不射精症

　　在性交时性器官(主要是阴茎头部)感受性冲动，通过传入神经到脊髓泄精中枢和射精中枢，再通过传出神经支配效应器(输精管、精囊、壶腹、膀胱颈及前列腺)，诱发射精并伴随快感。这种射精反射受到大脑的控制。如果射精通路任一环节发生功能或器质性障碍，均可导致射精障碍。

　　1、功能性不射精

　　(1)精神心理因素：为常见原因。如对配偶不满意、夫妻关系不协调、思想压力大、性生活环境不佳等，均可使男方对性生活采取克制态度，长此以往会导致不射精症。

　　(2)性知识缺乏：夫妻双方缺乏性知识，不知道如何性交，或者对性有恐惧心理(如女方害怕妊娠或疼痛)而限制男方大幅度、快速抽动，使男方不能达到射精的阈值导致不射精症。

　　(3) Sexual fatigue or ejaculation exhaustion: Frequent sexual intercourse or masturbation can easily cause functional disorders of the spinal ejaculation center, leading to anejaculation.

　　(4) Long-term masturbation: Long-term masturbators may cause anejaculation. Since the intensity of sexual stimulation during masturbation is often greater than that during sexual intercourse, the ejaculation center gets accustomed to the strong stimulation of masturbation and may not reach the ejaculation threshold during sexual intercourse. On the other hand, due to the influence of traditional concepts, masturbators usually have feelings of guilt and shame, which may also inhibit ejaculation.

　　2. Organic anejaculation

　　(1) Nervous system lesions and injuries: Such as lesions in the lateral lobe of the brain and spinal cord injury can cause anejaculation.

　　(2) Iatrogenic factors: Such as thoracolumbar sympathetic nerve resection and retroperitoneal lymph node dissection can damage nerves and cause anejaculation.

　　(3) Local lesions of the urinary and reproductive systems: Such as seminal colliculus hypertrophy, phimosis, or penile lengthening with narrow prepuce opening, penile injury, nodules, scars, fibrosis, severe hypospadias, and other diseases can cause anejaculation.

　　(4) Endocrine abnormalities: Diabetes, hypopituitarism, hyperthyroidism, and other diseases can cause ejaculation disorders.

　　(5) Drug-related factors: Antihypertensive drugs, sedative tranquilizers, or adrenergic blockers, as well as long-term alcoholism or drug abuse, can induce anejaculation.

　　Due to the decreased sensitivity of the glans, and the inattention of spirit and attention, patients often cause anejaculation due to reduced pleasure. The complications mainly include two aspects: physiological and psychological. Physiologically, due to anejaculation, it can directly affect fertility and can lead to infertility. Psychologically, although the disease is not serious, there may be mental depression and a tendency to induce depression.

　　During sexual intercourse, the patient's penis can maintain an erection for a relatively long time without softening, but cannot reach an orgasm, without ejaculation, and without seminal fluid being expelled from the body. According to whether the patient has nocturnal emission and whether ejaculation can be achieved through masturbation, anejaculation can be divided into functional anejaculation and organic anejaculation. Functional anejaculation accounts for about 90%, and patients do not ejaculate seminal fluid during sexual intercourse, but can ejaculate during masturbation or have nocturnal emission outside of sexual activity. Organic anejaculation cannot ejaculate under any circumstances and can be accompanied by symptoms and signs corresponding to the primary disease.

　　The prevention and adjustment of anejaculation should start from aspects such as life, diet, and spirit.

　　1. Life Adjustment

　　Regularly learning some healthy sexual knowledge is beneficial for eliminating sexual tension and shyness, establishing correct sexual concepts, and seeking medical guidance when necessary. Moderating sexual activity is to nourish kidney essence. Normal sexual life can enhance the joy of the couple's relationship and deepen emotional intimacy. However, frequent sexual activity or long-term masturbation can excessively stimulate the ejaculation center and lead to fatigue and exhaustion, causing difficulties in ejaculation. Pay attention to strengthening physical exercise to improve physical fitness. Avoid taking drugs that damage sexual function, such as guaifenesin, feneridine, and phenothiazine drugs, which can lead to anejaculation.

　　2. Diet adjustment

　　Diet should be light, eat less spicy and Yang-enhancing foods. Common dietary therapies still focus on tonifying the kidney, softening the liver, opening the orifices, promoting diuresis, activating blood circulation, nourishing Yin, and regulating Qi and blood.

　　1. Mulberry Soup: Suitable for anejaculation with both heart and spleen deficiency and kidney essence deficiency.

　　2. Yam and lotus seed porridge: Suitable for anejaculation with heart and spleen Qi deficiency and Yin fire hyperactivity.

　　3. Green Jade Soup: Suitable for anejaculation with downward flowing damp-heat and obstruction of the seminal duct.

　　4. Turtle Soup with silk: Suitable for anejaculation with kidney essence deficiency and命门火衰.

　　5. Yam dumplings: Suitable for anejaculation with both heart and spleen deficiency.

　　6. Braised nine types of mutton in a pot: Suitable for anejaculation due to kidney essence deficiency and命门火衰.

　　3. Mental adjustment

　　Patients with anejaculation often have a heavy mental burden and their self-confidence is greatly defeated. Doctors and family members should guide and comfort the patients with patience. The wife should encourage the patient to build confidence, melt him with care and affection, and improve the quality of sexual life. They can often take tonifying kidney and nourishing essence products such as Liuwei Dihuang Pill and Wuzi Yanzong Pill, and at the same time, they can enhance their physical fitness and prevent the disease by practicing Qigong, Tai Chi, and self-care massage.

　　For patients with anejaculation, doctors should not only inquire about the medical history in detail but also conduct relevant examinations, which are very necessary for the diagnosis of anejaculation. Doctors should carefully examine the development of the penis, such as the size, texture, and tenderness of the testicles. To exclude the causes of pain during ejaculation due to urogenital system diseases, endocrine diseases, mental illness, nervous system, and surgery, doctors should conduct corresponding examinations, such as routine examination of prostatic fluid, routine urine examination, or bacterial culture, to exclude inflammation of the prostate and reproductive tract. For primary anejaculation, it is also necessary to examine the bilateral epididymis, seminal vesicle, and perform excretory urography, seminal vesicle urography, and even CT or spiral CT examination to determine whether there is congenital malformation.

　　Patients with anejaculation should have a light diet, eat less spicy and Yang-enhancing foods. Common dietary therapies still focus on tonifying the kidney, softening the liver, opening the orifices, promoting diuresis, activating blood circulation, nourishing Yin, and regulating Qi and blood. (For reference only, specific needs should be consulted with a doctor).

　　1. Daylily buds and Portulaca oleracea drink

　　30 grams of daylily buds, 30 grams of Portulaca oleracea. Boil them with water and drink as tea. It has the function of clearing heat and detoxifying. It is suitable for anejaculation caused by heat in the liver meridian.

　　2. Herba Epimedii wine

　　60 grams of Herba Epimedii, 500 grams of white wine. Put Herba Epimedii into a gauze bag, soak in wine, seal the mouth for 3 weeks, and then it can be drunk. Drink 1 small cup at night before going to bed. It has the function of benefiting the liver and kidney, and assisting yuan yang. It is suitable for anejaculation caused by kidney yang deficiency.

　　3. White goat kidney porridge

　　Two slices of white goat kidney, 30 grams of Cistanche dried and soaked in wine, 120 grams of goat fat sliced, 6 grams of pepper, 3 grams of dried tangerine peel, 6 grams of bupleurum, 6 grams of amomum, scallions, salt, and ginger in appropriate amounts. First, put Cistanche, pepper, dried tangerine peel, bupleurum, amomum, and other ingredients into a bag, tie the bag tightly, and cook with goat kidney and goat fat to make a soup. After the soup is ready, remove the medicine bag, stir in flour paste to make white goat kidney porridge for consumption. Take 1 large spoonful in the morning and evening. It has the function of tonifying kidney yang. It is suitable for impotence and anejaculation due to kidney yang deficiency.

　　4, Peach Kernel Congee

　　10 grams of peach kernel, 50 grams of粳米. Grind the peach kernel and mix it with the rice, cook it as usual. Eat it as breakfast, add a little brown sugar when eating. It has the function of promoting blood circulation and removing blood stasis. It can be used for seminal emission disorder caused by blood stasis blocking the collaterals.

　　5, Tangerine Peel Drink

　　10-15 grams of dried or fresh tangerine peel, 10 grams of bitter almond, 10 grams of old loofah fiber. Boil the three ingredients for 15 minutes, add a little sugar after clarifying, and drink it as tea. In winter, it is hot, in spring and autumn, it is warm, and in summer, it is cool. It has the function of regulating qi, promoting collateral circulation, and resolving phlegm. It is used for seminal emission disorder caused by liver qi stagnation.

　　6, Red Bean Congee

　　30 grams of red bean, 50 grams of粳米, appropriate amount of sugar. Boil the red bean first, then add the粳米 to cook congee, add appropriate sugar after the congee is cooked. Eat it as breakfast. It can be eaten regularly. It has the function of clearing heat and promoting diuresis, and is suitable for seminal emission disorder caused by damp-heat accumulation for a long time.

　　7, Yuan Zhi Zao Ren Congee

　　10 grams of Yuan Zhi meat, 10 grams of fried Zao Ren, 50 grams of粳米. Cook the rice as usual, add Yuan Zhi and Zao Ren after boiling. Eat it as a night snack before going to bed every night. It has the function of calming the mind and benefiting the heart, and is used for seminal emission disorder caused by the heart and kidney not communicating.

　　8, Nourishing Marrow Field

　　One turtle, 200 grams of pig spinal cord, appropriate amounts of ginger, scallion, pepper, and monosodium glutamate. Clean and chop the turtle, cook it with the pig spinal cord, add appropriate seasoning after boiling, eat the meat and drink the soup, and use it as a side dish. It has the effect of nourishing yin and kidney, filling essence and marrow, and is suitable for seminal emission disorder caused by kidney yin deficiency and insufficient essence.

　　Patients with seminal emission disorder can relieve symptoms in addition to general treatment through traditional Chinese medicine treatment.

　　(1) Yin Deficiency and Fire Exuberance

　　The treatment principle is to nourish yin and strengthen water, and communicate the heart and kidney. The prescription is 20g of Tu Si Zi, 15g of Gou Qi Zi, 12g of Jin Ying Zi, 15g of Shan Yu Rou, 20g of Shan Yao, 12g of Dan Pi, 12g of Zhi Mu, 12g of Huang Bai, 12g of Ze Xie, one course of treatment from 1 to 4 weeks.

　　(2) Liver Qi Stagnation and Fire Exuberance

　　Regulate the liver and relieve the qi, calm the mind and purge the fire. The prescription is 15g of Long Dan Cao, 12g of Chai Hu, 12g of Sheng Di, 15g of Huang Qin, 12g of Zhi Mu, 15g of Dan Zhu Ye, 12g of Bai Mao Gen, 12S of Fu Ling, 9g of Shi Gang Pu, 12g of Ni Zhen Zi, 12g of Mu Xiang, 6g of Gan Cao, one course of treatment from 1 to 4 weeks.