiencing the challenges that they are:  

• Could physical or psychological factors be contributing to the inability to orgasm? Have you or your partner spoken with a health care provider about it?  
• What’s different about using hand stimulation or hand cream versus intercourse?  
• What are your frustrations, if any, with your sex life?  
• Are you open to having sex without the goal of orgasming every time?  

As a partner, it can be confusing and even a little distressing if you or your sexual partner experiences difficulties orgasming or ejaculating during sex. That said, some questions you could discuss with your partner to help understand what you’re both trying to get out of sex and how you can work through it together may include: 

• What are their frustrations with your sex life, if any?  
• How have they managed this issue in the past, if at all? 
• How might you and your partner spice up your sex life to try and reach orgasm?  
• Have you already tried foreplay, outercourse, using sex toys, or new positions? If not, is it something they’d be open to? 
• Are either of you open to having sex without the goal of orgasming every time? 

If you’re unsure how to start the conversation, check out the Communicating and Relating fact sheet for some tips.  

In addition to talking about these issues together, you may also consider meeting with a mental health professional specializing in sex or couple's therapy. These sessions can be done one-on-one or with a partner. Sex therapy could also help work through issues with intimacy, arousal, and connecting with your body. Finally, there are some medications that treat DE, and exercises like kegels that might also strengthen the pelvic floor muscles which are used in ejaculation.  

Whatever the cause, there are a multitude of solutions for what you’re experiencing. Whether the trouble with ejaculating comes from anxiety, medications, or an underlying condition, rest assured there are ways to come out of it.