Sluggish Ejaculation

Q. My husband and I have been trying to conceive for three years. Lately I have noticed that his sperm doesn’t squirt like it used to when he ejaculates. Instead it kind of just oozes over the head of his penis. Could this be making it difficult for us to conceive?

A. Rest assured that ejaculatory “oomph” is not required for conception to occur. As long as semen volume, sperm count and motility are normal, I would not be concerned with trajectory or distance.

The “distance effect” reflects many factors, including the openness of the genital pathways and the strength and the number of muscular contractions. Infections may obstruct the ejaculatory flow. As a man ages, prostate enlargement may interfere with the ejaculatory stream. Conditions such as diabetes and neurological disease, as well as certain blood pressure medications, may interfere with development and maintenance of the erection or closure of the bladder neck (which keeps the stream of sperm from detouring into the bladder). And psychological and relationship issues, such as “work-sex” vs. “fun-sex,” can play a role in ejaculatory competence as well.