What is Ejaculation?

Ejaculation is the emancipation of semen from the male reproductive organ after successful sexual activity. When a male is sexually aroused, his brain sends signals via nerves to the pelvic region to facilitate the contraction of pelvic tissues. This contraction imports the sperms along with prostatic & seminal fluid towards the penis; leading to ejaculation towards the climax.  Ejaculation is a vital part of natural conception and may happen involuntarily as well (such as during sleep).

Ejaculatory disorders can be a huge concern for any male. Data indicates that ejaculatory disorders are fairly common; however, very few cases are reported as most males find it embarrassing and painful to discuss their sexual deficiencies with their partner or healthcare professional.

There are different types of male ejaculation disorder; such as like premature ejaculation, retrograde ejaculation, delayed ejaculation or anejaculation etc.

How does ejaculation work?

Ejaculation in males occurs in two stages. First stage is called emission.

Testicles of men create sperm cells; these sperm cells are stored in a coiled shaped tube (known as epididymis). During emission stage, the vas deferens (the ducts responsible for carrying sperms from testes to penis) compresses the coiled epididymis. These sperms then move through the ejaculatory ducts, mixed with glandular fluids. This combination of sperms and glandular fluid is known as semen.

The second stage is ejaculation proper during which man experiences orgasm. Bulbocavernosus muscle compress over and over again which helps to move the semen from ejaculatory ducts to the urethra. From urethra semen is pressed and spurted out of penis. After ejaculation occurs, penis become soft again.

What are the common ejaculation problems in men?

There are three main types:

1. Premature ejaculation
2. Delayed ejaculation
3. Retrograde ejaculation.

 

1. Premature ejaculation:

It is by far the most frequently reported male ejaculatory disorder and is characterized by too early ejaculation during sexual activity with very little stimulation. The premature ejaculation makes the man unable to satisfy his partner and may put him in a lot of psychological distress. It is noteworthy that most cases of premature ejaculation are temporary and transient and resolves spontaneously; but if this issue persists or occur frequently then you should consult your doctor. According to some estimates, about 30 percent male experiences premature ejaculation at some point of their life.

Causes:

• Thyroid disorders
• Prostate problems
• Excessive use/ abuse of certain recreational or prescription drugs
• Chronic stress or depression.
• History of pelvic trauma
• Nervousness about sexual performance
• Morbid obesity (high body-mass index)
• Excessive alcohol consumption

 

The average time to ejaculate varies from person to person and even in the same person over a period of time; experts suggests that normal ejaculatory time (onset of sexual stimulation to climax) may range between 1 to 6 minutes. According to another study, it could range between 7 to 14 minutes; however, most experts believes that the diagnosis of ejaculatory disorders should be made on 3 criteria:

1. Early ejaculation
2. Lack of control on ejaculation
3. Lack of sexual gratification after sexual intercourse

 

2. Delayed Ejaculation:

In this condition, extended stimulation is needed to ejaculate.  The men suffering from this problem experiences an undesirable long time before they finally ejaculate (lasting for as long as 30-60 minutes in some males). An individual with previous history of normal ejaculation may also develop delayed ejaculation. Sometimes this problem occurs only in certain situations for example, male may ejaculate normally when he masturbates but face delayed ejaculation during sexual intercourse.

Causes:

This could be both physiological or physical

Physiological causes include;

• Stress
• Anxiety or depression.
• Any past sexual trauma.
• Relationship problems.

Physical causes include

• Diabetes
• Low testosterone
• Multiple sclerosis
• Medicines which effect central nervous system
• Any issue with the prostate gland
• Prostate gland or bladder surgery.
• Advancing age
• Sometimes antidepressants and pain killers can also cause this issue
• History of blood pressure or use of anti-hypertensive drugs
• Thyroid hormone.

 

3. Retrograde ejaculation;

It is a rare ejaculation problem (comprising of less than 1 to 4% of all ejaculatory disorders) and is characterized by backward flow of semen into the bladder rather than through the urethra.  Men who are suffering from retrograde ejaculation feel orgasm but this problem may affect their ability to become a father.

Causes:

The muscles around the neck of bladder prevent semen from entering the bladder when any damage occurs to these nerves or muscles and will result in retrograde ejaculation.

Surgeries of prostate gland, multiple sclerosis, or medicine to treat high BP which contain alpha blocker are some primary causes of retrograde ejaculation.

Bottom line,

If you are experiencing any ejaculatory dysfunction or a sexual issue, discuss with your doctor to learn what can be done about it. Your healthcare professional may perform a variety of tests & physical examination to evaluate the cause and discuss treatment options.

Discussion with your partner is also helpful because when you are seeking treatment, involvement of partner may prove really helpful.