Disorders of ejaculation and their treatment

Ejaculation is a crucial part of men's quality of sexual life. This process can often be adversely affected, however, which might lead to the development of psychic and relationship problems.
20-40% of men encounter some sort of problem with ejaculation in the course of their life, and it is very important to identify these in time.


Which are the most common sexual disorders?

  • anejaculation, or aspermia
  • retrograde ejaculation
  • premature ejaculation (You can read our article about premature ejaculation by clicking here)
  • delayed ejaculation
  • painful ejaculation


Anejaculation and its treatment

Anejaculation means the complete absence of semen.

Many things can be in its background:
  • 15% of cases are caused by a developmental anomaly
  • it can develop after an infection (prostate-, seminal vesicle-, or epididymis-inflammation)
  • indirectly, even drinking pathological amounts of alcohol can lead to anejaculation
  • radiation treatment focused on the lesser pelvis, or in rare cases, chemotherapy might also be in the background of its development
  • it is not as commonly known, but 40% of the people who have type 1 diabetes have problems with ejaculation, which usually means anejaculation
  • it might develop after certain rectal surgeries
  • neurological reasons might also be in the background, i.e. Sclerosis multiplex, injury of the spinal cord, stroke
  • certain medications can also cause aspermia, such as anti-depressants and hypotensive medications
  • in rare instances, psychic factors can also be in the background
Treatment:
Treatment is always preceded by a consultation with the patient. In light of that, the doctor determines the necessary examinations.  Once the patient's results are ready, the treatment can happen with medications, or with various neurostimulation methods (during these, we are trying to induce an ejaculation reflex with mechanical stimulation), or surgical semen extraction is also possible, if every other course of treatment turned out to be ineffective.


Retrograde ejaculation and its treatment

In the case of retrograde ejaculation, the semen discharges backwards, into the bladder. It might happen spontaneously, although in the majority of cases, it happens as a side-effect of medications, diabetes, or develops after certain urological surgeries, or perhaps it is caused by an anatomical difference.

Treatment:
After compiling the anamnesis and performing the examinations, we use medications for the treatment. If medications are ineffective, the semen that got into the bladder can be made adequate for artificial insemination.


Delayed ejaculation and its treatment

We consider it delayed ejaculation when the man cannot ejaculate at all from sexual stimulation, or just with difficulty, after a long time (35-40 minutes).
In the background of delayed ejaculation, there are usually psychic factors, such as a previous, traumatizing sexual experience, strictly religious upbringing, or lack of affection for the partner. In more rare instances, it can happen as a side-effect of medications.

Treatment:
If it developed as a side-effect of a medication, a change of medication can be attempted. In the case of psychic reasons, sexual therapy and partner therapy has a major role. Rarely, delayed ejaculation also causes infertility. In these cases, artificial insemination is possible with mechanical stimulation or surgical semen extraction.


Painful ejaculation and its treatment

Painful ejaculation usually occurs together with symptoms of the lower urinary tract, and causes milder sexual discrepancies. The pain affects the perineum, the urethra, and its opening.
The reason behind it might be inflammations, infections, but taking antidepressants, or psychic factors can also cause it.

Treatment:
According to the medical history and the laboratory examinations, treatment is done by ceasing the causative factor, i.e. inflammation, treating an infection, changing medication, psychotherapy.

Sexual health is part and parcel of a man's health, and the proper functioning of the processes of ejaculation is a crucial part of that. Thus, if you experience any of the problems discussed above, book an appointment with one of our andrologists!
Make an appointment with:
Zsolt Kopa MD, PHD
Zsolt Kopa MD, PHD
Ferenc Szabó MD
Ferenc Szabó MD