Psychotherapy of anejaculation represents the use of counseling and psychological support in treatment of anejaculation (the inability to ejaculate). For men with a psychological cause of the condition, psychotherapy alone may be the first-line and the most effective treatment. For men with an underlying disease as the cause, psychotherapy is often equally important in order to help them cope with the problem.
There are two kinds of anejaculation, one is situational and the second one is total.
Anejaculation has multiple causes, both physical and psychological.
Treatment of anejaculation depends on the cause. For psychological causes, psychotherapy comprising counseling and psychological support is usually effective. The therapy aims at removing the underlying psychological issue, such as stress, performance anxiety or relationship issues.
Psychotherapy is usually employed in the treatment of anejaculation in patients without a known organic (physical) cause of the condition. Specifically, cases of anejaculation termed as idiopathic (without an apparent cause) are treated by psychotherapy, as they are most probably caused by psychological issues.
The outcome of psychotherapy (and subsequently, sex therapy) depends on many factors. Whether the therapy is successful in resolving relationship issues, reducing anxiety by so-called cognitive behavioral therapy (psychological intervention aimed at behavioral patterns) and increasing the level of information about sexual intercourse plays a very important role in the outcome. Strict and/or religious upbringing of the patient may cause deep-rooted psychological issues leading to psychogenic anejaculation that may be difficult to treat.
Sex therapy sessions are focused on the individual's symptoms (such as the inability to ejaculate during sexual intercourse or under specific circumstances) rather than on underlying psychodynamic conflicts (such as beliefs and upbringing). A therapist's misunderstanding of these conflicts can lead to resistance or serve as a barrier to improving sexual dysfunctions that are directly or indirectly related to sex.
Evidence on the efficacy of psychotherapy in the treatment of ejaculatory disorders, including anejaculation, still needs to be documented in large-scale studies. However, even in cases where psychotherapy fails to restore normal ejaculatory function, anejaculation is nowadays a treatable condition.
Patients suffering from ejaculation can achieve a pregnancy with the use of assisted reproduction technology (ART), most notably penile vibratory stimulation. Semen collected using penile vibratory stimulation has been reported to have better quality to that collected by the electroejaculation technique. Therefore, penile vibratory stimulation is recommended as the first-line ART method for anejaculation patients.