Weak Ejaculation: Causes & Treatment Options

As you get older, you may have noticed a decline in libido and sexual function. You may even find you don’t ejaculate as much or with the same level of force as you did in your youth.

Weak ejaculation is very common in older men and is rarely cause for concern, unless you’re planning to have children. 

Semen volume varies from one man to another, but if you’ve noticed a reduction in the volume or force of your ejaculations, you may have questions. 

Some men find weak ejaculation affects the intensity of their orgasms while others report no change in their level of sexual satisfaction. 

If you’re still planning to have children, weak ejaculation could make it more difficult. 

Below, we’ve taken an in-depth look at weak ejaculation including its causes and symptoms. 

We’ve also explored potential treatment options and included some tips for potentially increasing your sperm count, if fertility is a concern for you and your partner.

Weak Ejaculation: The Basics

  • Weak ejaculation is characterized by reduced volume of semen and/or reduced force of ejaculation. It may also result in reduce intensity of orgasms. 
  • According to the International Society for Sexual Medicine, the average volume of semen per ejaculate ranges from 1.25 to 5 milliliters — roughly equivalent to ¼ to one teaspoon of semen. 
  • Semen volume ranges from one ejaculation to another. If you haven’t ejaculated for several days, you may experience a higher volume of semen than times when you’ve more recently ejaculated. Semen volume is not necessarily an indicator of sperm count.
  • Weak ejaculation is often related to increased age, particularly in correlation with decreasing levels of male sex hormones. 
  • Treatment for weak ejaculation typically involves addressing the underlying cause or, in cases where no singular cause is evident, pelvic floor exercises, drugs to enhance sexual function, or psychotherapy may help. 

What Is Weak Ejaculation? 

Ejaculation is the expulsion of semen from the body that occurs with sexual climax. 

The process of ejaculation occurs in two stages: emission and expulsion. Emission is the stage in which muscles contract to push semen into the prostate and urethra, and expulsion is the stage in which the muscles around the urethra contract to push the semen out. 

Weak ejaculation is largely subjective and orgasm intensity varies from one person to another, so it is difficult to characterize this condition with any clinical symptoms. In many cases, weak ejaculation may be a matter of perception.

Weak ejaculation may not be an indication of a medical problem, but experiencing ejaculation volumes under 2ml on two separate occasions may signify an underlying health issue like retrograde ejaculation. 

What Are the Causes? 

The underlying cause for weak ejaculation can be difficult to pinpoint, especially when it isn’t related to a medical problem. Anything that affects the nerves or muscles involved in ejaculation can impact the force of an ejaculation. 

Here are some of the potential underlying causes:

Retrograde ejaculation

Ejaculation disorders are typically divided into four types: premature ejaculation, delayed ejaculation (DE) or anorgasmia, absent ejaculation, and unsatisfactory sensation of ejaculation. 

While many ejaculatory disorders involve physiological and psychological causes, retrograde ejaculation is almost exclusively physiological in nature. It occurs when some or all of the ejaculate is forced back up into the bladder rather than passing out through the penis at sexual climax. Though this condition can cause infertility, it doesn’t cause any medical issues. 

Retrograde ejaculation has several possible causes including the following:

  • Damage from certain types of surgery (i.e. prostate surgery or bladder surgery)
  • Nerve damage subsequent to medical illness
  • Side effects of certain medications (i.e. SSRIs, antipsychotics, and drugs to treat enlarged prostate)

When retrograde ejaculation occurs as a complication following a surgical procedure, it generally involves damage to the muscles of the bladder or the nerves that control it. Nerve damage caused by medical illness is particularly common in men with uncontrolled diabetes or multiple sclerosis. 

Psychological factors 

It is estimated that 31 percent of men have some kind of sexual dysfunction. Many issues of sexual function have a psychological component, though they tend to be overlooked. 

The authors of a 2017 review of clinical practice guidelines and management of sexual dysfunction suggest that, in addition to biological factors, various psychosocial factors including societal/religious beliefs, health status, personal experience, socio-economic status, and psychological status play a role in a person’s sexual functioning.

Though psychological issues may not directly affect the volume of semen you produce during an ejaculation, mental health is closely linked to sexual health and could be a contributing factor to your concerns in ways that aren’t immediately apparent. 

Prostate conditions

If you’ve undergone surgery or treatment for prostate conditions like prostate cancer or enlarged prostate, it could affect your ejaculation. Prostate surgery can cause nerve damage which might affect your ejaculatory function, as can chemotherapy for prostate cancer. 

Certain medications 

Medications to treat certain mental health issues like depression, especially selective serotonin reuptake inhibitors (SSRIs) can cause weak or delayed ejaculation. Other medications which could be involved include antipsychotics, beta-blockers, muscle relaxants, and powerful analgesics such as methadone. 

If you’re currently taking medication and are concerned it might be affecting your ejaculatory function, talk to your healthcare provider. They will be able to help determine whether the medication is involved and, if so, discuss options to adjust your dosage or change medications. 

Treatment Options for Weak Ejaculation 

Weak ejaculation may simply be a consequence of aging and not something to panic about. 

If you’re concerned about changes in your ejaculatory function, the first step is to speak to your healthcare provider. They will be able to diagnose any underlying conditions that might be contributing to the problem, in which case the next step is to treat those issues. 

Here are some of the potential treatment options for weak ejaculation. 

Pelvic Floor Exercises

During ejaculation, the muscles in the pelvic floor contract to force semen out of the penis. Performing exercises to strengthen those muscles could help with ejaculation issues. 

Pelvic floor exercises, also known as kegel exercises, involve squeezing and releasing the muscles you use to stop the flow of urine. In men, these muscles support the bladder and bowel, encompassing the urethra as well as the anus. 

Here’s what you need to do:

  1. Make yourself comfortable sitting or lying down.
  2. Take a moment to identify your pelvic floor muscles by squeezing the muscles you use to stop the flow or urine or the passing of gas. 
  3. Keeping the muscles in your legs, buttocks, and stomach relaxed, squeeze the pelvic floor muscles. 
  4. Imagine you are trying to lift the base of your scrotum, drawing the muscles up into your pelvis. 
  5. Squeeze and hold those muscles for a count of five then relax.
  6. Repeat the process eight to 12 times, reason for about eight seconds between each hold. 

Complete this set of exercises at least three times per day, gradually increasing the length of each hold. Focus on keeping your buttocks and leg muscles relaxed as you do. 

Drugs to Improve Sexual Function 

There are no U.S. Food and Drug Administration (FDA)-approved drugs to treat weak ejaculation. That being said, there are several medications used to treat various sexual health issues like delayed ejaculation and premature ejaculation which may help improve your sexual function. Some of these drugs are used off-label for this purpose.

Here are some of the drugs used to treat ejaculatory disorders:

  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Paroxetine
  • Sertraline
  • Citalopram 
  • Clomipramine 
  • Dapoxetine 
  • Tramadol

If you’ve been diagnosed with retrograde ejaculation related to medication side effects, your healthcare provider may recommend stopping or reducing medications that might be causing your ejaculatory dysfunction. 

When medications aren’t the issue, medical therapy with alpha agonists might help. Alpha agonists like pseudoephedrine have been used off-label to improve bladder neck contraction to prevent retrograde ejaculation. 

In a small trial of twenty men, 70 percent demonstrated improvement in semen parameters with pseudoephedrine treatment. 

However, it’s worth noting that the improvement seen in semen parameters was minimal, but an improvement nonetheless.

Psychotherapy 

Sexual function is a complex process that involves multiple systems in the body, including the brain and nervous system. On top of biological issues, psychological factors can play a significant role in a person’s sexual health and sexual function. 

Though there is limited research on the effectiveness of psychotherapy for sexual dysfunctions, cognitive behavioral therapy and variations of it seem to be the most popular and have shown the most promise. If you’re concerned about your ejaculatory function and your healthcare provider has ruled out underlying medical causes, consider speaking to a counselor to work through the issue either on your own or with your partner. 

Tips to Increase Your Sperm Count

Weak ejaculation generally isn’t anything to worry about, medically speaking. If you’re trying to conceive a child, however, you may be concerned that a reduction in semen volume might also mean a reduced sperm count.

A normal sperm count is between 20 million and 150 million per milliliter of ejaculate. If you’re concerned about fertility, you may want to have your sperm count tested.

If your sperm count is low, here are a few things you might try:

  • Exercise on a regular basis. Overweight and obesity can reduce your sperm count, so make sure to maintain a healthy body weight through regular exercise. Just avoid long bouts of intense exercise which may reduce your sperm count.
  • Make sleep a priority. Research shows that men who sleep too little, too much or who go to bed too late may have a lower sperm count than men with healthy sleep habits. 
  • Follow a healthy diet. Eating a balanced diet is important for overall health and wellness but research shows a diet rich in antioxidants may help boost your sperm count.  You may also want to reduce your intake of fatty and fried foods — trans fats have been linked to lower sperm count. 
  • Quit smoking. Not only does smoking increase your risk for chronic diseases like cancer and heart disease, but it can affect your sperm count as well. 

In Conclusion 

Sexual health concerns can be difficult to talk about, even with your healthcare provider. 

It’s important, however, to bring your concerns to a healthcare professional who can help determine the underlying cause of your issues and point you in the right direction in terms of treatment. You deserve to enjoy satisfying sexual experiences, so don’t let any embarrassment over weak ejaculation stand in the way of getting the help you need. 

Talk to your healthcare provider about your concerns or complete an online consultation for free from the comfort of your own home. 

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.