Ejaculatory Problems
What is ejaculation?
Ejaculation is the release of semen from the penis following sexual climax. When a man is sexually stimulated, the brain sends signals to the genital area through nerves in the spinal cord to make the pelvic muscles contract.
At the start of this process, waves of muscle contractions transport the sperm, with a small amount of fluid, from the testes through to the vas deferens. The seminal vesicles and prostate gland add extra fluid to protect the sperm.
This mixture of fluid and sperm (semen) travels along the urethra to the tip of the penis where it is released (ejaculated) at the time of sexual climax (orgasm).
Ejaculation is the release of semen from the penis following sexual climax. When a man is sexually stimulated, the brain sends signals to the genital area through nerves in the spinal cord to make the pelvic muscles contract.
At the start of this process, waves of muscle contractions transport the sperm, with a small amount of fluid, from the testes through to the vas deferens. The seminal vesicles and prostate gland add extra fluid to protect the sperm.
This mixture of fluid and sperm (semen) travels along the urethra to the tip of the penis where it is released (ejaculated) at the time of sexual climax (orgasm).
What is retrograde ejaculation?
In men with retrograde ejaculation, the muscle at the opening of the bladder, which usually stops semen from entering the bladder during orgasm, does not close normally. When the muscle does not close properly semen flows back into the bladder. Therefore little or no semen is discharged from the penis during ejaculation, and the first urination after sex looks cloudy as the semen mixes into the urine. Retrograde ejaculation is uncommon and harmless.
What causes retrograde ejaculation?
Retrograde ejaculation can happen after surgery to the prostate or the neck of the bladder. Diabetes, multiple sclerosis, spinal cord injury, and some medications, in particular medicines for high blood pressure, can also cause it. Depending on the cause, retrograde ejaculation may be a temporary or permanent condition.
How is retrograde ejaculation treated?
Most men who have retrograde ejaculation do not need treatment. The important message is that it doesn’t cause serious problems. However, it is difficult for men with retrograde ejaculation to have a baby naturally.
For men wishing to have a family, treatment may correct the retrograde ejaculation, or sperm may need to be collected in other ways for use in assisted reproduction procedures such as in vitro fertilisation (IVF). A fertility specialist can take sperm from the urine, or they can take sperm directly from the testes in a small operation (biopsy).
What is delayed ejaculation?
Delayed ejaculation and anorgasmia describe the inability to ejaculate at will, so that ejaculation (and orgasm) takes much longer than desired, or does not happen at all. This might happen only with intercourse, or in all situations including self-stimulation (masturbation). The term anejaculation describes when a man does not ejaculate after orgasm. “Orgasm” and “ejaculation” are often used interchangeably, but some men can
experience orgasm even though they don’t ejaculate.
What causes delayed ejaculation?
Physical causes include spinal cord injury, major lymph node surgery, diabetes, multiple sclerosis and traumatic injury to the pelvic region, when the nerve supply is affected.
Delayed ejaculation is a well-documented side-effect of some antidepressants specifically SSRIs). While delayed ejaculation can be caused by relationship difficulties, persistent anorgasmia with no medical cause is very uncommon.
How is delayed ejaculation treated?
A change of antidepressant medication may be needed for men who are concerned about this side-effect. Vibrator stimulation and electrical stimulation of the penis can be used to promote reflex ejaculation in men who can’t ejaculate, but want to father a baby. Men who are concerned about being unable to ejaculate when there is no medical reason for this difficulty may need long-term individual counselling or
therapy.
What is painful ejaculation?
Painful ejaculation is when painful, burning sensations are felt during or following ejaculation. Pain can be felt in the perineum (the area between the anus and the genitals) and the urethra (a tube that runs from the bladder to the end of the penis).
The condition can cause discomfort in the testes and interfere with sexual pleasure.
What causes painful ejaculation?
Any condition that causes inflammation or an infection of the organs that are involved in ejaculation or surrounding structures may cause painful ejaculation.
How is painful ejaculation treated?
The treating doctor should assess the cause of the pain and treat as appropriate.
The treatment might be a course of antibiotics for infection, or it might need
referral to a specialist (urologist) for more complex investigations.
c/o Monash Institute of Medical Research Victoria Australia
Andrology Australia is an initiative funded by the Australian Government Department of Health and Ageing.
This information has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. Andrology Australia urges readers to seek the services of a qualified medical practitioner for any personal health concerns.
In men with retrograde ejaculation, the muscle at the opening of the bladder, which usually stops semen from entering the bladder during orgasm, does not close normally. When the muscle does not close properly semen flows back into the bladder. Therefore little or no semen is discharged from the penis during ejaculation, and the first urination after sex looks cloudy as the semen mixes into the urine. Retrograde ejaculation is uncommon and harmless.
What causes retrograde ejaculation?
Retrograde ejaculation can happen after surgery to the prostate or the neck of the bladder. Diabetes, multiple sclerosis, spinal cord injury, and some medications, in particular medicines for high blood pressure, can also cause it. Depending on the cause, retrograde ejaculation may be a temporary or permanent condition.
How is retrograde ejaculation treated?
Most men who have retrograde ejaculation do not need treatment. The important message is that it doesn’t cause serious problems. However, it is difficult for men with retrograde ejaculation to have a baby naturally.
For men wishing to have a family, treatment may correct the retrograde ejaculation, or sperm may need to be collected in other ways for use in assisted reproduction procedures such as in vitro fertilisation (IVF). A fertility specialist can take sperm from the urine, or they can take sperm directly from the testes in a small operation (biopsy).
What is delayed ejaculation?
Delayed ejaculation and anorgasmia describe the inability to ejaculate at will, so that ejaculation (and orgasm) takes much longer than desired, or does not happen at all. This might happen only with intercourse, or in all situations including self-stimulation (masturbation). The term anejaculation describes when a man does not ejaculate after orgasm. “Orgasm” and “ejaculation” are often used interchangeably, but some men can
experience orgasm even though they don’t ejaculate.
What causes delayed ejaculation?
Physical causes include spinal cord injury, major lymph node surgery, diabetes, multiple sclerosis and traumatic injury to the pelvic region, when the nerve supply is affected.
Delayed ejaculation is a well-documented side-effect of some antidepressants specifically SSRIs). While delayed ejaculation can be caused by relationship difficulties, persistent anorgasmia with no medical cause is very uncommon.
How is delayed ejaculation treated?
A change of antidepressant medication may be needed for men who are concerned about this side-effect. Vibrator stimulation and electrical stimulation of the penis can be used to promote reflex ejaculation in men who can’t ejaculate, but want to father a baby. Men who are concerned about being unable to ejaculate when there is no medical reason for this difficulty may need long-term individual counselling or
therapy.
What is painful ejaculation?
Painful ejaculation is when painful, burning sensations are felt during or following ejaculation. Pain can be felt in the perineum (the area between the anus and the genitals) and the urethra (a tube that runs from the bladder to the end of the penis).
The condition can cause discomfort in the testes and interfere with sexual pleasure.
What causes painful ejaculation?
Any condition that causes inflammation or an infection of the organs that are involved in ejaculation or surrounding structures may cause painful ejaculation.
How is painful ejaculation treated?
The treating doctor should assess the cause of the pain and treat as appropriate.
The treatment might be a course of antibiotics for infection, or it might need
referral to a specialist (urologist) for more complex investigations.
c/o Monash Institute of Medical Research Victoria Australia
Andrology Australia is an initiative funded by the Australian Government Department of Health and Ageing.
This information has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. Andrology Australia urges readers to seek the services of a qualified medical practitioner for any personal health concerns.
