Dear Dr. G,
Thank you so much for answering my query. I really hope I am not putting you on the spot for a difficult query of mine.
I am 28 year old and have been a diabetic person since I was a teenager. I am currently on daily insulin injections, and my control of sugar has been immaculate!
My wife and I have been married for the last two years and we are having difficulty when it comes to having babies. The truth is, I have been having ejaculation problems for a while.
Although I am diabetic, I am able to get reasonable libido and an erection to carry out my duty as a husband.
However, I have noticed that my ejaculation is becoming less and less. And I must say it is hardly noticeable these days.
I am getting frustrated with my sexual dysfunction. I read somewhere this is related to my diabetes. I wonder you can me to explain why?
I also found out online one way to solve the problem is a treatment called electroejaculation.
I am really interested to find out more about this therapy
Can you tell me what is electroejaculation and how difficult is it to apply this in the bedroom? How successful is the treatment and what harm will it cause.
I look forward to your response.
The inability to ejaculate despite sexual stimulation of the penis by intercourse or masturbation is termed anejaculation. The causes of anejaculation can be situational, which usually means it is mainly psychological. Alternatively, it could be due to a physical cause, which is commonly associated with neurological deficits.
Situational anejaculation is a common scenario when men are under pressure to produce semen for fertility analysis, or are unable to attain an orgasm with a partner but not with another. On the other hand, the physical cause of anejaculation is usually associated with neurological impairments such as spinal cord injuries or a stroke. Additionally, while 60 percent of men with such nerve damage can usually still achieve an erection, their ability to ejaculate is often affected.
Of course, men with diabetes who encounter ejaculatory impedance could be experiencing this impedance due to psychological or neurological reasons. On one hand, the anxiety to perform is evident. On the other hand, the underlying diabetic neuropathy may also play a role. The additional dimension for diabetic men who suffer from the inability to ejaculate may also be related to the backflow of semen into the bladder called retrograde ejaculation. This is due to the weakness of the musculature of the bladder neck caused by the diabetic changes to the smooth muscles.
The treatment of ejaculatory disorders in men with diabetes may be complicated, and it obviously depends on the causes. The interventions may include psychological counseling or medications such as ephedrine or imipramine. In reality, the effectiveness of the psychotherapy and pharmaceutical treatments are sub-optimal, as the success rates are low and the side effects may not be acceptable. The next line interventions are usually penile vibratory stimulation or electroejaculation therapy.
The process of electroejaculation, as the name suggests, is a procedure to stimulate the ejaculatory process by electricity. Such practice is commonly applied in veterinary medicine to obtain the semen of precious breeds of bulls and stallions for cryopreservation.
Although the process of electrically stimulating the ejaculatory apparatus to produce semen for recreation and procreation may sound enticing for some, this is definitely not for leisurely application in the bedroom. For starters, the procedure is usually carried out under general anesthesia due to the pain and contractions caused by the electric current. An electric probe is usually inserted to the rectum, adjacent to the prostate gland to deliver AC current of 12-24 volts at the frequency of 60Hz. The probe is activated every 1-2 seconds with a rhythmic delivery referred to as a stimulus cycle. The voltage is gradually cranked up until ejaculation is achieved. Electroejaculation is nearly 100% successful in men with no neurological defects. However, if the integrity of the nerve is damaged, the electroejacuation can only reach climatic outcome in 80% of cases.
The long-term complications of diabetes on sexual function are complex and often difficult to manage. Despite meticulous sugar control in many sufferers, the curse of testosterone depletion, erectile dysfunction and ejaculatory disorders can still adversely affect men. Dr. G is often put on the spot to come up with the magic touch to solve the problems of sexual dysfunctions in diabetic men. Although issues related to libido and erections can be resolved, the impedance of ejaculation currently still remains a conundrum with no real practical solutions. When it comes to anjeculation in diabetes, unless one is keen to endure the horror of cranking up that AC current in the rectal probe during intercourse, one just has to put up with the frustrations of dry orgasm!
Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at firstname.lastname@example.org