Ejaculatory Dysfunction

Men who are experiencing ejaculatory dysfunction should keep track of their symptoms and talk to a doctor. In most cases, patients are referred to a urologist since these professionals have more complex knowledge of the male reproductive system and the problems that may affect it.

There are three primary types of ejaculatory dysfunction, including:

• Premature: This type is characterized by the patient ejaculating very soon after penetration. This is the most common type and it is usually the result of the patient being nervous of his sexual performance. In some cases, it is unclear why it is happening, however. Doctors believe that past traumatic events and certain psychological factors may play role in some cases. Spinal cord damage or antidepressants might also contribute to this type.
• Retrograde: This type is characterized by the ejaculate going back into the bladder at orgasm. Males with diabetic neuropathy and diabetes are at a relatively high risk for this type. This is because the nerves in the bladder neck and bladder might be impacted. Certain psychological medications may also play a role.
• Inhibited or delayed: This type is characterized by ejaculation being slower than what is considered normal. Certain psychological factors, such as depression, may cause this type. Certain physical factors may also play a role, such as hormone issues, pelvic nerve injuries, and neurological disorders.

There is also anejaculation. This refers to men not ejaculating at all once they reach sexual climax. For some men this always happens, while for others it is situational (only happening under certain conditions).

A full physical examination and a psychological examination are generally the first steps in the diagnostic process. Certain physical tests that may be performed depending on the patient’s identified risk factors might include:

• Sensory testing for possible nerve damage
• Blood testing to look at hormones, cholesterol, blood sugar, and other potential risk factors
• Vascular assessment if the blood vessels are believed to play a role in the dysfunction

Treatment generally depends on the type of ejaculatory dysfunction the patient is experiencing and the underlying cause. For example, if depression is the cause, patients may be prescribed psychological counseling and antidepressant medications. If a man’s diabetes is thought to be responsible, getting his blood sugar under control and attending to any complications, such as diabetic neuropathy, may be necessary. It is important for all men to follow all treatment recommendations and let their doctor know how symptoms change.