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Understanding Ejaculation Problems

Are you or someone you care about facing issues with ejaculation? Are you in search of professional guidance to address this sensitive concern? Archish Fertility & IVF is here to provide comprehensive information and support. Ejaculation problems are a prevalent sexual health issue affecting men across different age groups. These problems can cause significant distress, impacting the individual’s quality of life and intimate relationships. Understanding the various types, causes, symptoms, and treatment options for ejaculation problems is crucial for those affected and their partners.

Types of Ejaculation Problems

1. Premature Ejaculation (PE)

Premature ejaculation, the most common ejaculation disorder, is characterized by ejaculation that happens sooner than desired, either before or shortly after penetration. It can be classified into:

  • Lifelong (Primary) PE: This type is present from the first sexual experience and persists throughout life.
  • Acquired (Secondary) PE: This develops later in life after a period of normal ejaculation.

2. Delayed Ejaculation (DE)

Delayed ejaculation involves a persistent difficulty or inability to ejaculate despite adequate sexual stimulation. This condition can be lifelong, acquired, situational (occurring only with specific partners or circumstances) or generalized.

3. Retrograde Ejaculation

This occurs when the semen enters bladder instead of exiting through the urethra during orgasm. This condition is usually due to a malfunction of the bladder neck muscles, resulting in little to no ejaculation and often cloudy urine post-orgasm.

4. Anejaculation

Anejaculation is the complete absence of ejaculation despite normal erectile function and orgasm sensation. This condition can be distressing and may be associated with neurological disorders, diabetes, or prostate surgery.

Causes of Ejaculation Problems

1. Psychological Factors

Psychological factors significantly contribute to many ejaculation problems. Issues such as performance anxiety, stress, depression, relationship difficulties, and past sexual trauma can all play a role.

2. Biological Factors

Various biological factors can lead to ejaculation problems:

  • Hormonal Imbalances: Reduced levels of testosterone or other hormonal issues can impact sexual function.
  • Neurological Conditions: Nerve damage from diabetes, multiple sclerosis, spinal cord injuries, or pelvic surgery can interfere with ejaculation.
  • Prostate Issues: Prostate infections, surgeries, or enlargement can affect ejaculatory function.
  • Medications: Certain medications, especially antidepressants and antihypertensives, can cause delayed ejaculation or anejaculation.
  • Chronic Health Conditions: Conditions like diabetes, hypertension, and cardiovascular disease impacts blood flow and nerve function, leading to ejaculation problems.

Symptoms and Diagnosis

  • Premature Ejaculation

Symptoms include ejaculation that occurs within one minute of vaginal penetration, inability to delay ejaculation during intercourse, and negative personal consequences such as distress, frustration, or avoidance of intimacy.

  • Delayed Ejaculation

Symptoms include prolonged effort to reach ejaculation, frustration during sexual activity, reduced sexual pleasure, and emotional distress related to sexual performance.

  • Retrograde Ejaculation

Symptoms include producing little to no semen during orgasm, cloudy urine post-ejaculation, and possible infertility.

  • Anejaculation

Symptoms include the inability to ejaculate despite achieving and maintaining an erection and experiencing orgasm.


Diagnosis involves a detailed medical and sexual history, physical examination, and possibly psychological evaluation. Blood tests, urine analysis, and specialized tests like ultrasound or neurological assessments may be conducted to identify underlying causes.

Treatment Options

1. Behavioral Therapies

Behavioural techniques, such as the stop-start method and squeeze technique, can help men with premature ejaculation gain better control over their ejaculatory response. Counselling or sex therapy can address underlying psychological issues and improve sexual communication between partners.

2. Medications

  • For Premature Ejaculation: Certain selective serotonin reuptake inhibitors (SSRIs) can delay the ejaculation.
  • For Delayed Ejaculation and Anejaculation: Adjusting medications that might be causing the problem and using medicines that enhance nerve function or stimulate ejaculation, such as certain types of antidepressants or dopamine agonists.
  • For Retrograde Ejaculation: Medications to strengthen the bladder neck muscles, such as pseudoephedrine, can be effective.

3. Medical Devices

Vibratory stimulation devices can help men with anejaculation or delayed ejaculation, particularly those with spinal cord injuries, by providing targeted stimulation to trigger ejaculation.

4. Surgery

In cases where structural issues cause retrograde ejaculation, surgical correction of bladder neck dysfunction or blockage might be necessary.

Preventive Measures and Lifestyle Changes

Adopting a healthy lifestyle improves overall sexual health. Here are some lifestyle modifications that can positively impact ejaculatory function:

  • Regular Exercise: Improves blood flow and reduce stress.
  • Balanced Diet: Ensures overall health and proper hormonal balance.
  • Quit Smoking: Smoking affects blood flow and nerve function.
  • Reduce Alcohol Consumption: Excessive drinking would lead to sexual dysfunction.
  • Stress Management: Practice mindfulness, meditation, or seek therapy to reduce stress.
  • Healthy Sleep Habits: Ensure adequate rest for overall well-being.

Seeking Professional Help

Ejaculation problems are treatable, and seeking help from a specialist can lead to significant improvements. A specialist in sexual health or a urologist would provide a thorough evaluation and personalized treatment plan.

If you or a loved one are struggling with ejaculation problems, don’t wait to seek help. At Archish Fertility & IVF, our experienced professionals are dedicated in offering compassionate and effective solutions tailored to your needs. Take your first step towards a healthier, happier, intimate life. Contact us today to schedule your consultation!

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Dr. Ankita Gahlot

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Dr. Anagha Nawal

Fertility Consultant

Dr. Lakshmi Kumari A

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Navin Desai

Male Fertility Expert / Embryology Head