Ask the Doc: Why can’t I cum?

There are many reasons why you might have a problem with reaching orgasm and ejaculating.

Your body’s lead-up to orgasm and ejaculation is quite complicated. It requires the coordination of different parts of your brain, nerves to and from your brain, and muscle activity in and around your reproductive system. If any part of the system isn’t working properly, it can affect your ability to cum.

Some people take a long time to reach orgasm and ejaculate — or they might not get there at all — almost every time they engage in sexual activity, or only occasionally. If it takes you a long time or you don’t get there, and it’s a cause of concern for you or your partner, you should see your doctor.

Problems with reaching orgasm and ejaculating can be due to your body or your mind (or both).

Problems with the development of the reproductive tract can cause trouble with reaching orgasm and ejaculation. So can the effects of injury, infection, disease or medical or surgical treatments. If these sorts of physical (body) problems are preventing orgasm and ejaculation, treatment of them might help.

Orgasm and ejaculation might be delayed, or might not occur at all, because of religious or cultural factors weighing on your mind. Problems with your relationship with your sexual partner, or in other parts of your life (like work or family stress) could be the cause.

Some people have trouble with maintaining arousal or getting aroused enough to reach orgasm during sexual activity with a partner. This might be because they’ve become used to stronger physical sensations that they get when they masturbate or have visual stimulation from viewing pornography. If this is the case, there are behavioural changes that a sex therapist can help you with so it’s easier for you to reach orgasm with your partner.

Some medications can prevent you from reaching orgasm and ejaculating. Commonly used antidepressants can prevent orgasm, which is why they are sometimes used to treat men with premature ejaculation.

Not being able to cum can be a source of frustration and can affect your relationship with your partner. If you’re worried about your sexual function in any way, your doctor can help you work out the cause of the problem and find a suitable treatment.