Ejaculation problems

Understanding premature, delayed and retrograde ejaculation


There are a range of different problems that can affect ejaculation. Premature ejaculation is the most common but delayed and retrograde ejaculation can also occur.

Premature Ejaculation

What is Premature Ejaculation?

Premature ejaculation is a condition in which a man ejaculates within 2 minutes of sex. This is not always an issue for every couple, as some partners may also climax quickly, or couples may be happy to use other methods, such as foreplay or other forms of stimulation, to ensure that both partners are sexually satisfied.

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What causes premature ejaculation?

There are two kinds of premature ejaculation, primary and secondary. Primary premature ejaculating problem begins from teenage years, when the man becomes sexually active. His initial sexual interactions psychologically condition him into finishing quickly, which becomes a lifelong issue later if it goes unnoticed in the beginning. The second kind of premature ejaculation occurs later in life, where external factors such as depression, anxiety and health, and internal health factors such as prostate disease reduce the sexual intercourse length overall.

How can I treat premature ejaculation?

  • Developing Control: When you feel like ejaculating or reaching climax, squeeze the head of the penis or take a pause and breath deeply when you feel you are nearing climax.
  • Masturbation: Masturbation has been known to increase stamina and prolong sexual performance.
  • Distraction: Distract yourself by thinking of non-sexual topics, i.e. mundane tasks, things that annoy you etc.
  • Thicker Condoms: Thicker condoms reduce the sexual sensitivity in the penis. This leads to a slower threshold build-up in the body, delaying climax.
  • Slower Pace: Positions that help you have slower and more gentle sexual intercourse may help men delay orgasm.
  • Medication: Medication and treatments such as EMLA cream, anaesthetic condoms and Priligy are used to improve sexual performance and encourage longer performance. Medications such as Viagra increase blood flow in the penile area and treat men who suffer from erectile dysfunction.
  • Counselling: Since psychological factors such as stress, depression and anxiety can be responsible for premature ejaculation, professional counselling can help improve this condition by treating the underlying psychological causes.

Delayed Ejaculation

What is Delayed Ejaculation?

Delayed ejaculation only affects around 3% of men. There are two types of delayed ejaculation: The first type is almost the opposite of premature ejaculation - it can take a very long time (30-60 mins of sex) for a man to ejaculate. However, in the second type, it can be impossible for a man to ejaculate, even if he has a normal erection.

What Causes Delayed Ejaculation?

Delayed ejaculation can be caused by alcohol or drug abuse, too frequent masturbation, SSRI antidepressants, nerve damage, ageing and psychological factors.

How is Delayed Ejaculation Treated?

If delayed ejaculation is thought to be caused by SSRI antidepressants, an alternative medication may be prescribed. If frequent masturbation is the issue, it may help to reduce the amount you masturbate. If alcohol or drug abuse is a factor, it may be beneficial to stop using these substances. For other causes, counselling or psychological therapies may be the best solution. For some nerve damage, including spinal injuries, an effective treatment may not be possible, but this does not have to prevent you from having an enjoyable sex life. Your doctor or relevant charity representatives may be able to give you advice.

Retrograde Ejaculation

What is Retrograde Ejaculation?

Retrograde ejaculation is the rarest ejaculation problem. In retrograde ejaculation, the sperm are ejaculated into the man’s bladder, instead of out of the end of the penis. This does not cause issues relating to sexual satisfaction, but it can cause issues if the couple are trying to conceive. Symptoms include producing little or no semen and/or producing cloudy urine after sex.

What Causes Retrograde Ejaculation?

Retrograde ejaculation can be caused by several elements, including substance abuse, nerve damage (sometimes related to diabetes), medication side effects and some surgical complications.

How is Retrograde Ejaculation Treated?

As retrograde ejaculation does not cause issues with sexual satisfaction, most people seeking treatment are trying to conceive. Some medications, such as imipramine, may be prescribed to temporarily close the passage connecting to the bladder, forcing the semen out of the end of the penis. If this treatment does not work, other fertility treatments may be able to help you and your partner conceive.

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