Ejaculation disorder can manifest itself in various guises. Common to the various forms of ejaculation disorder is that it is often caused by psychological factors.
What is ejaculatory disorder?
According to statistics, ejaculatory disorder is the most common sexual disorder in men. The term ejaculatory disorder includes various disorder patterns that occur in connection with ejaculation in men. The most common form of the disorder is premature ejaculation. In this case, ejaculation occurs within a very short time after an erection, so that, for example, functioning sexual intercourse may be limited or completely impossible. If an ejaculation disorder takes the form of delayed ejaculation, the affected man has difficulty in triggering orgasms and ejaculations. Another form of ejaculation disorder is characterized by a failure of the man to reach orgasm. Finally, the so-called backward ejaculation (also called retrograde ejaculation) occurs when the man’s semen is poured into his bladder and does not reach the outside.
Causes
Often, the exact causes of ejaculatory dysfunction cannot be clearly determined. However, in most cases, ejaculatory dysfunction does not hide physical dysfunction; therefore, in medicine, it is believed that various psychological factors are often behind the development of ejaculatory dysfunction. With regard to premature ejaculation in men, for example, causative factors such as anxious tension, stress and/or negative experiences with sexual contacts may play a role. An ejaculation disorder in the form of delayed ejaculations can also have psychological causes; but also the use of certain medications (such as various psychotropic drugs) or neurological diseases can promote delayed ejaculation. Psychological factors that may be behind a failure to reach orgasm include fears of pregnancy on the part of the partner. Finally, the ejaculatory disorder of retrograde ejaculation is caused by a lack of closure of the bladder neck.
Symptoms, complaints and signs
The complaints and symptoms of ejaculatory disorder can vary greatly, always depending on the exact cause of this disorder. As a rule, it is not possible for those affected to reach orgasm and thus feel pleasure during sexual intercourse. However, ejaculation disorder may also indicate another condition that needs to be treated. Ejaculatory dysfunction may also make it impossible to fulfill a desire to have children, which can lead to difficulties with one’s partner. Similarly, semen may flow back, blocking the bladder neck. In many cases, the disorder is also associated with and can be triggered by psychological discomfort. However, most sufferers feel uncomfortable as a result of this disorder and therefore suffer from inferiority complexes or significantly lowered self-esteem. Many patients are ashamed of the condition and therefore often do not consult a doctor. Often, ejaculatory dysfunction also leads to a significantly higher stress level in everyday life and thus to a reduced quality of life for the patient. Usually, life expectancy is not used by this disease, however, a possible underlying disease can have a negative impact on the patient’s life expectancy.
Diagnosis and course
Ejaculatory dysfunction can usually be diagnosed based on a patient’s reported symptoms alone. To uncover or rule out physical factors that may be behind ejaculatory dysfunction, an attending physician will usually ask about the patient’s particular medical history during a patient interview. If various forms of ejaculatory dysfunction (such as retrograde or delayed ejaculation) give rise to the suspicion of an underlying disease, injury or dysfunction, this can be checked by further diagnostic procedures. The course of an ejaculatory disorder is influenced by various factors. As a rule, however, successful treatment of the corresponding causes also has a positive effect on the disorder in question.If a cause can be completely eliminated (as is the case with retrograde ejaculation), the corresponding ejaculatory disorder may also subside.
Complications
The complications of ejaculatory dysfunction usually depend on its causes. If the disorder arises due to psychological discomfort, it is usually possible to treat the disorder and limit it completely so that it does not cause further discomfort to the patient. If the ejaculation disorder is called by another underlying disease, in the worst case it can lead to complete infertility of the man. Most often, patients suffer from psychological discomfort and depression due to the disorder. Sufferers also suffer from lowered self-esteem and inferiority complexes. Especially towards the partner, feelings of shame can occur and sexual desire is restricted, which can cause negative tensions in the partnership. In most cases, ejaculatory dysfunction can be treated relatively well. In case of psychological causes, this is done by a psychologist and the patient must reduce his stress level. Usually, creams and ointments can also be used to numb the glans and thus limit the ejaculation disorder. If infertility occurs, sperm can be collected in another way and used to fertilize the partner.
When should you see a doctor?
All ejaculatory disorders can be a reason to see a doctor. A distinction should be made here between the need to clarify organic causes (in the case of retrograde, absent, or painful ejaculation) and the resulting distress due to severely premature or delayed ejaculation. The approach by a specialist (in the first instance a urologist) differs according to the different forms of ejaculation disorders. The need for action is also considered to be higher in the case of painful, retrograde or absent ejaculations. Insofar as the affected person notices such a change in his ejaculation, a urologist should be consulted. The causes of this type of disturbance are manifold and range from the effects of medication to inflammation. Accordingly, it should be acted upon and, if necessary, treated. These forms of ejaculation disorders are also considered pathological in any case and therefore require a medical examination. Especially in the case of inflammation or impending erection problems, procrastination is also associated with the risk of irreversible damage. Premature or severely delayed ejaculations are more individual cases, in which a visit to the doctor should be made at the latest when there is real suffering. This therefore depends on whether the quality of life of affected men is affected by the ejaculation disorders. Here it may also be necessary to pursue sex therapy approaches, since these forms of ejaculatory dysfunction often have a psychological component.
Treatment and therapy
Therapy for ejaculatory disorder depends primarily on the form of the disorder present. Possible psychological causes of an ejaculation disorder can be countered, for example, with the help of targeted psychotherapy. It is often useful to involve the partner of an affected man in psychotherapy. In the fight against ejaculation disorders in the form of premature ejaculation, various measures are also offered, depending on the person affected: With the help of the so-called ‘stop and start technique’, for example, a man’s control over the timing of ejaculation is to be trained. Anesthetic creams can be used to reduce the sensitivity of the glans and thus delay ejaculation. Backward ejaculation can be treated with medication if the bladder neck is functioning, for example:
Appropriate medication leads to a closure of the bladder neck, so that the male semen pours outward. If a corresponding medical treatment is not possible in the individual case and there is a desire to have children, the semen can be processed from the urine for the purpose of artificial insemination. If physical diseases are hidden behind ejaculatory dysfunction, an important therapeutic step is to combat the underlying disease.
Outlook and prognosis
Ejaculatory dysfunction usually has a good prognosis. Often stress, rushing and excitement are the causes of the disorder.As soon as the affected person is in an emotional balance and can relax internally, a regulation of the complaints occurs. With life experience and a routine procedure within an intimate setting, the disturbance often alleviates. Disturbing factors should be eliminated and an informal atmosphere should be established. Ejaculatory dysfunction is in most cases only a temporary phenomenon and is strongly related to emotional processes. Worries, fears or lack of confidence trigger the disorder. If they are corrected, spontaneous recovery is possible at any time. Likewise, the disorder may recur throughout life. If there are renewed stressful periods of life or increased excitement, the disorder may show up again for a second time. If constriction of the vessels is the reason for the ejaculatory disorder, treatment is initiated. In very rare cases, surgical intervention is necessary. The prospect of improvement is also very good if medical care is needed. The prognosis worsens if other mental illnesses are present or medications as well as drugs are taken. If the present cause is stopped or cured, the ejaculatory disorder regresses to freedom from symptoms.
Prevention
Because psychological factors in particular that can lead to ejaculatory dysfunction cannot always be clearly defined and controlled, appropriate prevention is only possible to a limited extent. Physical factors that increase the risk of ejaculatory dysfunction should be treated as early as possible, according to expert advice.
Aftercare
Aftercare for ejaculatory dysfunction depends on the type of treatment and the cause. If surgical measures were necessary, aftercare measures are usually exhausted by the wound and scar care that follows. If infections that triggered the ejaculatory dysfunction were treated, a follow-up is advisable. Especially in the case of aggressive, bacterial infections in the area of the testicles or bladder, multiple follow-up checks should be performed. This way, a flare-up of the infection can be quickly detected and treated. The same applies to infections that caused pain or discomfort during ejaculation, for example. In the case of psychological distress or problems with sexual life, follow-up care is more complex. At best, aftercare consists of further psycho- and sex-therapeutic measures, which can be taken up by the affected person as needed. However, medical options are quickly exhausted here. The success of the treatment of psychologically induced ejaculation disorders is very subjective and, accordingly, aftercare can only consist of determining an improvement or a worsening. In addition, if an ejaculation disorder (of any kind) has reduced the quality of the sperm, a spermiogram can be performed regularly after treatment. This can simplify family planning in the further course.
What you can do yourself
Whether and how an ejaculatory disorder can be treated independently depends on the form of the disorder. If psychological causes such as stress or depression are causative, targeted psychotherapy is useful. In many cases, this therapeutic measure can be supported by sports, a change of diet or a change of workplace or environment. Sometimes it is also useful to involve the partner in the treatment. In the case of premature ejaculation, measures such as the “stop-start method” can be used to improve control over the timing of ejaculation. There are also anesthetic creams and special condoms, among other things. If the ejaculation disorder is disease-related, the causative disease must first be treated. In general, it is advisable for those affected to talk to a doctor at an early stage and find out the cause of the problems. It is also possible that the ejaculation disorder is due to the use of a certain medication, which can be discontinued in consultation with the doctor. Stimulating activities such as sports or eating certain foods help against age-related ejaculation disorders. Natural aphrodisiacs increase sexual desire and sometimes also prevent problems with ejaculation.
