A Guide to ejaculatory disorders
Ejaculation – scientifically defined as the release of sperm cells and seminal plasma from the male reproductive system is simultaneously a significant step towards ultimate sexual bliss for a penis owner. It occurs in 2 phases : in the initial(emission)stage, sperms are moved from the epididymis to the beginning of the urethra and in the final stage(ejaculation proper), the semen is moved through the urethra and expelled from the body. Studies reflect ejaculation to be an important metric of pleasure which determines your partner’s psychological and sexual satisfaction. Phrases like “cannot last long in bed” socially stigmatise complex sexual issues and categorically links sexual capability to male ego which leads to mistreatment, avoidance and neglect of glaring sexual problems. Therefore, ejaculatory complications and their corresponding corrective measures deserve greater awareness and attention.
3 Major Ejaculatory disorders and their causes
The 3 prominent categories of problems regarding ejaculation latency are :-
1)Premature Ejaculation – It is the most frequent and familiar ejaculatory disorder due to which the male ejaculates extremely quick during sexual intercourse. Intravenous ejaculation latency time can vary from individual to individual but a study surveying 500 couples from 5 countries concluded the average time taken to ejaculate during interourse to be around 5-5.5 minutes. If the time taken to ejaculate is around 1-2 mins, it is considered to be premature ejaculation. Various psychological as well as physical factors can cause premature ejaculation. Common physical causes include :-
- Prostate problems
- Thyroid problems – an overactive or underactive thyroid gland
- Usage of recreational drugs
Common psychological causes include :
- Depression, stress
- Relationship problems
- Anxiety regarding sexual performance
Continued premature ejaculation since becoming sexually active is possible but less common but can be attributed to numerous causes :-
- Conditioning – early sexual experiences can influence sexual behaviour. Forced early ejaculation can lead to a habit of premature ejaculation.
- Traumatic childhood sexual experience
- Strict upbringing and pre-conditioned beliefs about sex
- Extra sensitive penis can also pose as a cause
2) Delayed Ejaculation – Also known as male orgasmic disorder, it is classified as either :-
- experiencing a significant delay before ejaculation
- Being unable to ejaculate at all, even though the penis owner is willing and there is no abnormalcy with the erection.
Symptoms to recognise delayed ejaculation can consist of :-
- Experiencing repeated and undesired delay before ejaculation lasting for 30-60 minutes
- Inability to ejaculate at least half of the times during sexual intercourse.
Potential causes for delayed ejaculation can include :-
- Physical causes :-
- diabetes(usually only Type 1 diabetes)
- Spinal cord injuries
- Multiple sclerosis
- Surgery to the bladder or prostate gland
2. Some medicines are known to cause delayed ejaculation :-
- Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs)
- Medicines to treat high blood pressure(beta-blockers)
- Muscle relaxants(Baclofen widely used to treat motor neurone and multiple sclerosis)
- Powerful painkillers(methadone used to treat heroin addicts)
Psychological causes are similar to that of premature ejaculation.
3)Retrograde ejaculation – It happens due to semen travelling backwards into the bladder instead of moving forward through the urethra. The prominent symptoms of retrograde ejaculation are :-
- Producing no semen or only a small amount during ejaculation
- Producing cloudy urine containing semen when urinating after sex
Retrograde ejaculation does not pose any health threats but it can affect male reproductive ability. Common causes of retrograde ejaculation can be:-
- Damage to nerves or muscles surrounding the point where the urethra connects to the bladder
- Prostate gland surgery/bladder surgery
- Diabetes, multiple sclerosis, alpha blockers(medicines used to treat hypertension)
Methods of treating the aforementioned ejaculatory problems :-
Premature ejaculation –
Self – treatment before consulting medics –
- Use a thick condom to decrease sensation
- Take a deep breath to briefly shut down the ejaculatory reflex
Couples therapy –
- Therapist encourages couples to explore relationship issues, if any
- Squeeze technique – your partner makes use of the edging technique while masturbating you and squeezes the penis for 10 – 20 secs in between and repeats the process several times before ejaculation is allowed to occur
- Stop-Go technique – it is similar to the squeeze technique but penis is not squeezed
- Antidepressants (SSRIs) have an effect of delaying ejaculation but they have mild side effects which usually tend to improve after 2-3 weeks. Dapoxetine is a SSRI specifically designed to treat premature ejaculation and has been licensed in the UK.
- Phosphodiesterase-5 inhibitors – medicines used to treat erectile dysfunction but also helps with premature ejaculation.
Delayed ejaculation –
- Sex Therapy – a form of counselling that uses a combination of psychotherapy and structured changes in sex life which can make ejaculation easier
- Switching medicine – advised for delayed ejaculation caused by SSRIs
- Reducing alcohol or drug abuse
Retrograde ejaculation –
- Pseudoepherine(commonly used as a decongestant) can be effective in treating retrograde ejaculation caused by diabetes or surgery.
- Retrograde ejaculation caused by significant muscle or nerve damage might be untreatable. Artificial insemination or in-vitro fertilizations(IVF) are viable alternatives for men who want to reproduce.
Problems related to ejaculation, an indispensable part of both male and female sexual pleasure should not be neglected and any discomfort should receive reliable medical care without delay. The perception of ejaculation as a parameter of male ego is a patriarchal myth. Penis owners must be provided with a comfortable space to speak about their problems without social stigmatisation. Ejaculatory disorders can be of various types and if there are psychological causes, communication with your partner and therapeutic treatment are essential because ejaculation is an essential for healthy conjugal relationships.
Cover Illustration: Promescent