For David to be a successful faker-of-orgasms, he had to have some way to handle the “evidence” for Sarah. Is it possible for a man like David to have an orgasm without any fluid coming out?
Ejaculation in men is a key component of human reproduction. With orgasm, the man releases 1.5 to 5 cubic centimeters (for reference, a teaspoon is 5 cc) of semen, which is a mixture of com
ponents from three sources, combined at the critical moment of climax. About two-thirds of the fluid is produced by the seminal vesicles, a paired set of glands that lie just behind the prostate. For centuries, the seminal vesicles were believed to be a reservoir for sperm, but this is incorrect. The seminal vesicles produce fluid that is beneficial for the delicate sperm, with an alkaline pH and the sugar fructose, which serves as the primary energy source for sperm movement once they are ejaculated.
Most of the remaining fluid comes from the prostate, and a small portion, 5 to 10 percent, comes from the testicles, including the sperm. Thus, when a man has a vasectomy, he only loses the small amount that comes from the testicles. Most men don’t even notice a difference in the amount of fluid after vasectomy, contrary to the common myth that vasectomy results in a dry ejaculation.
During the first moment of ejaculation, all three fluids are deposited into the urethra as it passes through the central part of the prostate. Powerful muscular contractions around the prostate and at the base of the penis forcibly and rhythmically expel the semen out the tip of the penis. To ensure that the fluid doesn’t go backward into the bladder, the sphincter muscle at the junction of the bladder and prostate closes just before ejaculation. As men age, the expulsive forces are reduced and the semen comes out more slowly, oozing rather than spurting.
Normally, ejaculation is part of the orgasm experience, but not always. Sam was a sixty-two-year-old Ukrainian man who had undergone surgery for prostate cancer, an operation called radical prostatectomy. During the operation, the prostate and seminal vesicles are both removed in their entirety, and the tube carrying sperm from the testicles, called the vas deferens, is disconnected from the prostate. Thus everything that contributed fluid to the ejaculation is gone.
One of the common problems encountered by men who undergo this kind of surgery is poor erections, and this was what Sam wanted me to help him with. There were a number of options for Sam, but I also needed to learn more about his sexual functioning.
“Sam, how is your sex drive?” I asked.
“Strong!” he said with a smile.
“Can you have an orgasm?”
“What a question! Of course! But no fluid comes out. It feels the same, though, and I have the same throbbing sensation in my penis and behind my scrotum. Very satisfying, and an additional benefit is, no mess!”
For many men, however, the loss of semen can be quite disconcerting. One class of medication, called alpha blockers, can cause a severe reduction in the amount of semen that comes out with ejaculation, sometimes eliminating it completely. Alpha blockers are often prescribed for men with frequent or slow urination. As one patient, Brock, described it, “I was totally freaked out when I had sex and nothing came out of me. I didn’t know what to think. Did I have cancer? Was there something wrong with my equipment? There were a couple of awful nights there when I didn’t want to have sex. I was ticked off at my doctor that he didn’t tell me this could happen from the medication.”
There can be other medical reasons why a man might have an orgasm without ejaculation. In some men with diabetes or neurologic conditions, the urinary sphincter does not close properly at the beginning of orgasm, allowing the semen to seep into the bladder instead of coming out the tip of the penis, a condition called retrograde ejaculation. The sperm come out with the urine the next time the man urinates. Also, some operations can compromise the nerves controlling the ejaculatory process, leading to the same dry orgasm that Sam experienced.
With David, two main issues come to mind. The first is why he couldn’t have an orgasm during sex, and the second is why and how he faked it.
“David, do you think Sarah can tell that you’re faking?” I asked.
“I don’t think so,” he replied. “She seems pretty happy about our sex life. We’re pretty active, and she gives me the impression she er\joys herself. If she knows, she’s not saying anything.”
“What about the fluid? Doesn’t she notice that there’s no semen?”
David shrugged. “I don’t know. When we started seeing each other I used a condom, and I just made sure she didn’t have a chance to check me out before I flushed it down the toilet. When we decided to be exclusive we both got tested and I stopped using condoms when our tests came back okay.”
“You don’t think Sarah notices there’s no semen now that you don’t use a condom?”
“Sarah gets pretty wet,” he answered. “It seems to me there’s already plenty of fluid, and it would be hard for her to tell.”
There you have it. If the man does a good job hiding the absence of semen, there’s really no reason a man can’t fake an orgasm as well as a woman.