PEVR: How It Relates to ED and How to Recover Your Confidence

Perceived ejaculate volume reduction (PEVR) is a condition in which a man appears to ejaculate less semen, whether suddenly or over an observable period of time. This can be a distressing source of sexual frustration and may also be a sign of low testosterone production. Scientists are now beginning to establish a link between erectile dysfunction (ED) and PEVR, with many men experiencing both sexual disorders simultaneously.

As the name suggests, perceived ejaculate volume reduction is often a subjective experience, so treatment may not always be strictly medical. Sex therapy and making alterations to intimate connections can be useful tools in offsetting the emotional barriers created by PEVR.

The PEVR link to ED

A 2015 study by the International Society for Sexual Medicine focused on a group of 988 men who were being screened for potential testosterone therapy.

While many of the involved men were identified as having at least one ejaculatory disorder, 88 percent of the participants reported experiencing PEVR specifically. Though the connection isn’t well understood, it seems that low levels of testosterone can cause both ED and perceived ejaculate volume reduction. Both sexual disorders have psychological symptoms and effects that range beyond limiting physical intimacy.

In fact, a diagnosis of one of these conditions is often followed by a diagnosis of the other.

How sex therapy can help

Anxiety about sexual performance can increase the physical effects of sexual conditions such as PEVR.

Research indicates that negative thoughts work together with the disorder to lower a man’s desire for sex and his ability to produce semen during climax. Counteracting this cycle with sex therapy can assist in bringing satisfaction back to intimate relationships. Seeing a sex therapist isn’t a last resort but instead represents a proactive step toward keeping relationships strong and self-confidence high.

Therapists can also provide resources for dealing with the anger, frustration and depressive thoughts that are triggered by sexual disorders. Communication strategies, assistance in planning intimacy, or "homework" in the form of books or videos about sexual wellness may be part of the process. As the field of sex therapy continues to grow—and the scope of this important role becomes better understood—more inclusive treatment options are becoming viable.

Video appointments, which allow many people to get treatment from home, are also becoming a large part of the therapy process.

Consider spicing things up

Sometimes, improving a person’s sex drive can be given a jump-start with the addition of novelty. If your sexual experience has become routine, maybe it’s time to rethink how you and your partner are approaching intimacy.

Although it might sound counterintuitive, scheduling sex can build a sense of longing for initmacy, especially during those hectic weeks when both partners need to look forward to something exciting. If that sounds too mundane, make vacation plans, light candles, scatter rose petals—use your imagination and have fun.

Additionally, remembering to remain mentally present and open to your sexual experience may alleviate some of your symptoms. Regular, satisfying sex can work wonders in relationships, so finding ways to talk through the roadblocks created by PEVR will always be beneficial in the long run.

Perceived ejaculate volume reduction is a complex disorder with many factors involved, and contemporary studies suggest a link to ED. Men who deal with this condition may experience negative thoughts and anxiety about themselves and their sexual performance, which might increase the severity of PEVR.

Men who are living with PEVR should consider sex therapy as an ally to help combat these feelings. In addition, changing up intimacy habits may create new dynamics that improve performance, sexual satisfaction and confidence for men with perceived ejaculate volume reduction and their loved ones.