Erection and Ejaculation Problems

Erection and ejaculatory problems are amongst the most common issues with relation to the male reproductive system. Erection refers to the state of arousal which allows a male to have intercourse. Should a male be unable to get or maintain an erection, it is referred to as erectile dysfunction.  Ejaculation refers to the act of ejecting semen from the penis. There are different types of problems which can be associated with ejaculation.

Erectile Dysfunction (ED)

ED is a very common sexual dysfunction for males. The symptoms include a persistent inability to get an erection, keep an erection, and reduced sexual libido. It is not a single occurrence  but a consistent problem over a long period of time.

ED could be the sign of an underlying health disorder such as blocked blood vessels or nerve damage. Alternatively, it could be related to lifestyle issues such as being overweight, or excessive smoking and drinking. ED may also be caused by psychological reasons such as excess stress, fear, anxiety, depression, anger, or relationship problems.

Complications of ED include an unsatisfactory sex life and a sense of embarrassment leading to low self-esteem.  Treating ED starts with making lifestyle changes such as excising more, eating healthier and losing weight. The physical effect of looking after the body will usually resolve cases of lifestyle-related ED. Should the problem persist, a visit to the doctor will be called for.

The healthcare provider will check for any underlying health conditions that may cause ED. These could include diabetes, high blood pressure, heart conditions, thyroid problems, nervous system disorders, Multiple Sclerosis (MS), Parkinson’s disease, Peyronie’s disease, and spinal cord injuries.

Diagnostic tests would include a physical examination, blood tests, urine analysis, ultrasound imaging, an overnight erection test, as well as a detailed psychological examination of the patient. An accurate diagnosis at this stage plays an important role in treatment of ED. As corrective measures are taken to handle the health issue diagnosed, ED should also be resolved.

Ejaculation Problems

The time from initiating intimacy to finally ejaculating varies between individuals; this time period is known as ejaculatory latency time. It becomes a problem when the man or his partner experience distress due to the ejaculatory latency time. There are three main issues associated with ejaculation: premature ejaculation, delayed ejaculation and retrograde ejaculation.

Premature Ejaculation

This is characterized by a short ejaculatory latency time. The male ejaculates too soon during sexual intercourse, usually within 30 seconds of initiating sexual intimacy. The condition can affect the male’s ability to be in a satisfied long term relationships, and this is the most common of the ejaculation problems.

Psychological reasons like depression, stress, performance anxiety and relationship problems can cause the condition. Physical reasons such as prostate or thyroid problems may also cause premature ejaculation, as can prescribed drugs for existing medical problems. Therapy goes a long way in curing the psychological reasons.

Medication may be required to help with physical disorders. The drug Viagra helps maintain the erection even after ejaculation. Combined with sensitivity reducing ointments, the male will be able to ensure that the act sexual intimacy is fulfilling for both partners.

Delayed Ejaculation

In this case, the ejaculatory latency time is very long. The male experiences a long delay before being able to ejaculate during sexual intercourse and, in some cases, he may not be able to ejaculate at all, despite a normal erection.

Physical problems like diabetes, spinal cord injuries, MS, bladder surgery, prostate gland surgery as well as advancing age can be responsible for delayed ejaculation. Also antidepressant medication called Selective Serotonin Reuptake Inhibitors (SSRIs), antipsychotic medication, muscle relaxants, high blood pressure medication, and painkillers may also cause the issue. Switching to different medication may help.

Psychological reasons like early sexual trauma involving child abuse, a strict upbringing, depression, fear, sexual performance anxiety, stress in the relationship, or stress in general may also cause delayed ejaculation. Counselling and therapy will help managing the condition.

Retrograde Ejaculation

While premature and delayed ejaculation problems are common, retrograde ejaculation is rare. It is a medical condition wherein the semen moves backwards to the bladder rather than forwards through the urethra.

The neck of the bladder should ideally close up at the moment of orgasm, but muscle or nerve damage can prevent this. This leads to retrograde ejaculation. The primary symptom is the cloudy urine released after sexual intercourse.

The condition does not impede the male’s ability to enjoy sexual intercourse. It also has no ill effect on the health of the male, but it does render the male infertile. In light of this, treatment is only required if the male is trying to conceive a child with his partner. The most common way to deal with retrograde ejaculation is artificial insemination or in-vitro fertilization.

Reviewed by Afsaneh Khetrapal BSc (Hons)

References

Further Reading

Last Updated: Jan 18, 2017

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