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Ejaculation Problems

Premature Ejaculation is the most common ejaculation problems. It is a condition when a man ejaculates too early during sexual intercourse than he or his partner would wish to.
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Ejaculation problems

There are 3 main ejaculation problems faced by men:

  • Premature Ejaculation – ejaculate too early
  • Delayed Ejaculation – ejaculate too late
  • Retrograde Ejaculation – ejaculate with backflow

Premature Ejaculation is the most common ejaculation problems. It is a condition when a man ejaculates too early during sexual intercourse than he or his partner would wish to.

The average time for ejaculation to take place during intercourse is around 5.5 minutes. Having said that, it’s up to each couple to decide how long sex should last and happy for the time to take place before ejaculating.

Occasional episodes of premature ejaculation can be normal. However, if premature ejaculation happens too frequently, it can develop into negative emotions such as stress and loss of self-esteem as well as put a strain on the relationship between you and your partner.

What causes of premature ejaculation?

This can be subdivided into physical (medical) related causes and psychological causes.

Physical related causes:

  • Thyroid disease
  • Prostate diseases
  • Usage of recreational drugs

Common psychological causes:

  • Relationship problems
  • Stress
  • Anxiety about sexual performance (especially at the beginning of a new relationship, or a man has had performance problems in previous relationships)

Sometimes, a man can develop premature ejaculation even after becoming sexually active. This can be due to

  • A traumatic sexual experience from childhood- such as sexual abuse, being caught during the act of masturbation
  • Conditioning – A previous sexual experience influencing future sexual behavior. A person can condition himself to ejaculate early to avoid being caught masturbating, this can become a habit that is brought to the bedroom.
  • Strict cultural restrictions and values towards sex during one’s upbringing
  • Biological causes – such as having a hypersensitive penis
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What can I do if I have premature ejaculation?

  • Consider masturbation 1-2 hours before having intercourse
  • Use a thick condom to reduce the sensation
  • Practice deep breathing techniques to stop the ejaculation reflex
  • Have intercourse with your partner on top to allow them to pull away when you are going to ejaculate
  • Takes short breaks during intercourse and thinks about something non-arousing
  • Couple therapy
  • Squeeze technique

Allow your partner to masturbate you, but stops before ejaculation and squeeze the head of the penis firmly for 10-20 seconds. Then let go and wait for 30 seconds and continue masturbation. Repeat this process a few times before allowing ejaculation to occur.

  • Stop-Go technique

In stop-go technique, it is similar to the squeeze technique except without squeezing the penis. Try a few cycles, when you are more confident about delaying ejaculation, you and your partner can try the act of sex.

These techniques may seem simple but require practice and open communication with your partner.

What do I expect when I consult my doctor for premature ejaculation?

When you have tried various own methods without success, your doctor may offer medication options such as

  • Selective Serotonin Reuptake Inhibitors (SSRIs) – this is also used to treat depressants
  • Local anesthetics cream or ointment- applied onto the penis to reduce sensation
  • Use of condom with or without anesthetic cream

Delayed ejaculation

Delayed Ejaculation is defined as experience of an unwanted delay that last for at least 30-60 minutes before ejaculation, or being unable to ejaculate at all despite the man has desire and has normal erection at least half the time when having sex.

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What causes delayed ejaculation?

Psychological causes of Delayed Ejaculation are similar to those or Premature Ejaculation that was discussed in the previous topic.

Physical causes include

  • Endocrine causes such as diabetes
  • Spinal cord injuries
  • Neuromuscular conditions such as multiple sclerosis
  • History of bladder or prostate surgery
  • Part of Ageing
  • Medicine – Antidepressants (SSRIs), blood pressure medications, muscle relaxant, painkillers

What treatments are available for delayed ejaculation?

  • Behavioral and Sexual therapy
  • Moderate alcohol consumption and avoid usage of recreational drugs
  • Prescribed Medication

Retrograde ejaculation

Retrograde Ejaculation is uncommon. It occurs when the semen flow backs into the bladder instead of flowing into the usual tube (urethra) where urine passes through. In this

condition, one can produce no semen, or cloudy urine especially during the first pee after sex. This could result in fertility issues which will affect couples who are trying to conceive.

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What causes retrograde ejaculation?

Retrograde ejaculation can be due to nerve and muscle damage over the bladder neck. When orgasm occurs, the nerves around the bladder neck will stimulate the muscles to contract to ensure the ejaculated semen does not back flow into the bladder and flows normally out of the urethra.

Problems of back flow ejaculation can be due to

  • Prostate or bladder surgery
  • Diabetes
  • Multiple sclerosis
  • Blood pressure medication

What treatments are available for retrograde ejaculation?

Most men do not seek treatment for this condition as they can still enjoy sex. Treatment may be required in those trying to father a child. Medications such as pseudoephedrine can sometimes be effective in reversing this condition. Other options such as artificial insemination or in-vitro fertilization (IVF) can also bypass this condition.

Sharing is Caring

It is encouraged for someone suffering from premature ejaculation to be open with your partner about your sexual concerns as much as possible. This will help reduce anxiety and allow your partner to develop a better understanding about your condition and help you through it.

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