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Ejaculation Problems Page 1 of 2 Factsheet Ejaculation problems Page 1 of 2 What is ejaculation? Ejaculation is the release of semen from the penis at orgasm (sexual climax). When a man is sexually stimulated, the brain sends signals to the genital area through nerves in the spinal cord to make the pelvic muscles contract. At orgasm, waves of muscle contractions transport the sperm, with a small amount of fluid, from the testes through to the vas deferens. The seminal vesicles and prostate contribute extra fluid to protect the sperm. This mixture of sperm and fluid (semen) travels along the urethra to the tip of the penis where it is ejaculated (released). What are ejaculation problems? Men can experience different kinds of variety of causes, both physical and your local doctor (GP) is the best place ejaculation problems, including: psychological. Physical causes include to start to find out the cause of the • premature ejaculation some illnesses such as diabetes, some problem and how it may be treated or • retrograde ejaculation types of surgery or trauma, some types managed. The GP may refer you to a • delayed ejaculation (or no of inflammation or infection, certain specialist if needed. ejaculation) medicines, and chemical imbalances in What about partners? • painful ejaculation. the brain (neurobiological disorders). Psychological causes include stress, Talking to your partner can be helpful, How common are particularly if you are feeling anxious ejaculation problems? anxiety (such as anxiety about ‘sexual performance’), relationship difficulties about your ejaculation problem. When Premature ejaculation is the most and depression. For each type of seeking treatment, involving your common male sexual problem and ejaculation problem and for each partner is also a good idea. In some affects men of all ages. individual man there may be one or cases partners have their own sexual Premature ejaculation is more common more causes of an ejaculation problem. problems that may need to be managed. in younger men where it is known as What should I do if I have an RETROGRADE EJACULATION a neurobiological disorder. Ejaculation ejaculation problem? generally takes longer as men get older. What is retrograde ejaculation? Younger men may be less sexually If you have an ejaculation problem In men with retrograde ejaculation, the experienced or feel less secure with that is bothering you, a discussion with muscle at the opening of the bladder, the situation in which they are having sex and this may contribute to the premature ejaculation. What is the urethra? More details about premature The urethra is a tube that runs from the bladder to the end of the penis. It carries ejaculation can be found in a separate urine from the bladder to the outside of the body. In men, it also carries semen out Andrology Australia fact sheet. of the body. The other ejaculation problems are less The urethra is made up of two parts. The prostatic urethra is the part of the urethra common than premature ejaculation that runs from the bladder through the prostate. The penile urethra is the part of the but can also cause distress for the man urethra that runs through the penis. and his partner. A ring of muscle called the internal sphincter is located at the base of the bladder What causes ejaculation and when closed, it stops urine and semen leaving the body through the urethra problems? at the same time. At orgasm, this muscle ring closes tightly to stop sperm passing Ejaculation problems can have a backwards into the bladder. Ejaculation problems Page 2 of 2 which usually stops semen from the urine, or take sperm directly from PAINFUL EJACULATION entering the bladder during orgasm, the testes in a small operation (biopsy). What is painful ejaculation? does not close normally. When the Painful ejaculation is when painful, muscle does not close properly semen DELAYED EJACULATION burning sensations are felt during or flows back into the bladder. Therefore, What is delayed ejaculation? following ejaculation. little or no semen is discharged from Delayed ejaculation and anorgasmia the penis during ejaculation, and the During ejaculation, pain can be felt in describe the inability to ejaculate at will, the perineum (the area between the first urination after sex looks cloudy as so that ejaculation (and orgasm) takes the semen mixes with the urine. anus and the genitals) and the urethra much longer than desired, or does not (a tube that runs from the bladder to Retrograde ejaculation is uncommon happen at all. This might happen only the end of the penis). The condition and usually harmless. with intercourse, or in all situations can cause discomfort in the testes and What causes retrograde including masturbation. interfere with sexual pleasure. ejaculation? The term anejaculation describes when What causes painful ejaculation? Retrograde ejaculation can happen a man does not ejaculate after orgasm. after surgery to the prostate or the “Orgasm” and “ejaculation” are often neck of the bladder. Diabetes, multiple thought to be the same, but some men Painful ejaculation is sclerosis, spinal cord injury, and some can experience orgasm even though medications, in particular medicines they don’t ejaculate. when painful, burning for high blood pressure and medicines What causes delayed ejaculation? sensations are felt to treat benign prostate enlargement Physical causes include spinal cord can also cause retrograde ejaculation. injury, major lymph node surgery, during or following Depending on the cause, retrograde diabetes, multiple sclerosis and traumatic ejaculation ejaculation may be a temporary or injury to the pelvic region, when the permanent condition. nerve supply is affected. How is retrograde Delayed ejaculation is a well- Any condition that causes inflammation ejaculation treated? documented side-effect of some or an infection of the organs involved Most men with retrograde ejaculation antidepressants (specifically SSRIs). in ejaculation or the surrounding do not need treatment. The important While delayed ejaculation can be caused structures, such as prostatitis, may message is that it does not cause by relationship difficulties, persistent cause painful ejaculation. serious problems. However, it is difficult anorgasmia with no medical cause is How is painful for men with retrograde ejaculation to very uncommon. ejaculation treated? have a baby naturally. How is delayed The treating doctor should assess For men wishing to have a family, sperm ejaculation treated? the cause of the pain and treat as A change of antidepressant medication appropriate. The treatment might may be needed for men who are concerned be a course of antibiotics for Retrograde ejaculation about this side-effect. infection, or it might need referral Vibrator stimulation and electrical to a specialist (urologist) for more is uncommon and stimulation of the penis can be used to complex investigations. usually harmless promote reflex ejaculation in men who Where can I find information can’t ejaculate, but want to father a baby. about other sexual problems? Men who are concerned about being Andrology Australia has fact sheets may need to be collected in other ways for unable to ejaculate when there is no on other sexual problems including use in assisted reproduction procedures medical reason for this difficulty may need ‘Premature ejaculation’, ‘Erectile such as in vitro fertilisation (IVF). long-term individual counselling or therapy. dysfunction’ and ‘Low libido’. See our website for the full range of fact sheets. A fertility specialist can take sperm from For more information visit www.andrologyaustralia.org, call 1300 303 878, or speak to your doctor. Expert reviewer Dr Michael Lowy Andrology Australia is an initiative funded by the Australian Government Department of Health MBBS MPM FAChSHM FECSM School of Public Health and Preventive Medicine, Monash University The Male Clinic, Sydney 553 St Kilda Road, Melbourne, Victoria 3004, Australia Date reviewed: May 2018 The information in this fact sheet has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. AA15.2.2 EJACPROB/FS © Andrology Australia 2018 Andrology Australia urges readers to seek the services of a qualified medical practitioner for any personal health concerns. AA23.5.18 EJAC/FS.
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