Men’s ability to sustain sexual intercourse and reproduction depends on a combination of factors: psycho-emotional state, physiological, and hormonal changes.
What is Erectile Dysfunction?
Erectile dysfunction (impotence) is the inability to maintain an erection for a satisfactory sexual performance. Depending on the underlying cause, erectile issues can be temporary (situational) or permanent, characterized by a gradual and consistent decrease in libido.
Why Can’t a Man Reach Orgasm?
The inability of a man to reach orgasm or maintain an erection can be due to organic (physiological) or psychogenic factors. The physiological causes of erectile dysfunction include:
- Insufficient or excessive synthesis of sex hormones (hypogonadism or hypergonadism).
- Poor blood flow to the corpus cavernosum due to cardiovascular diseases (hypotension, varicose veins, atherosclerosis).
- Sexually transmitted diseases or urinary system disorders (prostatitis, urethritis).
- Penile or testicular injuries (corpus cavernosum rupture, testicular torsion).
- Peripheral nervous system disorders (stroke, heart attack, post-operative nerve damage).
- Use of psychoactive substances (alcohol, caffeine, medications).
- Smoking.
- Excess body weight.
Other factors contributing to difficulty reaching orgasm include sleep quality and duration, regularity of physical activity and sexual life, and age (testosterone levels decrease with age, reducing libido). Penis size or racial background do not influence the likelihood of erectile issues.
Psychological Causes of Erectile Problems
Emotional and psychological factors can lead to temporary libido reduction — a loss of sexual attraction or desire for intimacy with a partner. Emotional causes of erectile dysfunction include:
- Traumatic experiences leading to performance anxiety.
- Feelings of guilt.
- Fatigue.
- Chronic stress.
- Relationship issues.
- Low self-esteem.
Depression, anxiety disorders, and other psychological conditions can also affect the ability to maintain an erection and achieve orgasm. Addressing these issues often requires consultation with a psychologist or psychotherapist.
Hormonal Disorders That Affect Orgasm
Hormonal imbalances, such as low testosterone levels (hypogonadism) or thyroid hormone deficiencies (hypothyroidism), can be the reason a man takes a long time to reach orgasm or is unable to maintain an erection. Diabetes can also impair erectile function by damaging penile blood vessels and disrupting blood flow. Hormonal disorders should be evaluated by an endocrinologist.
Which Cardiovascular Diseases Affect Men’s Health?
The functionality of a healthy penis capable of achieving erection largely depends on the state of the circulatory system. Cardiovascular diseases (atherosclerosis, varicose veins) can cause impaired blood circulation, leading to reduced blood flow to the corpus cavernosum. Additionally, erectile dysfunction can be a side effect of antihypertensive drugs used to treat high blood pressure.
How Do Genitourinary Diseases Affect Penile Health?
Inflammatory diseases of the reproductive system (balanoposthitis, epididymitis) can cause discomfort in the penile head, pain during erection and sexual intercourse. Inflammatory processes can also affect the aesthetic appearance — a healthy penis should have a uniform skin color, full glans exposure, and no lesions, roughness, discharge, or odors.
Infectious diseases (e.g., gonorrhea, syphilis, chlamydia) and urinary system disorders (urethritis, urolithiasis) manifest as pain during urination, itching, discharge, and unpleasant odors, hindering normal social activities and sexual intercourse. If genitourinary diseases are suspected, a consultation with a urologist is necessary.
What is Male Anorgasmia?
Male anorgasmia is the inability to ejaculate while still being able to maintain an erection during intercourse. Male anorgasmia can be congenital or secondary (due to psychological or physiological issues) and can also be situational (achieved only under certain conditions, such as prostate stimulation, masturbation, or oral sex). The absence of orgasm can also be caused by the use of certain medications (antidepressants, antihypertensives, diuretics).
Is It Harmful for a Man Not to Ejaculate?
Research suggests that temporary abstinence can improve sperm quality and reduce the risk of prostate cancer with frequent ejaculation (more than 21 times per month). However, prolonged abstinence does not have a proven direct negative effect on male health.
What to Do if a Man Cannot Reach Orgasm During Sex?
If a man is unable to reach orgasm during sex, consulting a urologist or sexologist is necessary to determine whether impotence is the cause. For situational issues, when ejaculation is not achieved due to stress or fatigue, a doctor may prescribe stimulating medications. Viagra may be recommended for a short period, provided there are no contraindications, to support erection and enable full intercourse.
Should a Man See a Doctor If He Can’t Reach Orgasm?
Early consultation with a doctor, if a man cannot reach orgasm during sex for several weeks, can help avoid prolonged treatment. If the lack of orgasm persists over a longer period, a doctor’s consultation is necessary. Signs of erectile problems include:
- Reduced libido.
- Lack of morning erections.
- Decreased time needed to achieve ejaculation.
- Prolonged refractory period (time between ejaculation and the next sexual act).
- Difficulty maintaining an erection throughout intercourse.
- Flaccidity of the penis, sudden loss of erection after it’s achieved.
- Inability to reach orgasm.
Seeking medical advice early can help identify the root cause of the condition, and the doctor may recommend physical exercises to improve potency, and if necessary, medication. Timely consultation with a urologist can preserve penile health, avoid prolonged treatment, and prevent potential complications (lower self-esteem, reduced quality of life, relationship issues).
How Can a Man Maintain Genitourinary Health?
To ensure a healthy genitourinary system and maintain erectile function, several rules should be followed. For a healthy penis and genitourinary system:
- Practice proper intimate hygiene.
- Do not delay urination.
- Urinate immediately after intercourse.
- Use contraceptives.
Regular check-ups with a urologist are essential for maintaining the health of the genitourinary system. Comprehensive, systematic examinations by a venereologist, andrologist, and endocrinologist can help detect potential diseases and conditions in their early stages.
Can Potency Be Improved Through Physical Exercises?
Physical activity promotes the production of sex hormones, positively affecting mental well-being and sexual desire. Physical exercises, including Kegel exercises for men’s pelvic floor muscles, improve blood circulation, making it easier to achieve full engorgement of the corpus cavernosum (the penile structure responsible for erection).
What are Kegel Exercises for Men?
Kegel exercises are a set of movements involving the pelvic floor muscles aimed at improving erection, prolonging intercourse, enhancing the sensitivity of genitalia, and improving the quality of orgasm. Kegel exercises for men involve contracting and relaxing the pelvic floor muscles. Reverse Kegel exercises for men are used to address urination issues — the exercise helps tone the urinary system, preventing leaks and involuntary urination.
How Are Kegel Exercises Beneficial for Men’s Health?
Kegel exercises for men strengthen the pelvic floor muscles that extend from the coccyx to the pubic bone. The benefits of Kegel exercises for men include improving erection quality, as well as supporting and enhancing the tone of the bladder and intestines. Noticeable results can be achieved after three months of daily training (two to three sets of 10-15 minutes).
When Should Men Avoid Kegel Exercises?
Men should exercise caution when performing Kegel exercises if they have acute or chronic conditions of the genitourinary system and intestines. Kegel exercises are contraindicated in men with urethral catheters. Other contraindications include severe hemorrhoids, acute prostatitis, thrombosis or tumors in the genital area, and purulent-inflammatory conditions in the groin area.
