Hacker Newsnew | past | comments | ask | show | jobs | submitlogin

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.



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.


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.


> 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.


Relatedly, this is also why the “failure” rate for vasectomy isn’t vanishingly close to 0%: it’s almost all dudes having unprotected sex in the first month or so after the procedure.

Spontaneous reconnection happens but is extremely rare. If you can follow the doctor’s orders for a few weeks, vasectomy’s failure rate may as well be 0%.


What's the mechanism for that? Maybe a few sperm are stuck in the sperm ducts past the point they were severed, but the ducts are cut and sealed, aren't they? Even if they weren't sealed, it would be Russian Roulette trying to get across the gap in what's effectively just body cavity space.

My expectation would be the first sample might have lower but significant sperm count, and each subsequent sample would decrease dramatically until any residual sperm died and the count was zero. You're talking about motility, not count, but it doesn't sound like you noticed a drastic decrease from sample to sample. That doesn't seem right according to my understanding.


Well, to be clear, I didn’t actually count the sperm, as I was more interested in a rough, qualitative (rather than rigorous, quantitative) observation.

That said, yeah, the relative amount of sperm didn’t drop off noticeably at the offset. And I think that kind of makes sense: as someone with a relatively short refractory period, let’s suppose I ejaculate two or three times in 5 minutes: I doubt (though I could be wrong) that my body actually evacuated all of the seminal fluid (and fully replaced it) each time. I would bet there’s simply a bunch “left in the tank”. Would be interesting to hear from a urologist (or someone with similar expertise).


Thank you for sharing this!


> And that's true, anejaculatory orgasms can feel strange or less satisfying for some, but it is not universal.

I would have been ok with less satisfying but it felt horrible, like it was going somewhere else instead of coming out. I wouldn't recommend this to anyone


> Both mice and non-human primates fully regained fertility after stopping the drug. Mice regained fertility within six weeks, and non-human primates fully recovered their sperm count in 10-15 weeks.

Hard pass on messing with my fertility like that, too, TBH.


You realize female birth control drugs have the same lingering effect on fertility too right?


What exactly is your point? I have already stated my preferred methods, none of which involve hormonal birth control pills. Moreover, I have never attempted to persuade or pressure anyone into using such medications.

In relationships, mutual understanding and compromise are essential. I fully acknowledge that certain decisions come with trade-offs. For example, I would not hesitate to take Silodosin and deal with its potential side effects if it benefited the relationship. I would expect the same level of consideration in return (reciprocity), but that does not equate to coercion or irresponsibility.

My position remains unchanged: I would avoid hormonal contraceptives for myself, and I do not advocate their use by others. My preferred approaches are non-hormonal and do not carry such implications (as I have stated in previous comments). That said, I believe that in a committed relationship, some level of shared sacrifice or compromise is not only inevitable, but necessary.

Given that, I fail to see how your point is relevant to the context of our discussion. If your intention was to imply that I expect others to make sacrifices I would not make myself, then I outright reject that assumption. Mutual responsibility, respect, and voluntary compromise are foundational to any relationship I engage in, coercion has no place in it.

If this conversation is shifting from an exchange of ideas to personal insinuations, I see little value in continuing it further.

Thank you. :)


Edit:

"I would avoid hormonal contraceptives" -> "I would avoid hormonal contraceptives and pills affecting fertility in the aforementioned ways".


> clinical trials measured rates as high as 90-99%.

This is in the same range as, like, pulling out, for what it's worth.


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


I haven’t pulled out in 25 years. What’s the point in sex if you can’t keep going to completion?


Completion can mean many different things for different people.


What's the point? Well, the other 99% of the experience and all its pleasure, intimacy and sensation adds up to a lot more than those few seconds of ejaculation.


Not sure what you mean. It is to completion, you pull out right before completion and finish immediately outside. It’s all about timing.

Apologies for tmi


Yeah same experience as that, and being a bit more careful around fertile times of her cycle.

Was completely effective for us.


To be fair, I think most normal people in a relationship use this method, but if you tell people on the Internet about it, they get upset for some reason.


Most normal people? The implied judgement aside, that is wildly untrue. Most people (80+ % who are not trying for a child) use birth control, this is an easy stat to look up. Maybe people “get upset” because you’re making things up?


I'm not saying it's a very common method (maybe, maybe not), but cycle timing is often included in "birth control" stats and used as a secondary measure with other forms of birth control.


You can just look up these numbers, of various forms of birth control. That exclude cycle timing.

And none of them say it’s “most people”. Perhaps some unmeasured population uses it as a secondary method, that’s total speculation and kind of beside the point


Are we (or the grandparent) talking most people at one point in time, or most people at any time during their life? If it's the latter, then I do think it's a valid claim, but I haven't seen any stats that cover those sorts of numbers. Eg have more than 50% of people in a committed relationship never used the timing method? Most of the couples I am good friends with have used the cycle timing method when they want another kid, want to delay it, but are open to having one sooner. This is also commonly combined with secondary measures, such as condoms, pulling out, or even abstinence during the fertile window (why measure cycle timing if you're not changing your behavior, using another method, based on the observation).


The 80% using contraceptive methods stat includes pulling out as a contraceptive method.


no, this doesn’t seem to be the case. more than 80% of those avoiding pregnancy use condoms, pill, tied tubes, vasectomy, iud, etc… this 80% does not include withdrawal. [0]

5.8% rely on withdrawal.

[0] https://www.guttmacher.org/fact-sheet/contraceptive-method-u...


The 80% claim must include withdrawal, because their claim is that the population not using any method has only a 15% non-pregnancy rate within a year. But withdrawal has a much higher 80-96% rate of non-pregnancy within a year.

https://www.guttmacher.org/fact-sheet/contraceptive-use-unit...

> Sexually active couples who do not use any method of contraception have approximately an 85% chance of experiencing a pregnancy over the course of a year.

Therefore, withdrawal is a method of contraception.


the 80% does not include withdrawal. the numbers are here [0].

80+% rely on things like pill, condom, tied tubes, etc...:

23.9: tube ligation/implants

16.4: pill

13.2: condom

12.0: iud

8.50: vasectomy

2.6: implant

2.1: injectable

1.2: vaginal ring

.4: patch

80.3% rely on the contraceptions listed above.

The remaining rely on: withdrawal, emergency contraception, family planning, etc...:

5.8%: withdrawal

2.6%: family planning

0.2%: emergency contraception

0.2%: other

11%: no method

the 80% does not include withdrawal.

[0] https://www.guttmacher.org/fact-sheet/contraceptive-method-u...


To be fair, that isn’t correct at all.

i could be misinterpreting what you mean by “most normal people” but it’s a wildly strange use, most people who aren’t seeking pregnancy use some form of contraceptive [0], the pill, condoms, etc… it’s almost 90% of sexually active and its been this steady since 2002.

> … who were not seeking pregnancy, 88% were using a contraceptive method in 2016, and this proportion has remained steady since 2002.

it seems most normal people are using contraceptives.

> …they get upset for some reason

im sure very few people are “upset” about this. are you misinterpreting someone correcting your overestimations as if they’re being upset?

[0] https://www.guttmacher.org/fact-sheet/contraceptive-use-unit...


Pulling out counts as a contraceptive method for that stat.


oh, indeed, thanks. only like 5.8%. and only 2.6 rely on family planning. more than 80% are using pills, condoms, iud, vasectomy, etc.

again, “most normal people” are not relying on pulling out. most people, by a significant amount, are relying on other methods.


Couples using this method tend to be mostly fine with any "failure". They might want a child but not now, or are not completely sure but would do their best if it happens.

Couples who clearly don't want children typically have already discussed their stance in the couple and will be way more thorough about birth control. That's typically not the demographic that will YOLO it, so I guess you'd get much more pushback on that front ?


I agree and want to add that the scenarios you point out could also be for a single couple at different points in time. Risk tolerance changes over time with different circumstances.


What? This is the definition of anecdotal evidence. It’s not very effective at all in practice, statistically.

> For every 100 people who use the pull out method perfectly, 4 will get pregnant.

> But pulling out can be difficult to do perfectly. So in real life, about 22 out of 100 people who use withdrawal get pregnant every year — that’s about 1 in 5.

https://www.plannedparenthood.org/learn/birth-control/withdr...

These are not hard stats to look up.


> For every 100 people who use the pull out method perfectly, 4 will get pregnant.

Are those 4-in-100 distributed randomly?

Did the pregnancies result despite 100% adherence to the method, or was there occasional failure to adhere?

There's a big difference between a method being ineffective from the perspective of a health care provider, and a method being ineffective in absolute terms.

A provider has to care about what broad cross sections of people will actually do, rather than what they say they will do.

If you're an individual person who knows they can adhere to the method perfectly, the fact people on average cannot or will not adhere perfectly has no particular relevance to you.

I have no horse in this race, but the same difference in the meaning of "efficacy" arises in all sorts of aspects of health care, like advice on diet and exercise, or the prescription of specific exercises for physical therapy.


I’m sure the majority of individuals practicing think they can be/are perfect adherents. Statistically they are wrong.


some are likely correct, however


The stats are not hard to look up, but they do seem somewhat hard to gather. The site you linked doesn't reference a study, but I imagine that asking a bunch of people if they pulled out "perfectly", even for quite stringent definitions of "perfectly" will result in quite a lot of variance.

I'm not trying to no-true-Scotsman birth control methods, just pointing out that it's hard to draw meaningful conclusions when all you have is people's word.


So, it can be very effective but a whole lot of people apply it terribly and stupidly.


Everyone assumes they’re the smart one applying it “right”. Statistically they’re not.


96% efficacy is pretty good; more or less on par with condoms.


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.


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.)


I edited my comment.


Yea similar with tracking ovulation dates. Seems like pretty bad EV for messing with my nervous system.


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.


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


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.


I wonder if this leads to higher risk of prostate cancer, as an inverse to studies on relatively frequent ejaculation lowering prostate cancer risk.


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.


What do you think happens with a vasectomy? It gets reabsorbed.


With a vasectomy, you still ejaculate. Most of the fluid in an ejaculation comes from the prostate, which isn't affected by severing the vas deferens


Hmm, I wonder if it's really unaffected. Have they found a mechanism for the small but statistically significant increase in prostate cancer rates related to vasectomy?


Vasectomies don't prevent ejaculation. The semen is just sperm-free (after a brief period of time).


Preventing ejaculation sounds awful.


As compared to ... unplanned pregnancy?


As compared to, why have sex if you don’t finish ?


As they said, it still allows orgasm, but with no ejaculation.


I can't believe I'm typing this on hn and it's not meant to be funny but ...some people like ejaculate


Lmao, yeah. I mean it is entirely up to the couples. I personally do not care which method they choose, whatever works for them.


You’re really hung up on this aren’t you


Not having sex is a great birth control yes, but birth control is for sex to be safe not to remove it entirety


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


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.


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.


It's funny that residual contamination, in the right context, might lead to the world's best magic - life.


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.)


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.


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


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.


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.


We're basically there with VR porn and ever more realistic toys.


Not parent but made a comment to parent, and damn, completely forgot about that! You are right.




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: