Overcoming problems with ejaculation

Overcoming problems with ejaculation

For a man, being able to ejaculate with no problems at the moment of pure pleasure is often considered a given.  But, that is not always the case for some men.  When it comes to ejaculation, there are basically three different things that can go wrong:

1.  Premature ejaculation

This tends to be the main concern and complaint men have about their sexual performance.  Reportedly, premature ejaculation (PE) affects an estimated 30 percent of men who say they come too quickly.  However, there are many jokes ridiculing men who experience PE which often moves them to suffer in silence.  Not only do they not speak up and address it with their doctor but they may even keep it secret from their partner.  While untreated PE is not associated with any long-term problems, it is associated with an increase in stress, anxiety, and relationship problems. 

Treating PE

For many men, bringing up premature ejaculation with their doctor can be embarrassing and yet it needs to be addressed as it is a common and treatable condition. There are several methods of treating premature ejaculation and with a little time and effort, it can be remedied.

One way is with behavioral techniques.  Masturbating for an hour or two before intercourse to be able to delay ejaculation during sex can help. Another technique is to avoid intercourse for a few days and instead focus on sexual play where there is no pressure to have sexual intercourse.

There are topical anesthetic creams and sprays with a numbing agent that can be applied to the penis right before sex to reduce sensation helping to delay ejaculation. There can be potential side effects from this of decreased sexual pleasure for both the man and woman.

Certain oral medications are another way to possibly treat premature ejaculation.  Some of the medications possibly helping include common antidepressants, analgesics, and phosphodiesterase-5 inhibitors – none of which are specifically approved by the Food and Drug Administration to treat premature ejaculation but have been found to be effective for some men.  Discuss with your doctor to see if these options would be suitable or not.

Another technique to try is called the squeeze-pause method credited to Masters and Johnson, highly renowned sex therapists who pioneered research in sex and sexual dysfunction in humans from 1957 to the 1990’s.  By practicing this method, a man can train his body to delay orgasm longer avoiding premature ejaculation. 

The sooner a man addresses any issues he may be having with premature ejaculation, the sooner he and his partner can begin having a more pleasurable and satisfying sex life. 

2.  Delayed ejaculation

Also known as impaired ejaculation, delayed ejaculation affects a much smaller percentage of men – as few as only 3% according to some estimates.  It is one of the most poorly understood ejaculation problem with some men not being able to reach orgasm at all, even with a partner. 

Treating delayed ejaculation

Treatment for delayed ejaculation depends on the underlying cause. It is advised to start with a urologist to determine if the cause is due to a psychological or a physical reason. 

If it is determined that the problem is due to taking a medication, reducing the dose or switching medications may solve the problem.  Sometimes, adding a medication may help. 

If the cause involves a psychological reason, then a man should be sent to a therapist who specializes in ejaculation problems.  This type of therapy is known as sex therapy and should involve both partners.  The therapist’s job will be to help the couple learn how to communicate and guide each other in providing the right stimulation.  Usually the outlook or prognosis of using a sex therapist is about a 70-80% success rate.

What will help increase the likelihood of successful treatment and a better outcome is if:

·      The man has not had the problem for a long time

·      He still has feelings of sexual desire, love and attraction for his partner

·      He is motivated to get treated

·      He does not have a serious psychological problems

3.   Retrograde ejaculation

Of all ejaculation problems, retrograde ejaculation is the least common men will experience.  Retrograde ejaculation is when semen backs up into the bladder during orgasm instead of exiting by way of the penis.  The semen is later flushed out when a man urinates.  It can be caused by diabetes, nerve damage, various medications, and surgery disturbing the sphincter muscle.  It is considered harmless and does not interfere with the pleasurable feeling of orgasm.

Treating retrograde ejaculation

Often no treatment is necessary since there is no harm.  For men who want to father children, there are some options such as changes in medications or to be prescribed medications to improve muscle tone in the bladder neck.  The important thing for any man who is experiencing a noticeable change in his ejaculate amount and suspects it might be retrograde ejaculation, is to see a urologist who will ask questions about symptoms, conduct a physical exam and will assess urine for the presence of semen after an orgasm.  Depending on what the cause is determined to be, will determine if or any treatment is required.