Ejaculation disorders

Ejaculation disorders are sexual dysfunctions that affect a man's ability to control ejaculation. These disorders can have a significant impact on quality of life and sexual satisfaction.

There are different types of ejaculatory disorders, including premature ejaculation, delayed ejaculation and retrograde ejaculation. Modern medical approaches offer effective diagnosis and treatment options to help affected men.

Quickfacts

Causes & Symptoms

Diagnosis

Treatment

Rehabilitation

Quick facts

Prevalence: Affects up to 30% of men
Common disorders: Premature ejaculation, delayed ejaculation, retrograde ejaculation
Diagnosis: Medical history, physical examination, specialised tests
Treatment: medication, behavioural therapy, psychological counselling
Success rate: High satisfaction rate with correct treatment

Causes

Ejaculation disorders can be caused by a variety of physical and psychological factors:

Physical causes: prostate diseases, diabetes, neurological disorders, hormonal disorders, medication
Psychological causes: stress, anxiety, depression, relationship problems
Other factors: Excessive alcohol consumption, drug abuse

Symptoms

Symptoms vary depending on the type of ejaculation disorder:

Premature e jaculation: inability to delay ejaculation for more than one minute after the start of intercourse
Delayed e jaculation: Significant delay in ejaculation or inability to ejaculate at all
Retrograde ejaculation: ejaculation occurs backwards into the bladder instead of from the penis, often characterised by ‘dry’ orgasms

Diagnosis

The diagnosis of ejaculation disorders involves several steps:

Anamnesis: Detailed survey of the medical history and current complaints
Physical examination: Examination to identify physical causes
Laboratory tests: Checking hormone levels, blood sugar and other relevant parameters
Specific tests:
- Urodynamic tests: assessment of bladder and urethral function
- Neurological examinations: Examination of nerve function

Treatment

The treatment of ejaculation disorders depends on the specific disorder and its causes:

Drug therapy:
- Premature e jaculation: Selective serotonin reuptake inhibitors (SSRIs), topical anaesthetics
- Delayed ejaculation: adjustment or change of medication causing the disorder
- Retrograde e jaculation: Alpha-blockers or other medications to improve bladder neck closure
Behavioural therapy:
- Techniques: start-stop technique, squeeze technique to delay ejaculation
- Sex therapy: improving sexual communication and reducing pressure to perform
Psychotherapy:
- Counselling: treatment of underlying psychological problems such as stress, anxiety and depression
- Couples therapy: support to improve the relationship and sexual intimacy
Physical interventions:
- Surgical interventions: rarely necessary, but considered for certain anatomical problems or severe cases of retrograde ejaculation

Rehabilitation

Rehabilitation after the treatment of ejaculation disorders includes

Aftercare: Regular medical examinations to monitor progress
Psychological support: Continuation of psychological counselling if needed
Lifestyle care: Maintaining healthy habits to support sexual health

Ejaculatory dysfunction is a treatable problem, and with proper diagnosis and treatment, most men can regain satisfactory sexual function. It is important to talk openly about this issue and seek medical advice to get the best possible treatment.