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Ejaculation problems - Introduction

NHS Choices Medical Reference

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Ejaculation problems, such as premature ejaculation, are a common cause of sexual problems in men.

There are three main types of ejaculation problems:

  • premature ejaculation
  • retarded ejaculation
  • retrograde ejaculation

These are described in more detail below.

Premature ejaculation

Premature ejaculation is the most common ejaculation problem. It is where the male ejaculates too quickly during sexual intercourse.

Many men are unsure about how long 'normal' sex should last before ejaculation. A study looking at 500 couples from five different countries found the average time between a man putting his penis into his partner's vagina and ejaculation was around five-and-a-half minutes.

However, it is up to the individual and his partner to decide whether or not they are happy with the time it takes for him to ejaculate.

Regularly ejaculating before or within one minute of entering your partner's vagina would usually be regarded as a medical problem that requires treatment.

Retarded ejaculation

Retarded ejaculation is a delay in achieving ejaculation, or an inability to achieve ejaculation during sexual activity, even though the male wants to and his erection is normal.

Retarded ejaculation is sometimes known as delayed ejaculation or male orgasmic disorder.

Retrograde ejaculation

Retrograde ejaculation is a rarer type of ejaculation problem. It happens when sperm travels backwards and enters the bladder instead of coming out of the end of the urethra (the tube that passes from the bladder, through the penis and through which urine passes).

Retrograde ejaculation patients experience the feeling of an orgasm, but produce no, or very little, semen. The condition does not pose a danger to health, but can affect the ability to father a child (infertility).

Read more about the different types of ejaculation problems and their symptoms.

Treating ejaculation problems

Premature ejaculation can be treated with medication, such as the selective serotonin reuptake inhibitors (SSRIs) type of antidepressant which can also help delay ejaculating.

Couples therapy can be useful in coming up with techniques for partners to practice to help delay ejaculation.

Recommended treatments for retarded ejaculation depend on the underlying cause. If it is thought to be a side effect of medication, switching to an alternative medication will help. However, if the cause is thought to be psychological, counselling may be recommended.

Most men do not require treatment for retrograde ejaculation because they are still able to enjoy a healthy sex life and the condition does not affect their health. Although there is medication that helps restore normal ejaculation in some cases.

However, if you want to have children, you may need fertility treatment to extract a sample of sperm.

Read more about treating ejaculation problems.

What causes ejaculation problems?

Ejaculation problems are complex and can be caused by a number of things, such as:

  • stress
  • relationship problems
  • anxiety; such as a man being anxious that he will lose his erection (erectile dysfunction) causing him to 'rush' the intercourse
  • previous traumatic sexual experiences
  • depression
  • some medical conditions or medicines - for example diabetes can cause delayed ejaculation

Some researchers think certain men are more prone to premature ejaculation because of their biological make-up, such as having an unusually sensitive penis.

Retrograde ejaculation is caused by damage to nerves or muscles that surround the neck of the bladder (the point where the urethra connects to the bladder). This damage can often occur as a complication of prostate or bladder surgery.

Read more about the causes of ejaculation problems.

Who is affected

Premature ejaculation is the most common type of ejaculation problem.

A number of surveys have found around 1 in 3 men reported being affected by premature ejaculation. The true figure is probably much higher as many men are reluctant to admit they have this problem.

While less common, retarded ejaculation is probably more of a problem then most people realise. One study found around 1 in 20 people had problems achieving an orgasm over the course of a month during the past year.

Although retrograde ejaculation is rare, it can be a common complication of some types of surgery, such as prostate surgery, or in men with certain health conditions that can damage the nerves, such as diabetes or multiple sclerosis.

Medical Review: March 31, 2012
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