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Ejaculation Problems

An orgasm occurs when a man ejaculates. Ejaculatory problems include premature ejaculation, delayed ejaculation, the absence of ejaculation and retrograde ejaculation.

Premature Ejaculation (PE)
The Second International Consultation on Sexual and Erectile Dysfunction defined PE as:

‘ejaculation with minimal stimulation and earlier than desired, before or soon after penetration, which causes bother or distress, and over which the sufferer has little or no voluntary control’

In layman’s terms “you come too quickly”. This can occur before there is even penetration, or within seconds or a minute or two of penetrating your partner. This problem is particularly common in younger men. It can be embarrassing for a man and can cause problems in a relationship. Most women who are able to have an orgasm from penetrative sex require at least 10 minutes of penetration.

The “squeeze technique”.
The sexual partner can squeeze the penis just behind the head as the man is about to ejaculate. This will stop the ejaculation. By repeating this manoeuvre several times, the man can be trained to delay his ejaculation long enough for satisfactory intercourse to take place. The problem with this technique is that most partners do not squeeze hard enough.

Erectile Squeeze
Using local anaesthetic cream
Another method of treating this condition is to apply a local anaesthetic cream to the penis or to use a condom that contains local anaesthetic. This reduces the sensitivity of the penis and delays ejaculation.
Treatment using medication
A group of antidepressant medications called selective serotonin reuptake inhibitors (SSRI’s) cause delayed ejaculation. Although they are not registered for treating premature ejaculation, they are extremely effective. A doctor’s prescription is required. Some types of prescription pain killers are also effective as they numb sensation.

Retrograde ejaculation (RE)

This is a condition in which the ejaculate (seminal fluid) travels backwards in the urethra instead of forwards out of the penis. The urethra is the tube that transports urine from the bladder out of the penis.
With retrograde ejaculation the ejaculate ends up in the bladder. Basically, you will experience the sensation of having an orgasm but it will be a “dry orgasm”. The condition is normally a result of damage caused during surgery.

Delayed ejaculation and absence of ejaculation
This occurs when a man is unable to ejaculate (anorgasmia) or it takes him much longer than usual to ejaculate (delayed ejaculation). It is commonly caused by medications such as the SSRI antidepressants and pain killers. Excessive alcohol intake can also cause this condition. If it occurs only in specific situations then the psychological issues need to be addressed. For example, some men are able to ejaculate easily whilst watching pornography and masturbating but not with a partner. In this case referral to a sexologist or sexual health physician may be required.

Adapted from: The SASHA Guide to Erections and Erection Problems. Smart D. © Ronin-Do (Pty) Ltd 2004 and Know your manhood. Lissoos I. KYB Pocket Books 1984
Used with permission from the publishers