Understanding and Managing Ejaculation Problems

A Comprehensive Guide to Male Sexual Health

Family Medicine

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Last updated: Mar 24, 2025

Overview

Ejaculation problems are common conditions that can affect men's sexual health and well-being. The three main types are:

  • Premature ejaculation (PE)
  • Delayed ejaculation
  • Retrograde ejaculation

Common Types of Ejaculation Problems

Premature Ejaculation

  • Occurs when ejaculation happens sooner than desired
  • Usually within 1-3 minutes of sexual activity
  • Most common ejaculation problem
  • Can cause significant distress

Delayed Ejaculation

  • Difficulty reaching orgasm
  • Takes an unusually long time to ejaculate
  • May be unable to ejaculate at all
  • Can occur in specific situations or all the time

Retrograde Ejaculation

  • Semen enters bladder instead of exiting through penis
  • Results in little or no visible ejaculate
  • Often caused by surgery or certain medications

Common Causes

Physical Causes

  • Hormonal imbalances
  • Neurological conditions
  • Prostate problems
  • Medications
  • Diabetes

Psychological Causes

  • Stress and anxiety
  • Depression
  • Relationship issues
  • Past traumatic experiences
  • Performance anxiety

Treatment Options

Medical Treatments

  • Medications (SSRIs, topical anesthetics)
  • Hormone therapy when appropriate
  • Treatment of underlying conditions

Behavioral Techniques

  • Start-stop technique
  • Squeeze technique
  • Pelvic floor exercises
  • Masturbation training

Psychological Support

  • Counseling
  • Sex therapy
  • Couples therapy

When to Seek Help

  • If the problem persists for several months
  • If it causes distress or relationship problems
  • If it occurs with other symptoms
  • If it starts suddenly

Prevention Tips

  • Maintain good overall health
  • Practice stress management
  • Communicate openly with partners
  • Maintain a healthy lifestyle

Outlook

Most ejaculation problems can be successfully treated with appropriate medical care and support. Early intervention typically leads to better outcomes.

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