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Premature or Early Ejaculation
Summary •
Singular definitions •
Causes •
Treatment •
References •
Inhibited or delayed ejaculation
Summary •
Singular definitions •
Causes •
Treatment •
References •
Retrograde ejaculation
Summary •
Singular definitions •
Causes •
Treatment •
References •
INHIBITED OR DELAYED EJACULATION
CAUSES
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Causes:
Any single, or a combination of psychological or medical disease, surgical procedure or drugs that interferes with the nerves or any of the structures involved in ejaculation [neck of the bladder, prostate gland or penis] can result in inhibited ejaculation.
Psychological:
Any single, or a combination of psychological or medical disease, surgical procedure or drugs that interferes with the nerves or any of the structures involved in ejaculation [neck of the bladder, prostate gland or penis] can result in inhibited ejaculation.
Psychological:
- Fear: of pregnancy or of losing control, difficulty due to repeated treatments for infertility.
- Problems with intimacy: preference for masturbation over partnered sex.
- Relationship: hostility, lack of love or attraction, insufficient arousal through lack of guiding or unwillingness on the part of the partner, fear of soiling because of his partner’s dislike of it, anger at women.
- Anxiety: about pleasing his partner, work, finance, illness, performance anxiety. The man may have always masturbated in an unusual way, and the stimulation he receives from his partner is not able to bring him to climax [2]. Some men cannot masturbate for cultural or religious reasons, and have not learned to ‘let go’ during intercourse.
- Drugs and medication: especially some anti-depressants, some anti-hypertensive drugs, alcohol.
- Neurological [disease of the nerves]: multiple sclerosis, spinal cord injury, diabetes.
- Congenital: if ejaculation is completely absent even with masturbation then medical investigations would have to be done to exclude a physical abnormality.
- Hormonal: inability to ejaculate is one of the sexual consequences of testosterone deficiency and is rapidly restored with testosterone replacement treatment [3]. Consult your doctor, and a blood test would show if there is a low testosterone level.
- Ageing: ejaculation is delayed or absent intermittently with increasing age. In older men reduced sensitivity of the penis may result in difficulty in getting the required threshold of sensation to achieve ejaculation.
- Contraception: men who use coitus interruptus [‘withdrawal method’ of contraception] learn to control themselves in order to prevent ejaculation into the vagina, and in some instances over-control and anxiety about causing pregnancy prevent ejaculation into the vagina, and this persists even when the risk of pregnancy no longer exists.
