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Erection, but no ejaculation.

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For the past 2 weeks I have been unable to acheive climax and subsequent ejaculation. I have had sex regularly for 28 years with the same woman, previously without problems like this. I have had some ED issues in the past few years and take Cialis as needed. I also have been on Effexor (150mg) or Cymbalta (60mg) for depression, for the past few years as well. I am looking into diet and health reasons for this inability. Please provide any advice and recommendations you can.

Thanks, John
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replied October 30th, 2008
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There is a condition called "orgasmic dysfunction". Many factors can contribute to orgasmic dysfunction. They include:

* A history of sexual abuse or rape
* Boredom and monotony in sexual activity
* Certain prescription drugs, including fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
* Hormonal disorders and chronic illnesses that affect general health and sexual interest
* Medical conditions that affect the nerve supply to the pelvis (such as multiple sclerosis, diabetic neuropathy, and spinal cord injury)
* Negative attitudes toward sex (usually learned in childhood or adolescence)
* Shyness or embarrassment about asking for whatever type of stimulation works best
* Strife or lack of emotional closeness within the relationship


You might want to request a testosterone test which is ordered when infertility is suspected or if a man has a decreased sex drive or erectile dysfunction, all of which can result from low testosterone levels. You might find these websites helpful as well:

http://jama.ama-assn.org/cgi/reprint/291/2 4/3076.pdf
http://womenshealth.gov/mens/sexual/ams.cf m
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