Ejaculation Problems

There are 3 main types of ejaculation problems:

  • Premature ejaculation.
  • Delayed ejaculation.
  • Retrograde ejaculation.


Premature ejaculation
Premature ejaculation is when a man reaches orgasm too early, and can lead to significant distress and avoidance of sexual intimacy in some instances. It can occur at any age across a man's lifespan. To date, the efficacy of both medical (e.g. local anaesthetic gels, antidepressants) and psychosexual therapy are still being investigated, yet preliminary results show that premature ejaculation can be treated with some success.

Delayed ejaculation
Delayed ejaculation occurs when a person typical male characteristics male requires longer sexual stimulation (between 30-60 minutes) to reach orgasm and ejaculate. One may not ejaculate at all.

Causes of delayed ejaculation:

  • Psychological trauma.
  • Diabetes mellitus (usually type 1).
  • Spinal cord injuries.
  • Multiple sclerosis.
  • Surgery to the bladder or prostate gland.
  • Increasing age.
  • Treatment (such as antidepressants, antipsychotics, muscle relaxants, high-blood pressure medicines, and methadone).


Retrograde ejaculation
Retrograde ejaculation is when the semen travels backwards into the bladder instead of through the urethra. It is very rare. This may affect fertility.

Symptoms:

  • No semen production or small amount during ejaculation.
  • Cloudy urine due to seminal fluid mixed with urine when you first go to the toilet after having sex.


Causes of retrograde ejaculation:

  • Damage to the nerves or muscles that surround the neck of the bladder.
  • Cancer.
  • Prostate gland surgery.
  • Diabetes mellitus.
  • Multiple Sclerosis.
  • High blood pressure treatment.


Treatment
Treatment for ejaculation problems may vary, depending on the underlying cause. Treatment might include:

  • Changing medications you are currently on.
  • Stopping or reducing the use of alcohol or drugs.
  • Psychological counselling for trauma.

Speak to your medical practitioner for guidance and support.