Ejaculation provides an essential function in conception by expelling semen through the urethra and out of the penis. A variety of physical and psychological factors can impact ejaculation, but fortunately ejaculation disorders are often treatable.
Types of Ejaculation Disorders
There are four types of ejaculation disorders:
- Premature ejaculation
- Delayed ejaculation
- Retrograde ejaculation
What is Premature Ejaculation?
Premature ejaculation is when a man ejaculates or climaxes sooner than wanted. It occurs in about one-third of men and it is the most common type of ejaculatory dysfunction (75% of ejaculation disorder cases).
Premature Ejaculation Causes
Causes of premature ejaculation include:
- Psychological factors, such as anxiety or depression
- Heightened sensitivity
Premature Ejaculation Treatment
Premature ejaculation can be treated in a variety of ways, including medications, physical therapy, psychological counseling, and/or behavior modifications. Oral medications are often effective in delaying ejaculation. There are also relaxation techniques and methods that can help prolong or delay ejaculation. Of the four types of ejaculation disorders, premature ejaculation is most easily treated.
What is Delayed Ejaculation?
Delayed ejaculation is when it takes a prolonged period of time to ejaculate after sexual stimulation. A man with delayed ejaculation might notice that his urine is cloudy after having an organism. Delayed ejaculation can be a lifelong problem, or it may occur on occasion or only in certain situations.
Delayed Ejaculation Causes
Delayed ejaculation is caused by a number of physical and psychological factors, as well as the use of certain medications, such as antidepressants, antipsychotics, diuretics, and medications for seizures and high blood pressure.
Additional causes of delayed ejaculation include:
- Hormone issues
- Birth defects
- Prostate surgery
- Neurological disorders
Delayed Ejaculation Treatment
The type of treatment prescribed is dependent on the cause of the delayed ejaculation. Counseling can be effective in addressing psychological causes of delayed ejaculation and there are also medications that can also be used to treat delayed ejaculation.
What is Retrograde Ejaculation?
During ejaculation, there are muscles near the neck of the bladder that prevent the ejaculate from entering the bladder. In some instances, the muscles do not contract properly, which causes some or all of the ejaculate to be discharged into the bladder instead of the penis. This condition is known as retrograde ejaculation. While retrograde ejaculation isn’t harmful, it can impact fertility.
Retrograde Ejaculation Causes
Retrograde ejaculation can be caused by nerve damage from a medical condition, such as diabetes, surgery, as well as certain medications.
Retrograde Ejaculation Treatment
It isn’t necessary to treat retrograde ejaculation unless it is causing infertility and the goal is to achieve pregnancy. Retrograde ejaculation occurs in less than 2% of cases of infertility. Discontinuing use of medications that is causing the retrograde ejaculation is one form of treatment. There are also certain medications that can help the bladder neck muscle remain closed during ejaculation.
For couples struggling with infertility due to retrograde ejaculation, fertility treatments, such as intrauterine insemination (IUI) or in vitro fertilization (IVF) can be very effective in helping to achieve pregnancy.
What is Anejaculation?
Anejaculation is the inability for a man to ejaculate. Anejaculation may either be situational in which the man can’t ejaculate in certain situations or with certain people, or he is unable to ejaculate in any situation.
Anejaculation is caused by a variety of factors, including as a reaction to certain medications or surgical procedures, injuries to nervous system, as well as an infection in the prostate. Anejaculation can also be caused by stress or psychological factors.
For anejaculation caused by stress, the most common treatment is psychological counseling/therapy to address underlying causes. Treatment of anejaculation for infertility includes sperm retrieval and IUI or IVF. For men experiencing anejaculation as a result of spinal cord injury, a therapy known as penile vibratory stimulation can help the man to ejaculate.
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