Ejaculation Disorders

Ejaculation disorders

Ejaculation disorders are common sexual problems in men - There are 3 main types:

• Premature ejaculation (reaching orgasm and ejaculating too quickly)
• Delayed or inhibited ejaculation (reaching orgasm too slowly or not at all)
• Retrograde ejaculation (dry ejaculation)

These conditions can cause sexual dissatisfaction and relationship difficulties for many couples. At London Men's Clinic, our team of experienced consultants will provide you with quality care and support until your sexual health is at its best. If you think that you have one of these conditions and are looking for treatment, you can call to schedule an appointment with one of our expert team.

Premature ejaculation

Premature ejaculation is when a man ejaculates too early during sexual activity and can be frustrating and bothersome to both him and his partner. Some men have difficulty controlling their orgasm from the moment they start sexual activity.

At London Men's Clinic we do not base our diagnosis of premature ejaculation on how long a man can last before ejaculating. The important factor we take into consideration is whether a man and his partner are satisfied with how long sexual activity lasts.

The exact cause of Premature ejaculation is not known. While in many cases Premature ejaculation is due to performance anxiety during sex, other factors may be:

• Stress related/psychological
• Temporary depression
• History of sexual repression
• Low self-confidence
• Lack of communication or unresolved conflict with partner

There are a number of psychological, behavioural, and physical therapies that can be used to delay the ejaculation. One way is to learn how to identify and control the sensations leading up to an orgasm. The treatments that we can help you with at London Men's Clinic would be the following:

• Masters and Johnson method - this method will help you learn how to identify and regain control over your point of climax.
• Stop-Squeeze technique- The “squeeze” forces blood out of the penis and reduces the erection.
• Psychosexual counselling – At London Men's Clinic we have a dedicated psychosexual counsellor as part of the team
• Topical anaesthetics (desensitisation) e.g. gels, creams, sprays
• Medications e.g. antidepressants (SSRIs), Tramadol

Delayed or Inhibited ejaculation

Men who experience delayed ejaculation, typically take a very long time to ejaculate (30 to 45 minutes) or never ejaculate at all (anejaculation).

Physical causes include chronic (long-term) health problems, hormonal abnormalities, diabetes, neurological diseases, spinal cord injury medication side effects, alcohol abuse, abdominal or pelvic surgeries (e.g. retroperitoneal lymph node dissection, radical prostatectomy), congenital abnormalities. The disorder can also be caused by psychological factors such as depression, anxiety, stress or relationship problems.

At London Men's Clinic, the treatments that we recommend vary depending on the situation and cause. Some useful treatments include:

• Psychosexual counselling - At London Men's Clinic we have a dedicated psychosexual counsellor as part of the team
• Stopping certain kinds of medications
• Using devices like high-speed vibrators

Side effects of delayed ejaculation include sexual dissatisfaction, inhibited sexual desire, relationship breakdown and difficulty conceiving.

Retrograde ejaculation

This is when ejaculation occurs, but the semen goes backward (retrograde) into the bladder instead of coming out of the tip of the penis. The ejaculate typically comes out later with the urine. The classic sign of this condition is when very little or no fluid comes out of the penis during orgasm.

Retrograde ejaculation is most commonly seen in men with diabetes who suffer from diabetic nerve damage. In other cases, retrograde ejaculation may be a side effect of some medications, due to spinal cord injuries or happen after an operation on the bladder neck, prostate or surgery on lymph nodes in the abdomen.

A urine test soon after ejaculation can help diagnose retrograde ejaculation. If retrograde ejaculation is the concern, a large amount of sperm will be seen in the urine.

Stopping the contributing medications will regain your normal sexual function. However, it can be difficult to treat retrograde ejaculation, if it is caused by surgery or diabetes, but there are medications that may be successful.

There is typically no need to treat this type of ejaculatory disorder unless you are trying to conceive or do not like how it feels. For men who are trying to have a baby, semen can be collected from your post ejaculate urine and used for Assisted Reproductive Techniques (ART) such as In Vitro Fertilization (IVF).