DELAYED EJACULATION

What is delayed ejaculation?

Delayed ejaculation is the inability to ejaculate at will, so that ejaculation takes much longer than desired, or does not happen at all. This might happen only with intercourse, or in all situations including self-stimulation (masturbation).

Causes

Diabetes, spinal cord injury, pelvic injury, side-effect of certain medications, relationship trouble, <

Management

Underlying medical condition has to be appropriately managed. There are some specific techniques for spinal cord injured patients. Men who are concerned about being unable to ejaculate when there is no medical reason for this difficulty may need long-term individual counselling.

ANEJACULATION

What is anejaculation?

Anejaculation is when a man does not ejaculate after orgasm.

Causes

The main causes of anejaculation are: Pelvic surgery, prostatitis, certain medical and surgical conditions

Management

Treatment of the underlying medical or surgical condition. Otherwise, when fertility is not an issue, no medical treatment is needed. Men who are concerned by not being able to ejaculate may benefit from counselling to discuss their concerns.

Can men with anejaculation still have children?

Men with anejaculation can still have children using assisted reproductive technologies.

How can anejaculation affect a man’s life?

Anejaculation can cause distress, especially when the man doesn’t understand what is happening. Discussing his feelings with a doctor or psychosexual therapist may help him come to terms with having an orgasm without ejaculation and accepting that this is normal for him.

Why is anejaculation a problem for some men?

Men with anejaculation usually have an orgasm that feels normal, but in some men this feeling is reduced. Infertility can also be an issue because there is no ejaculation. However, these men do produce sperm. Using assisted reproductive technologies, sperm can be collected for use in IVF treatments to achieve pregnancy.

RETROGRADE EJACULATION

What is retrograde ejaculation

During normal ejaculation, semen is propelled forward through the urethra and out the tip of the penis. In men with retrograde ejaculation, the muscle at the opening of the bladder, which usually stops semen from entering the bladder during orgasm, does not close normally. This allows semen to flow back into the bladder.  Therefore little or no semen is discharged from the penis during ejaculation, and the first urination after sex looks cloudy as the semen mixes into the urine. This uncommon condition is harmless.

Causes

After surgery to the prostate or bladder neck.  Diabetes, multiple sclerosis, spinal cord injury, and some medications, in particular drugs to treat blood pressure can also cause it. It may be a temporary or permanent condition.

Management

Most men who have retrograde ejaculation do not need treatment. The important message is that it is not a sign of serious illness. Men wishing to have a family may need to see a fertility specialist for assisted reproductive techniques if the cause of the problem is not reversible.

PAINFUL EJACULATION

What is painful ejaculation?

Painful ejaculation is when painful, burning sensations are felt during or following ejaculation. Pain can be felt in the perineum (the area between the anus and the genitals) and the urethra (a tube that runs from the bladder to the end of the penis). The condition can cause discomfort in the testes and interfere with sexual pleasure.

Causes

Inflammation of urethra or prostate, sexually transmissible infections, nerve damage to the penis, blockage in the ejaculatory duct and psychological problems.

Management

A doctor should investigate all causes of painful ejaculation and the best treatment must be given. If no physical cause is found, some behavioural techniques to relax the muscles in the pelvic area may help some men. If the cause is psychological, counselling may help deal with any underlying concerns.

How can painful ejaculation affect quality of life?

Painful ejaculation is not life threatening, but may affect sexual pleasure and can cause a man distress, anxiety and lower self esteem. If a man is in a relationship, both the man and his partner may be affected by his experience of painful ejaculation.