Treatments & Diagnosis
Ejaculatory Dysfunction (EjD)
Diagnosis and treatment for premature ejaculation, retrograde ejaculation, and anejaculation, including options that support fertility.
Treatment & Diagnosis for Premature Ejaculation
Premature ejaculation (PE) means ejaculating sooner than a man or his partner would like during sex, often with little control over the timing. An occasional early finish isn't unusual, but when it happens consistently and causes distress, it's worth discussing with a doctor.
Studies estimate the average time to ejaculation during intercourse at around 5 minutes, though this varies widely and isn't a strict benchmark, what matters more is whether it's happening in most sexual attempts and causing frustration for either partner.
PE can stem from biological, emotional, or neurological factors affecting sexual response. Common treatment options include:
- Behavioural Therapy: Techniques like the stop-start method, practiced with a partner's involvement, to build control over timing.
- Medical Therapy: Certain medications increase serotonin activity in the brain, which is linked to delayed ejaculation. These are typically taken an hour before intercourse, with effects reviewed over time.
- Numbing Creams or Sprays: Topical solutions that reduce sensation to help delay ejaculation. These need to be washed off before intercourse.
Treatment & Diagnosis for Retrograde Ejaculation
Retrograde ejaculation happens when semen enters the bladder instead of exiting through the urethra during orgasm. It doesn't affect the sensation of orgasm or overall health, but it can affect fertility since little or no semen is released.
Common causes include prostate surgery, diabetes, multiple sclerosis, and certain medications such as alpha-blockers. If fertility isn't a concern, retrograde ejaculation usually doesn't need treatment on its own.
For men who want to father children, sperm can often be retrieved from urine and used in assisted reproductive techniques such as intrauterine insemination (IUI) or in-vitro fertilisation (IVF).
Treatment & Diagnosis for Anejaculation
Anejaculation is the inability to ejaculate despite normal sexual arousal. When it's caused by medication, stopping or switching the drug, under a doctor's guidance, may restore function. For men with certain neurological conditions, vibrostimulation can often trigger ejaculation where it wouldn't otherwise occur.
Vibrostimulation: A non-invasive technique using targeted vibration to stimulate ejaculation, effective in roughly 60% of men with spinal cord injuries. It's also used to retrieve semen for procedures like IUI and IVF.
