Too Quick, Too Slow, and Not at All Erectile dysfunction and ejaculation problems are the most widespread sexual disorders in male persons. Since the invention of PDE5 inhibitors, treatment of erectile dysfunction has become much easier: it is enough for the patient to take a pill and in half an hour, his erection will be normal. However, problems with ejaculation are more difficult to cure and often cause not only physiological discomfort but also great psychological one. In this article, we will tell you about the three ejaculatory disorders and the methods of their treatment.
Too Fast – Premature Ejaculation
Premature ejaculation is undesired ejaculation that occurs due to minimal sex stimulation before, during, or immediately after the penetration of the penis into the vagina. The prevalence of the condition is 15-30% among males of all ages. Thus, it is the most common ejaculation disorder causing severe psychological problems in male persons.
Causes & Diagnosis
There are the following causes of the disease:
- Psychological (the beginning of sex life, unsuccessful sexual experience in the past).
- Neurophysiological (increased excitability of motor neurons in the spinal ejaculation center).
- Hormonal (increased prolactin levels in the blood, as stated in the study by Cohen PG, 1997, and some other studies).
- Hypersensitivity of some areas of the penis caused by inflammatory and other diseases. To diagnose the condition, a doctor will discuss sex history & anamnesis with a patient. Some lab tests can be used.
Treatment of the Disorder
The two main groups of medical remedies may be used to delay ejaculation in males. The first one includes selective inhibitors of serotonin uptake (or SSRIs). These drugs are used as antidepressants. The side effect of SSRIs is increasing the duration of sex intercourse. For the development of psychotropic action, long-term use of drugs in large doses is necessary. At the same time, taking small doses of drugs or administering "as needed" (i.e. before sexual intercourse) is sufficient to slow ejaculation. Some other antidepressants can also be used to treat the condition.
The second group includes gels, creams, and sprays with anesthetic agents. One of the most common remedies of this type is Stud Spray from AWC Pharmacy. This remedy is available over the counter (without a prescription). It contains lidocaine as the main active agent. Stud Spray comes in small bottles of 3 inches in height. It is applied directly on the penile organ. Each spray provides 7 mg of active substance, you should use it at least 3 times (but not more than 10 times) 5-10 minutes before sexual penetration. Stud Spray slightly reduces sensitivity of the penis allowing you to prolong the time of coitus. Also it serves as lubricant. The remedy has a great effectiveness, as it can prolong your sex up to 8 times. In addition, special sexual techniques (“squeeze” & “start-stop”) and condoms may help to deal with fast ejaculation.
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Too Slow – Delayed Ejaculation
Delayed ejaculation is a difficulty in achieving a male orgasm or an inability to reach it. If after half an hour of vaginal sex, ejaculation does not occur, it is considered to be a deviation. The condition is relatively rare: from 1 to 4% of male persons suffer from it. Delayed ejaculation may cause psychological problems in a man and his partner. So a female can think that a man with the condition finds her unattractive.
Causes & Diagnosis
The condition may be caused by physiological and psychological factors.
The first group includes:
- side effects of some meds (SSRIs, antihypertensive drugs, painkillers, etc.);
- alcoholic beverages and using of some recreational drugs;
- neurological factors (multiple sclerosis, injury of spinal cord, severe form of diabetes mellitus);
Psychological factors include unexpressed anger, fear of female pregnancy, unwillingness to enjoy sex, fear of female genitalia, religious beliefs (for example, men may think that sex is a sin). To make a diagnosis, a healthcare professional will speak with a man about the symptoms and their occurring. To rule out some problems urine & blood tests can be used.
Treatment of Delayed Ejaculation
Treatment methods are selected depending on the cause of the disease.
For example, if some antidepressants are the cause, some alternatives can be prescribed.
However, delayed ejaculation disorder is difficult to be treated as it’s poorly understood (Butcher MJ et al., 2015). Some medical remedies can improve the symptoms of the condition. However, none of them haven't been approved by state regulators to treat it.
Meds with some reported beneficial effects include:
- Cyproheptadine (Periactin trade name) – an antiallergic drug;
- Amantadine (Symmetrel trade name) – a medicament used to treat Parkinson's disease;
- Buspirone (Buspar trade name) – a medication for fighting against anxiety.
Not at All – Retrograde Ejaculation
Like delayed ejaculation, this type of disorder isn’t common compared with rapid ejaculation. It is revealed in the form of a decrease in the volume of sperm or its complete absence since part of the sperm (or all the sperm) enters the bladder instead of exiting through the penile organ (via the urethra). A man notices such a change during ejaculation. The process is not accompanied by discomfort or pain. Sperm that enters the bladder is excreted along with the urine. Therefore, after the sexual contact, men with retrograde ejaculation note turbidity of urine. Patients often do not attach much importance to these changes and do not consult a doctor. This disease is harmless and does not interfere with sensations during ejaculation. In addition, retrograde ejaculation can facilitate clean-up after a sexual act. However, the disease worsens male fertility. Therefore, some male persons may require treatment if they try to conceive a child and their female partners cannot become pregnant.
Causes & Diagnosis
The process of ejaculation can be disturbed by various causes.
Doctors distinguish several causing factors:
- deterioration of the structure of the urinary system;
- concomitant ailments, such as diabetes mellitus (especially in the case of prolonged poor control of blood glucose rates);
- benign prostatic hyperplasia;
- taking certain antidepressants and antipsychotic medications;
- unsuccessful surgical operation;
- spinal injuries, etc.
A frequent cause of retrograde ejaculation is a deterioration of the structure of the urinary tract. If there is excitation, the sphincter cannot block the neck of the bladder due to an incorrect location. If the neck is located below the cervix or has a deformed shape, it does not compress the neck. As a result, sperm enters the urinary bladder. Diagnosis of the disease is usually done with the help of ultrasound examination, urinalysis, and physiological examination.
Treatment of Retrograde Ejaculation
The treatment of the condition depends on its cause. Medicaments may be effective, but only in few situations. Meds, such as chlorphenamine and imipramine, can help if retrograde ejaculation is a result of slight damage of nerves caused by multiple sclerosis, diabetes mellitus or injuries of the spinal cord. They are ineffective if nerves damage is caused by prostate surgery. In some situations, surgical intervention can be used for curing retrograde ejaculation, but it is rarely selected as the first treatment option.
The Bottom Line on Treating Ejaculation Problems
Regardless of the type of ejaculatory problem you have, you can always find a solution. First of all, you should consult a doctor, because ejaculatory disorders can be a signal of other more serious health problems. Seeking for medical help is not the whole treatment. You should talk about your problem with your partner. This is what many men often do not want to do because of fear, shame or embarrassment.
Remember, silence is not an option because with time the situation will only aggravate.
If partners know about the problem, males can try with them new tricks in the bedroom that will help to defeat ejaculatory disorders even without the use of meds.
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