6 ms·

We had alpha-blockers for a long time now, which prevents ejaculation but not orgasm; read: it can completely block the emission phase of ejaculation, while org

We had alpha-blockers for a long time now, which prevents ejaculation but not orgasm; read: it can completely block the emission phase of ejaculation, while orgasmic function is retained. Example: Silodosin. You need to experiment with it. Sensitive clinical trials measured rates as high as 90-99%. It is entirely non-hormonal. It does not affect libido (rarely), while hormonal male contraceptives do, and it is reversible upon cessation, without any delay, unlike hormonal male contraceptives.

steanne 2y ago
it's been a few decades, but i don't recall sperm in seminal fluids being entirely limited to the grand finale, only mostly.
- johnisgood 2y ago
  Fair, and it needs clarification to avoid conflating pre-ejaculate, seminal plasma, and sperm emission. It may be confusing, so to clarify: "seminal fluids" is a term typically used to refer to the fluid released during ejaculation, not throughout the arousal phase. The idea that sperm would be in the mix before the emission phase goes against standard reproductive physiology. Sperm are only actively introduced into seminal fluid during the emission phase of ejaculation; the so-called "grand finale." :D. Before that, in the arousal phase, the fluids released (like pre-ejaculate) typically contain no sperm unless there's residual contamination from a previous ejaculation.
  - yard2010 2y ago
    It's funny that residual contamination, in the right context, might lead to the world's best magic - life.
    - johnisgood 2y ago
      I know, especially if you think about it! It is indeed "magic", to me, too. :) (And FWIW, if one might wonder: thankfully this aforementioned "residual contamination" poses no health risk or birth defects.)
- loeg 2y ago
  Sperm is virtually entirely absent from pre-ejaculation fluids if you've peed since the last time you ejaculated. Almost all of the "sperm can be in pre-ejaculate" effect is from having sex a second time in a row without anything flushing out the tubes.
- harshreality 2y ago
  It's not. I think johnisgood and loeg both know this, but they're being dangerously simplistic in some of their replies. If you recognize emission — not just when expulsion is imminent — and if you pull out and that's the end of vaginal intercourse until you've cleared the urethra again, then that's probably nearly perfect at preventing pregnancy.
BurningFrog 2y ago
If it's never ejaculated, what happens to the fluid?
- johnisgood 2y ago
  The body has several well-regulated mechanisms for handling it. If semen isn't ejaculated, the body reabsorbs the sperm in the epididymis and recycles the cellular material. Seminal fluids, which are produced during arousal, are either reabsorbed or, in cases like retrograde ejaculation (e.g., with alpha-blockers), pass into the bladder and are later urinated out. The system self-regulates; there's no harmful buildup to worry about. :) So, TL;DR: You will just urinate it out in our case.
  - giantg2 2y ago
    I wonder if this leads to higher risk of prostate cancer, as an inverse to studies on relatively frequent ejaculation lowering prostate cancer risk.
    - johnisgood 2y ago
      From what I gathered, it does not appear to have an impact on prostate cancer risk since the prostate still undergoes stimulation and fluid production, and the contents are still expelled. Silodosine-induced retrograde ejaculation does not prevent ejaculation from occurring, it simply redirects the pathway (different anatomical exit). It is different from chronic ejaculatory abstinence.
- chneu 2y ago
  What do you think happens with a vasectomy? It gets reabsorbed.
  - aaronbrethorst 2y ago
    Vasectomies don't prevent ejaculation. The semen is just sperm-free (after a brief period of time).
Mountain_Skies 2y ago
Take it a step further into 'Demolition Man' territory to get the orgasm without any physical contact. Certainly would be good for reducing STDs though no doubt would come with a whole range of societal impacts.
- johnisgood 2y ago
  In all honesty, orgasm without physical contact is entirely possible already (mental orgasm / psychological stimulation), but it is not common and not easy. Fantasy, meditation, hypnosis, Kegel exercises... They could lead to orgasms and sometimes even ejaculation (which would be bad in this case). Some medications rarely may cause spontaneous orgasms, even, without physical contact, arousal or stimulation.
- giantg2 2y ago
  We're basically there with VR porn and ever more realistic toys.
  - johnisgood 2y ago
    Not parent but made a comment to parent, and damn, completely forgot about that! You are right.
AstralStorm 2y ago
Closer to 90%, and generally the side effects are a bit annoying too. Circulatory ones. Sometimes even to floppy. (Like 1% dosage dependent) Plus the thing does not stop the drip so you do have to pull out sooner rather than later or else. It does not stop sperm production. Also dry ones tend to result. They're sometimes uncomfortable. Tamsulosin is I believe the modern one but all of them are for long term. Probably least side effects. Otherwise if taken as a single dose fresh, side effects like orthostatic hypotension are vastly increased.
- johnisgood 2y ago
  Circulatory side effects like dizziness or orthostatic hypotension do occur, though they tend to be mild and dose-dependent. You're right that it doesn't stop sperm production, just emission. As for "the drip"; that's pre-ejaculate, which doesn't contain sperm inherently, but can pick up residual sperm in the urethra from a prior ejaculation. And that's true, anejaculatory orgasms can feel strange or less satisfying for some, but it is not universal. > Otherwise if taken as a single dose fresh, side effects like orthostatic hypotension are vastly increased. That is true. Edit: I / We will have to research the side-effect profile and mechanisms of the mentioned pill (in the submission). I have not yet done so. They mention no side-effects but it might be too early to tell.
  - cstrahan 2y ago
    > You're right that it doesn't stop sperm production, just emission. As for "the drip"; that's pre-ejaculate, which doesn't contain sperm inherently, but can pick up residual sperm in the urethra from a prior ejaculation. I’d like to stress that point a bit. I had a vasectomy about a year ago, and being the weirdo that I am, I figured I’d see how much sperm remained in my ejaculate (and for how long) after the procedure. I waited maybe two or three days after the procedure, and then for the next three days, I’d collect three samples per day and take a look under my microscope. In the first four or five samples, the swimmers were swimming hard. Told my brother (who had been trying for a kid for a couple years, and had observed his own samples trying correlate diet and other factors to improved motility) about the straight laser beams I was seeing in the scope — he nearly had a fit when I described how long it took them to go from one side of the slide to the other under the given magnification. It was the ninth sample when there were very few observable sperm, and what remained looked kinda drunk and unmotivated. All of that to say: if you’re going to get a vasectomy, when your doctor tells you to abstain from condom-less/birthcontrol-less sex until you come back for a sperm count, take that seriously. It’s amazing how motile they are even when kinda old, and also amazing how many hang around downstream of the vas deferens after many ejaculations. And, while rare, sometimes the vas deferens do manage to reconnect. And a bonus tip along these lines: testosterone replacement, even without hCG, is not a reliable form of birth control. I’m on (and was on) TRT, without hCG, and the concentration of sperm under the scope looked higher than any YouTube video I could find at the same magnification (meanwhile my bro is taking silly amounts of hCG and struggling). I hear a lot of people joke about TRT having the beneficial side effect of infertility, but that’s far from a certainty.
loeg 2y ago
> clinical trials measured rates as high as 90-99%. This is in the same range as, like, pulling out, for what it's worth.
- __turbobrew__ 2y ago
  Yea similar with tracking ovulation dates. Seems like pretty bad EV for messing with my nervous system.
- johnisgood 2y ago
  The similarity is not the same. If no semen is emitted, the chance of pregnancy is null (more about it in my other comments). Plus 90–99% suppression of ejaculation has been recorded and suggested that it has a potentially high contraceptive efficacy, so that is way better than withdrawal. Experiment, maybe it affects you in a way that you get 99%, which would make it a very efficient hormone-free male birth control pill. Side-note: personally I prefer IUDs, and/or a medication that has been extensively studied, so this pill can wait.
  - loeg 2y ago
    The "as typically used" quoted figure for pulling out ("withdrawal") is 80% success, but the ideal use figure is 96-98%. If you know a little bit about yourself and also aren't going back to back without peeing, you can do a lot better than the 80% figure. (Also yeah, it's amusing that both of these figures are more or less identical to male condoms.) (Meta-comment: probably best to keep everything in "success" percentage figures for direct comparison, instead of switching to failure percentages for some figures.)
    - johnisgood 2y ago
      I edited my comment.
- wonderwonder 2y ago
  I have always been amazed at how effective the pull out method was. I had sex for years with my wife and always pulled out. 2x a week for probably 10 years. After we decided to have a kid, she was pregnant in a month. Really incredible how effective such a simple solution is
throwaway743 2y ago
Retrograde ejaculation is a weird thing to experience. It's the physical manifestation of the sound of a slide whistle both ways. Alpha blockers also give one hell of a stuffy nose. Worst sleep ever after taking one.
locusofself 2y ago
Preventing ejaculation sounds awful.
- ignoramous 2y ago
  As compared to ... unplanned pregnancy?
  - Vilian 2y ago
    Not having sex is a great birth control yes, but birth control is for sex to be safe not to remove it entirety
  - 486sx33 2y ago
    As compared to, why have sex if you don’t finish ?
    - amanaplanacanal 2y ago
      As they said, it still allows orgasm, but with no ejaculation.
      - kacesensitive 2y ago
        I can't believe I'm typing this on hn and it's not meant to be funny but ...some people like ejaculate
        johnisgood 2y ago
        Lmao, yeah. I mean it is entirely up to the couples. I personally do not care which method they choose, whatever works for them.
    - mock-possum 2y ago
      You’re really hung up on this aren’t you
Obscurity4340 2y ago
So its like a dry orgasm pill? How is that not huge, does it affect the refractory period?

steanne 2y ago

it's been a few decades, but i don't recall sperm in seminal fluids being entirely limited to the grand finale, only mostly.

johnisgood 2y ago
Fair, and it needs clarification to avoid conflating pre-ejaculate, seminal plasma, and sperm emission. It may be confusing, so to clarify: "seminal fluids" is a term typically used to refer to the fluid released during ejaculation, not throughout the arousal phase. The idea that sperm would be in the mix before the emission phase goes against standard reproductive physiology. Sperm are only actively introduced into seminal fluid during the emission phase of ejaculation; the so-called "grand finale." :D. Before that, in the arousal phase, the fluids released (like pre-ejaculate) typically contain no sperm unless there's residual contamination from a previous ejaculation.
- yard2010 2y ago
  It's funny that residual contamination, in the right context, might lead to the world's best magic - life.
  - johnisgood 2y ago
    I know, especially if you think about it! It is indeed "magic", to me, too. :) (And FWIW, if one might wonder: thankfully this aforementioned "residual contamination" poses no health risk or birth defects.)
loeg 2y ago
Sperm is virtually entirely absent from pre-ejaculation fluids if you've peed since the last time you ejaculated. Almost all of the "sperm can be in pre-ejaculate" effect is from having sex a second time in a row without anything flushing out the tubes.
harshreality 2y ago
It's not. I think johnisgood and loeg both know this, but they're being dangerously simplistic in some of their replies. If you recognize emission — not just when expulsion is imminent — and if you pull out and that's the end of vaginal intercourse until you've cleared the urethra again, then that's probably nearly perfect at preventing pregnancy.

BurningFrog 2y ago

If it's never ejaculated, what happens to the fluid?

johnisgood 2y ago
The body has several well-regulated mechanisms for handling it. If semen isn't ejaculated, the body reabsorbs the sperm in the epididymis and recycles the cellular material. Seminal fluids, which are produced during arousal, are either reabsorbed or, in cases like retrograde ejaculation (e.g., with alpha-blockers), pass into the bladder and are later urinated out. The system self-regulates; there's no harmful buildup to worry about. :) So, TL;DR: You will just urinate it out in our case.
- giantg2 2y ago
  I wonder if this leads to higher risk of prostate cancer, as an inverse to studies on relatively frequent ejaculation lowering prostate cancer risk.
  - johnisgood 2y ago
    From what I gathered, it does not appear to have an impact on prostate cancer risk since the prostate still undergoes stimulation and fluid production, and the contents are still expelled. Silodosine-induced retrograde ejaculation does not prevent ejaculation from occurring, it simply redirects the pathway (different anatomical exit). It is different from chronic ejaculatory abstinence.
chneu 2y ago
What do you think happens with a vasectomy? It gets reabsorbed.
- aaronbrethorst 2y ago
  Vasectomies don't prevent ejaculation. The semen is just sperm-free (after a brief period of time).

Mountain_Skies 2y ago

Take it a step further into 'Demolition Man' territory to get the orgasm without any physical contact. Certainly would be good for reducing STDs though no doubt would come with a whole range of societal impacts.

johnisgood 2y ago
In all honesty, orgasm without physical contact is entirely possible already (mental orgasm / psychological stimulation), but it is not common and not easy. Fantasy, meditation, hypnosis, Kegel exercises... They could lead to orgasms and sometimes even ejaculation (which would be bad in this case). Some medications rarely may cause spontaneous orgasms, even, without physical contact, arousal or stimulation.
giantg2 2y ago
We're basically there with VR porn and ever more realistic toys.
- johnisgood 2y ago
  Not parent but made a comment to parent, and damn, completely forgot about that! You are right.

AstralStorm 2y ago

Closer to 90%, and generally the side effects are a bit annoying too. Circulatory ones. Sometimes even to floppy. (Like 1% dosage dependent) Plus the thing does not stop the drip so you do have to pull out sooner rather than later or else. It does not stop sperm production. Also dry ones tend to result. They're sometimes uncomfortable. Tamsulosin is I believe the modern one but all of them are for long term. Probably least side effects. Otherwise if taken as a single dose fresh, side effects like orthostatic hypotension are vastly increased.

johnisgood 2y ago
Circulatory side effects like dizziness or orthostatic hypotension do occur, though they tend to be mild and dose-dependent. You're right that it doesn't stop sperm production, just emission. As for "the drip"; that's pre-ejaculate, which doesn't contain sperm inherently, but can pick up residual sperm in the urethra from a prior ejaculation. And that's true, anejaculatory orgasms can feel strange or less satisfying for some, but it is not universal. > Otherwise if taken as a single dose fresh, side effects like orthostatic hypotension are vastly increased. That is true. Edit: I / We will have to research the side-effect profile and mechanisms of the mentioned pill (in the submission). I have not yet done so. They mention no side-effects but it might be too early to tell.
- cstrahan 2y ago
  > You're right that it doesn't stop sperm production, just emission. As for "the drip"; that's pre-ejaculate, which doesn't contain sperm inherently, but can pick up residual sperm in the urethra from a prior ejaculation. I’d like to stress that point a bit. I had a vasectomy about a year ago, and being the weirdo that I am, I figured I’d see how much sperm remained in my ejaculate (and for how long) after the procedure. I waited maybe two or three days after the procedure, and then for the next three days, I’d collect three samples per day and take a look under my microscope. In the first four or five samples, the swimmers were swimming hard. Told my brother (who had been trying for a kid for a couple years, and had observed his own samples trying correlate diet and other factors to improved motility) about the straight laser beams I was seeing in the scope — he nearly had a fit when I described how long it took them to go from one side of the slide to the other under the given magnification. It was the ninth sample when there were very few observable sperm, and what remained looked kinda drunk and unmotivated. All of that to say: if you’re going to get a vasectomy, when your doctor tells you to abstain from condom-less/birthcontrol-less sex until you come back for a sperm count, take that seriously. It’s amazing how motile they are even when kinda old, and also amazing how many hang around downstream of the vas deferens after many ejaculations. And, while rare, sometimes the vas deferens do manage to reconnect. And a bonus tip along these lines: testosterone replacement, even without hCG, is not a reliable form of birth control. I’m on (and was on) TRT, without hCG, and the concentration of sperm under the scope looked higher than any YouTube video I could find at the same magnification (meanwhile my bro is taking silly amounts of hCG and struggling). I hear a lot of people joke about TRT having the beneficial side effect of infertility, but that’s far from a certainty.

loeg 2y ago

> clinical trials measured rates as high as 90-99%. This is in the same range as, like, pulling out, for what it's worth.

__turbobrew__ 2y ago
Yea similar with tracking ovulation dates. Seems like pretty bad EV for messing with my nervous system.
johnisgood 2y ago
The similarity is not the same. If no semen is emitted, the chance of pregnancy is null (more about it in my other comments). Plus 90–99% suppression of ejaculation has been recorded and suggested that it has a potentially high contraceptive efficacy, so that is way better than withdrawal. Experiment, maybe it affects you in a way that you get 99%, which would make it a very efficient hormone-free male birth control pill. Side-note: personally I prefer IUDs, and/or a medication that has been extensively studied, so this pill can wait.
- loeg 2y ago
  The "as typically used" quoted figure for pulling out ("withdrawal") is 80% success, but the ideal use figure is 96-98%. If you know a little bit about yourself and also aren't going back to back without peeing, you can do a lot better than the 80% figure. (Also yeah, it's amusing that both of these figures are more or less identical to male condoms.) (Meta-comment: probably best to keep everything in "success" percentage figures for direct comparison, instead of switching to failure percentages for some figures.)
  - johnisgood 2y ago
    I edited my comment.
wonderwonder 2y ago
I have always been amazed at how effective the pull out method was. I had sex for years with my wife and always pulled out. 2x a week for probably 10 years. After we decided to have a kid, she was pregnant in a month. Really incredible how effective such a simple solution is

throwaway743 2y ago

Retrograde ejaculation is a weird thing to experience. It's the physical manifestation of the sound of a slide whistle both ways. Alpha blockers also give one hell of a stuffy nose. Worst sleep ever after taking one.

locusofself 2y ago

Preventing ejaculation sounds awful.

ignoramous 2y ago
As compared to ... unplanned pregnancy?
- Vilian 2y ago
  Not having sex is a great birth control yes, but birth control is for sex to be safe not to remove it entirety
- 486sx33 2y ago
  As compared to, why have sex if you don’t finish ?
  - amanaplanacanal 2y ago
    As they said, it still allows orgasm, but with no ejaculation.
    - kacesensitive 2y ago
      I can't believe I'm typing this on hn and it's not meant to be funny but ...some people like ejaculate
      - johnisgood 2y ago
        Lmao, yeah. I mean it is entirely up to the couples. I personally do not care which method they choose, whatever works for them.
  - mock-possum 2y ago
    You’re really hung up on this aren’t you

Obscurity4340 2y ago

So its like a dry orgasm pill? How is that not huge, does it affect the refractory period?