Materiały źródłowe

• #1 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Ejaculation problems are common sexual problems in men. […] The 3 main types of ejaculation problems are: premature ejaculation, delayed ejaculation, retrograde ejaculation. […] Various psychological and physical factors can cause a man to suddenly experience premature ejaculation. […] Common physical causes include: prostate problems, thyroid problems an overactive thyroid or an underactive thyroid, using recreational drugs. […] Common psychological causes may include: depression, stress, relationship problems, anxiety about sexual performance. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression.

• #2 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Ejaculation problems are common sexual problems in men. The three main ejaculation problems are: premature ejaculation, delayed ejaculation, and retrograde ejaculation. Premature ejaculation is the most common ejaculation problem. Various psychological and physical factors can cause a man to suddenly experience premature ejaculation. Common physical causes include prostate problems, thyroid problems, and using recreational drugs. Common psychological causes include depression, stress, relationship problems, and anxiety about sexual performance. Delayed ejaculation can also be caused by psychological and physical factors. Physical causes of delayed ejaculation include diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, and increasing age. Many medicines are known to cause delayed ejaculation, including antidepressants, medications to treat high blood pressure, antipsychotics, muscle relaxants, and powerful painkillers. Retrograde ejaculation is caused by damage to the nerves or muscles that surround the neck of the bladder where the urethra connects. The most common causes of retrograde ejaculation include prostate gland surgery and bladder surgery. Other potential causes include diabetes and multiple sclerosis.

• #3 Ejaculatory Disorders | University of Utah Health

  https://healthcare.utah.edu/fertility/conditions/ejaculatory-disorders

  Ejaculation disorders are problems with how your penis releases semen (ejaculates). […] Anything that damages your nerves or interferes with the ejaculation process can lead to an ejaculation disorder. […] Ejaculation problems can cause significant distress and sexual dissatisfaction. There are a few common types of ejaculation problems: […] Experts dont know the exact cause of premature ejaculation. It could have to do with your sensitivity levels or hormones. Sometimes its psychological. Several factors could influence the speed of your orgasm: […] Retrograde ejaculation is uncommon. But some conditions and medications can lead to this problem: […] Delayed ejaculation can occur for psychological reasons. It can also occur due to physical causes:

• #4 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  Delayed ejaculation can be a brief or lifelong problem. Possible causes of delayed ejaculation include certain ongoing health conditions, surgeries and medicines. […] Some medicines, certain ongoing health conditions and surgeries can cause delayed ejaculation. Other causes include substance misuse or a mental health concern, such as depression, anxiety or stress. Often, it’s due to a mix of physical and psychological concerns. […] Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions. Relationship problems due to stress, not communicating well or other concerns. Anxiety about performance. Poor body image. Cultural or religious taboos. Differences between the reality of sex with a partner and sexual fantasies. […] Medicines and other substances that can cause delayed ejaculation include: Some antidepressants or antipsychotics. Certain high blood pressure medicines. Certain water pills, called diuretics. Some antipsychotic medicines. Some antiseizure medicines. Too much alcohol.

• #5 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Ejaculation problems are common sexual problems in men. […] The 3 main types of ejaculation problems are: premature ejaculation, delayed ejaculation, retrograde ejaculation. […] Various psychological and physical factors can cause a man to suddenly experience premature ejaculation. […] Common physical causes include: prostate problems, thyroid problems an overactive thyroid or an underactive thyroid, using recreational drugs. […] Common psychological causes may include: depression, stress, relationship problems, anxiety about sexual performance. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression.

• #6 Premature ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-ejaculation/symptoms-causes/syc-20354900

  Premature ejaculation occurs in men when semen leave the body (ejaculate) sooner than wanted during sex. The exact cause of premature ejaculation isn’t known. It was once thought to be only psychological. But health care providers now know that premature ejaculation involves a complex interaction of psychological and biological factors. Psychological factors that might play a role include: Early sexual experiences, Sexual abuse, Poor body image, Depression, Worrying about premature ejaculation, Guilty feelings that can cause you to rush through sex. A number of biological factors might contribute to premature ejaculation. They may include: Irregular hormone levels, Irregular levels of brain chemicals, Swelling and infection of the prostate or urethra, Inherited traits.

• #7 Delayed ejaculation – Wikipedia

  https://en.wikipedia.org/wiki/Delayed_ejaculation

  Psychological (acute psychological distress, relationship distress, psychosexual skill deficit, disconnect between arousal and sexual situations, masturbation style and frequency, etc.) […] Psychological and lifestyle factors have been discussed as potential contributors, including insufficient sleep, distraction due to worry, distraction from the environment, anxiety about pleasing their partner and anxiety about relationship problems. […] Religious guilt over sex can cause delayed ejaculation. […] „Spectatoring”, the problem of perceiving sex as a performance rather than a mutual experience and process of pleasure „in the moment” can cause delayed ejaculation. […] Men who are solely aroused by sexual fetishes may be unable to ejaculate from regular intercourse. […] Idiosyncratic masturbation (also known as „idiosyncratic masturbatory style”) and lack of desire for stimuli are also proposed risk factors for DE.

• #8 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  Psychogenic and biogenic etiologies of DE usually are neither independent nor mutually exclusive, with both categories overlapping and including a combination of factors involving both etiological domains. […] There are many psychological and relational factors that have been traditionally implicated as predisposing and/or confounding factors in the etiology of DE, such as fear and/or ambivalence regarding pregnancy and fertility issues, hostility and anger, fear of loss of control, fears of abandonment/rejection, fears of intimacy and loss of autonomy, paraphilic inclinations/interests, and fears of hurting/defiling the partner. […] Masters and Johnson were the first to claim that DE in some men might be associated with orthodoxy of a religious belief. Such prohibitions may limit the male’s sexual experience necessary for learning to ejaculate or may result in an inhibition of normal function.

• #9 The 3 types of ejaculation problems (yes, 3!)

  https://www.numan.com/premature-ejaculation/causes/3-types-of-ejaculation-problems

  Its not uncommon for a man to run into a problem with ejaculation, but most men dont realise that there are actually 3 distinct types of ejaculation problems. […] Heres everything you need to know about the types, causes, and treatments for each ejaculation problem. […] The root cause of your premature ejaculation can be either psychological or physical. […] Physical causes of premature ejaculation include: Prostate problems such as prostatitis (inflammation of the prostate), Thyroid issues (an overactive or underactive thyroid gland), Problem with nerves, Recreational drugs or prescription medication, Biological predisposition (having a particularly sensitive penis). […] Psychological causes of premature ejaculation include: Relationship issues, Stress, Depression, Performance anxiety, Guilty feelings about sex (this could be brought on by a strict upbringing with specific beliefs about sex), Fear of sex, Early sexual experiences that encouraged quick ejaculation (such as a fear of being caught masturbating by parents), Sexual trauma (such as sexual abuse or an uncomfortable sexual experience).

• #10 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  Physical causes of delayed ejaculation include: Certain birth defects that affect the reproductive system. Injury to the pelvic nerves that control orgasm. Certain infections, such as a urinary tract infection. Prostate surgery, such as transurethral resection of the prostate or prostate removal. Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord. Hormone-related conditions, such as low thyroid hormone level, called hypothyroidism, or low testosterone level, called hypogonadism. A condition in which the semen goes backward into the bladder rather than out of the penis, called retrograde ejaculation.

• #11 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. […] The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors. Despite the many publications on this condition, the exact pathogenesis is not yet known. […] Many of these etiologic factors are not supported by good evidence-based data, but rather are based on case reports and case series. […] Ejaculation involves emission, bladder neck closure, and expulsion (ejaculation proper). […] On one hand, it was argued that DE may be caused by psychosexual, psychosocial, or relationship problems. On the other hand, it has been argued that DE is caused by genetic, neurobiological, endocrine, anatomic, and infectious factors, or may be drug-induced.

• #12 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis. […] Retrograde ejaculation happens when the neck of the bladder does not close and semen passes into the bladder. […] Causes of retrograde ejaculation include prostate gland surgery, bladder surgery, diabetes, multiple sclerosis, and a class of medicines known as alpha blockers.

• #13 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can have physical or psychological causes. […] There are physical and psychological (mental and emotional) causes for delayed ejaculation. […] Physical causes may include conditions that affect your nervous system, such as a stroke, spinal cord injury or multiple sclerosis (MS) nerve damage may also occur as a complication of diabetes or surgery. […] Psychological causes may include feeling guilty about sexual intercourse, possibly due to your upbringing or religious background. […] Many men have delayed ejaculation issues as they get older. […] It depends. The hormone testosterone is essential for sperm production and enhances your sex drive. […] Delayed ejaculation can affect anyone.

• #14 Weak Ejaculation: Symptoms, Causes, Treatment, and Home Remedies

  https://www.healthline.com/health/mens-health/weak-ejaculation

  Some causes of weak ejaculation may include aging, stress, low testosterone levels, and erectile conditions, among others. […] Weak ejaculation is when you dont ejaculate with as much force or volume as you used to. […] A problem during the emission stage may reduce the amount of semen you ejaculate, while a problem during the expulsion stage could reduce the force with which semen is expelled. […] Weak ejaculations are most commonly related to getting older. Just as age may weaken your eyesight, it can also reduce both the strength and volume of your ejaculation. […] Age also has a significant impact on testosterone levels, which is a male hormone that plays a key role in sex drive, sperm production, and sperm quality. […] However, testosterone levels start to decrease by up to 2% each year after age 30 years. Over time, this could lead to weak ejaculations and other sex-related problems.

• #15 Ejaculatory Dysfunction | Urology Associates | Denver Metro

  https://www.denverurology.com/mens-fertility-sexual-health/ejaculatory-dysfunction/

  The cause of retrograde ejaculation is a fault in the muscle at the neck of the bladder that usually prevents ejaculate from flowing back into the bladder through the tube carrying ejaculate from the prostate to the urethra. The fault may be due to nerve damage from a medical condition (diabetes, spinal cord injury), reaction to certain medications or surgery (bladder, prostate). […] Reactions to certain medications can cause anejaculation, as can surgical procedures that affect the nerves involved in ejaculation. Most likely, the cause is a psychological issue that may involve upbringing and lack of affection.

• #16 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Acquired PE may occur due to psychological problems – such as sexual performance anxiety, and psychological or relationship problems and/or co-morbidity, including ED, prostatitis, hyperthyroidism and poor sleep quality. […] A significant proportion of men with ED also experience PE. […] High levels of performance anxiety related to ED may worsen PE, with a risk of misdiagnosing PE instead of the underlying ED. […] Other reported risk factors for PE include genetic predisposition, poor overall health status and obesity, prostate inflammation, hyperthyroidism, low prolactin levels, high testosterone levels, vitamin D and B12 deficiency, diabetes, MetS, lack of physical activity, emotional problems and stress, depressive symptoms, and traumatic sexual experiences. […] The aetiology of DE can be psychological, organic (e.g., incomplete spinal cord lesion or iatrogenic penile nerve damage), or pharmacological (e.g., SSRIs, antihypertensive drugs, or antipsychotics).

• #17 Ejaculatory Dysfunction | Urology Associates | Denver Metro

  https://www.denverurology.com/mens-fertility-sexual-health/ejaculatory-dysfunction/

  Ejaculatory dysfunction is the inability of a man to efficiently ejaculate semen from the penis at the moment of sexual climax. […] Ejaculation disorders, also called aspermia, can be caused by a problem at birth (primary) or by acquired dysfunctions (secondary) after birth (often much later in life), such as disease, injury and adverse drug reactions. […] Causes of premature ejaculation are erectile dysfunction, anxiety, heightened sensitivity and neurological problems. […] Causes of delayed ejaculation can be physical, psychological or the side effects of certain medications. Causes also include alcohol abuse, diuretics (drugs or food and beverage ingredients that accelerate the body’s loss of water), high blood pressure, or the use of antidepressant, anti-seizure or antipsychotic medications.

• #18 Delayed or Absent Ejaculation | Department of Urology | UPMC

  https://www.upmc.com/services/urology/conditions/delayed-or-absent-ejaculation

  A delayed or absent ejaculation happens when a man takes an especially long time to ejaculate or can’t come at all. […] The causes of delayed ejaculation (DE) vary but may be due to: Chronic health conditions, Surgeries, Medicine. […] Physical causes of DE include: Blocks in the ducts that semen passes through, Nervous system diseases, Nerve damage to the pelvis from surgery, Anti-seizure drugs or antidepressants, Alcoholism, Urinary tract infections, Hormone issues, such as low thyroid or low testosterone, Birth defects to the male reproductive system. […] Mental causes include: Depression or tension, Cultural or religious taboos, When the fantasy differs from the sex partner, Relationship problems, such as problems bonding, Poor self-confidence. […] Physical causes of DE include: Blocks in the ducts that semen passes through, Nervous system diseases, Nerve damage to the pelvis from surgery, Anti-seizure drugs or antidepressants, Alcoholism, Urinary tract infections, Hormone issues, such as low thyroid or low testosterone, Birth defects to the male reproductive system.

• #19 Delayed ejaculation – Wikipedia

  https://en.wikipedia.org/wiki/Delayed_ejaculation

  Neurogenic causes (diabetic autonomic neuropathy, spinal cord or nerve root injury from trauma or disc prolapse, multiple sclerosis, etc.). DE can be due to the injury to pelvic nerves responsible for orgasm from trauma as a result of pelvic surgery (viz., prostate surgery including transurethral resection of prostate and bladder neck incision, proctocolectomy, bilateral sympathectomy, abdominal aortic aneurysmectomy, para-aortic lymphadenectomy etc.). […] Some researchers believe that circumcision has a negative effect on men’s ejaculation during sex, while others believe that circumcision has no effect. […] Endocrine (hypogonadism, pituitary disorders such as hyperprolactinaemia and Cushing’s disease, thyroid disorders, etc.). […] Delayed ejaculation is a possible side effect of alcohol and certain medications, including antipsychotics, antidepressants including selective serotonin reuptake inhibitors (SSRIs), opiates such as morphine or oxycodone, many benzodiazepines such as Valium or Xanax, and certain antihypertensives including thiazide diuretics, alpha-adrenergic blockers and ganglion blockers.

• #20 Erectile Dysfunction | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/erectile-dysfunction

  Ejaculation problems can result from certain treatments for prostate problems, including medications, surgeries and radiation therapy. Ejaculation changes are also common as men age. […] Changes in ejaculation also influence the perception of orgasm for some men, while others experience ejaculation but have a mild or even no sensation of orgasm. […] ED is most commonly related to aging, but it also has a wide range of psychological, neurological, vascular, hormonal and pharmaceutical causes, and may result from radiation and surgical treatments for prostate and bladder cancer. […] The cavernous nerve bundles, the nerves that drive erection, are located next to the prostate gland. During a radical prostatectomy, these nerves may be injured. In many cases, this results in ED that is permanent, although the degree of dysfunction may be lessened through treatment.

• #21 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  Delayed ejaculation can be a brief or lifelong problem. Possible causes of delayed ejaculation include certain ongoing health conditions, surgeries and medicines. […] Some medicines, certain ongoing health conditions and surgeries can cause delayed ejaculation. Other causes include substance misuse or a mental health concern, such as depression, anxiety or stress. Often, it’s due to a mix of physical and psychological concerns. […] Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions. Relationship problems due to stress, not communicating well or other concerns. Anxiety about performance. Poor body image. Cultural or religious taboos. Differences between the reality of sex with a partner and sexual fantasies. […] Medicines and other substances that can cause delayed ejaculation include: Some antidepressants or antipsychotics. Certain high blood pressure medicines. Certain water pills, called diuretics. Some antipsychotic medicines. Some antiseizure medicines. Too much alcohol.

• #22 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Delayed ejaculation is when you have trouble reaching orgasm and ejaculating. […] Delayed ejaculation can be a temporary or lifelong condition. […] Treatment depends on the cause. […] The causes of delayed ejaculation are different for everyone and can be complicated. […] Many different types of medicines can cause delayed ejaculation, including antidepressants, some strong pain-relief medicines, and some medicines for high blood pressure and heart disease. […] Alcohol and some recreational drugs can also cause delayed ejaculation. […] There can be physical reasons for delayed ejaculation, such as surgery or trauma to your pelvis or genitals, problems with your reproductive system, problems with your nerves or spinal cord, some hormonal conditions, chronic illnesses, such as diabetes or multiple sclerosis, and ageing.

• #23 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  An age-dependent increase in the prevalence of DE was reported in various studies. […] These findings have led to the hypothesis that genetic factors can affect a person’s predisposition to DE/AE. […] The significant heterogeneity in the occurrence and the presentation of SSRI-related sexual dysfunction may suggest underlying genetic factors. […] The list of organic causes possibly leading to DE/AE is extensive and is outlined in Table 1, 2, 3. […] Complaints of DE/AE in patients taking medications are not uncommon. Different medications may interfere with either central or peripheral control of ejaculation, potentially affecting the IELT.

• #24 Delayed Ejaculation: Symptoms, Causes & Treatment | hims

  https://www.forhims.co.uk/blog/delayed-ejaculation-causes-treatment

  Sexual performance anxiety. Even if you don’t have an anxiety disorder, it’s common to feel anxious before sex. This is called sexual performance anxiety, and it may cause symptoms such as erectile dysfunction or difficulty ejaculating. […] Sometimes, delayed ejaculation is linked to a physical factor, like nerve damage or taking a certain type of medication. […] Potential physical causes of delayed ejaculation include: Insufficient sexual stimulation. One study found that men with delayed ejaculation had decreased sensitivity in the penile shaft. […] Some medications may affect your ability to orgasm and ejaculate. Prescription drugs associated with delayed ejaculation include antidepressants like SSRIs (selective serotonin reuptake inhibitors), diuretics, high blood pressure (hypertension) medications, anti-seizure meds, and antipsychotics. […] Damage to the pelvic nerves (those responsible for controlling the ability to orgasm and ejaculate) can cause delayed ejaculation. […] Conditions like low testosterone or hypothyroidism (underactive thyroid) could affect sexual performance and the ability to reach orgasm and ejaculate.

• #25 Overcoming Ejaculation Problems: Delayed, Premature, and Retrograde Ejaculation

  https://www.webmd.com/men/features/overcoming-ejaculation-problems

  There are lots of different reasons for delayed ejaculation. Some medicines — like antidepressants — can cause it. For many men, it happens due to age. As we grow older, the nerve endings in the penis become less sensitive, says Barbara Keesling, PhD, author of All Night Long: How to Make Love to a Man Over 50, and a professor of human sexuality at the California State University, Fullerton. […] But while masturbation can cause delayed ejaculation, it can also aid in the cure. If a guy won’t agree to keep his hands off, Perelman will urge him at least to alter his masturbation style — to switch hands, for example — in order to break old habits. […] For men who aren’t helped by any of these techniques, there’s a pharmaceutical option. Since some antidepressants — selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation, researchers tried them as a way to treat premature ejaculation.

• #26 Weak Ejaculation: Symptoms, Causes, Treatment, and Home Remedies

  https://www.healthline.com/health/mens-health/weak-ejaculation

  Any condition that affects the muscles and nerves controlling ejaculation can lead to a weaker-than-normal orgasm. […] Perceived ejaculate volume reduction (PEVR) is another common type of ejaculation dysfunction in males that could cause weak ejaculation. […] Several psychological factors have been associated with conditions that may cause ejaculation problems, such as weak ejaculation. […] Some causes of weak ejaculation include aging, low testosterone levels, retrograde ejaculation, psychological stressors, and lifestyle factors like smoking, having obesity, and drinking alcohol. […] Having an orgasm with little or no semen is known as anejaculation. Some causes of anejaculation may include prostate surgery, conditions like diabetes and multiple sclerosis, and medications like alpha-blockers. […] Problems with ejaculation are common in males, particularly as you get older.

• #27 Ejaculation Disorders – Types, Causes & Treatment | CCRM Fertility

  https://www.ccrmivf.com/ejaculation-disorders/

  Ejaculation provides an essential function in conception by expelling semen through the urethra and out of the penis. A variety of physical and psychological factors can impact ejaculation, but fortunately ejaculation disorders are often treatable. […] Causes of premature ejaculation include: Psychological factors, such as anxiety or depression; Heightened sensitivity; Diabetes. […] Delayed ejaculation is caused by a number of physical and psychological factors, as well as the use of certain medications, such as antidepressants, antipsychotics, diuretics, and medications for seizures and high blood pressure. […] Additional causes of delayed ejaculation include: Hormone issues; Birth defects; Infections; Prostate surgery; Neurological disorders; Anxiety; Depression; Alcohol. […] Retrograde ejaculation can be caused by nerve damage from a medical condition, such as diabetes, surgery, as well as certain medications. […] Anejaculation is caused by a variety of factors, including as a reaction to certain medications or surgical procedures, injuries to nervous system, as well as an infection in the prostate. Anejaculation can also be caused by stress or psychological factors.

• #28 I have been suffering from premature ejaculation for many years. Please help.

  https://www.icliniq.com/qa/premature-ejaculation/what-are-the-possible-causes-for-premature-ejaculation-for-many-years

  There are many reasons for premature ejaculation, such as: […] Diabetes, hypertension, and thyroid issues affect premature ejaculation. Keeping your blood sugar, blood pressure, and thyroid hormones under control will help you. […] On long-term medication related to hypertension and anti-psychiatric drugs. […] Frequent masturbation. […] Excess porn. […] Receiving less foreplay from a partner or lack of knowledge regarding foreplay and female masturbation. […] Lack of exercise and obesity.

• #29 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Ejaculation is a complex physiological process that comprises emission and expulsion processes and is mediated by interwoven neurological and hormonal pathways. Any interference with those pathways may cause a wide range of ejaculatory disorders. The spectrum of ejaculation disorders includes premature ejaculation (PE), retarded or delayed ejaculation, anejaculation, painful ejaculation, retrograde ejaculation, anorgasmia and haemospermia. […] The aetiology of PE is relatively unknown, with limited data to support suggested biological and psychological hypotheses, including anxiety, penile hypersensitivity and 5-hydroxytryptamine (HT) receptor dysfunction. […] It has been hypothesised that the pathophysiology of lifelong PE is mediated by a complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and epigenetic factors.

• #30 Premature Ejaculation: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/435884-overview

  Premature ejaculation is the most common sexual disorder in men younger than 40 years, with 30-70% of males in the United States affected to some degree at one time or another. It has historically been considered a psychological disease with no identified organic cause. […] Premature ejaculation may be lifelong or acquired. Lifelong premature ejaculation applies to individuals who have had the condition since they became capable of functioning sexually (ie, post puberty). […] Acquired premature ejaculation means that the condition began in an individual who previously experienced an acceptable level of ejaculatory control and, for unknown reasons, began experiencing premature ejaculation later in life. Acquired premature ejaculation is not related to a general medical disorder and usually is not related to substance inducement, though in rare cases, hyperexcitability might be associated with a psychotropic drug and resolve when the drug is withdrawn.

• #31 Premature Ejaculation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546701/

  Premature ejaculation is primarily psychological in nature. However, the precise cause of premature ejaculation remains largely undetermined. Several contributing risk factors, both biological and psychological, have been identified. […] Abnormal levels of the brain neurotransmitter serotonin (low serotonin levels shorten the time to ejaculation) […] Depression […] Anxiety […] Stress […] Guilt […] Narcissism […] Distorted thinking […] Unrealistic expectations about sexual performance […] Performance anxiety […] History of sexual repression […] Overall lack of confidence/poor body image […] History of sexual abuse or prior bad experience […] Relationship problems […] Control issues with partner […] Feeling of self-loathing […] Unrealistic fear of harm from vaginal penetration

• #32 How Do You Fix Ejaculation Problems? 3 Causes & 5 Methods

  https://www.medicinenet.com/how_do_you_fix_ejaculation_problems/article.htm

  It’s common for ejaculation problems to occur as you age. […] Experts estimate that at least one in five men will struggle with ejaculation problems sometime during their life. While the problem is primarily psychological, an individuals biology may also be a factor. […] Ejaculation problems usually dont pose health concerns, but they can be embarrassing to experience. […] Serotonin: This is a chemical your body produces to balance feelings and emotions. Higher amounts of serotonin lead to a longer wait before ejaculation. If your serotonin levels are low, you may experience premature ejaculation. […] Mental health: If you are struggling with psychological issues, it may lead to premature ejaculation. When you address mental health issues, you may be able to overcome ejaculation problems.

• #33 Premature ejaculation – Wikipedia

  https://en.wikipedia.org/wiki/Premature_ejaculation

  PE may be caused by prostatitis or as a medication side effect. […] PE has been classified into four subtypes – lifelong, acquired, variable and subjective PE. The pathophysiology of lifelong PE is mediated by a complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and epigenetic factors. Acquired PE may occur due to psychological problems – such as sexual performance anxiety, and psychological or relationship problems – and/or co-morbidity, including erectile dysfunction, prostatitis and hyperthyroidism.

• #34 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  Delayed ejaculation (DE) is probably least studied, and least understood of male sexual dysfunctions, with an estimated prevalence of 14% of the male population. Pathophysiology of DE is multifactorial and including psychosexual-behavioral and cultural factors, disruption of ejaculatory apparatus, central and peripheral neurotransmitters, hormonal or neurochemical ejaculatory control and psychosocial factors. […] Although knowledge of the physiology of the DE has increased in the last two decades, our understanding of the different pathophysiological process of the causes of DE remains limited. […] The pathophysiological etiology of DE should be established thorough medical, psychosexual and psychosocial history. The etiology of DE is usually multidimensional, resulting from the man’s biologic ejaculatory latency being affected by multiple organic biological, or psychogenic factors in varying combinations during his life. It can be of the primary (lifelong) or secondary (acquired) origin.

• #35 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  Delayed ejaculation (DE) occurs when a man needs more than 30 minutes of sexual stimulation to reach orgasm and ejaculate. […] DE has multiple causes, including anxiety, depression, neuropathy, and reactions to medications. […] There are many potential causes of DE, including psychological concerns, chronic health conditions, and reactions to medications. […] Psychological causes of DE can occur due to a traumatic experience. Cultural or religious taboos can give sex a negative connotation. Anxiety and depression can both suppress sexual desire, which may result in DE as well. […] Certain chemicals can affect the nerves involved in ejaculation. This can affect ejaculation with and without a partner. […] Surgeries or trauma may also cause DE. The physical causes of DE may include damage to the nerves in your spine or pelvis, certain prostate surgeries that cause nerve damage, heart disease that affects blood pressure to the pelvic region, infections, especially prostate or urinary infections, neuropathy or stroke, low thyroid hormone, low testosterone levels, and birth defects that impair the ejaculation process.

• #36 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm. Etiologies of DO/AO include medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia. […] There remains a paucity of standardized treatments for men with ejaculatory and/or orgasmic dysfunction. […] Male orgasmic dysfunction can be dichotomized as two ends of a spectrum: premature ejaculation (PE) versus DO and anorgasmia (AO). […] Several etiologies have been identified in the pathophysiology of DO, owing to the multifactorial, complex nature of the disorder. The most common etiologies include selective serotonin reuptake inhibitors (SSRI; 42%), psychogenic (28%), low testosterone (T; 21%), abnormal penile sensation (7%), and penile hyperstimulation (2%).

• #37 Delayed Ejaculation Disorder | Symptoms, Causes, Diagnosis

  https://firstlightpsych.com/delayed-ejaculation-disorder/

  Delayed ejaculation is also known as impaired ejaculation. It is a disorder where it takes a prolonged period of sexual stimulation for a man to reach orgasm and to ejaculate (the expulsion of semen from the body). Some men suffering from this disorder are not able to achieve ejaculation at all. […] Delayed ejaculation affects approximately 1 to 4 percent of men. […] Successful treatment is dependent upon the cause of delayed ejaculation and the type of ongoing treatment. […] Psychological causes include: Anxiety, Depression, or other mental health conditions, Relationship issues related to stress or related concerns, Performance anxiety, Poor body image, Cultural, or religious restrictions, Differences between sexual fantasies and reality. […] Medications and substances include: Certain anti-depressants, Some medications of high blood pressure, Diuretics, Antipsychotic medications, Anti-seizure medications, Excessive use of alcohol.

• #38 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  In his review on the psychological etiology of DE, Apfelbaum noted that some males appear capable of achieving erections sufficient for intercourse despite a relative absence of subjective arousal. […] Another commonly accepted pathophysiological factor for DE is autosexual orientation, a term used to describe men with DE who prefer masturbation over partnered sex. […] The pathophysiology of DE in relation to congenital abnormalities is complex and is dependent upon anatomical variations of the pelvic floor and the physiological functioning of the organs located into the pelvic floor. […] Acquired or secondary DE is the result of an identifiable surgical procedure, a different medical condition or psychosexual changes. It may affect ejaculation by a variety of ways, such as via disruption of the chemical or nervous control of ejaculation, or directly at the site of the ejaculatory organs themselves.

• #39 Delayed ejaculation: Causes, treatment, and outlook

  https://www.medicalnewstoday.com/articles/284679

  Delayed ejaculation refers to a difficulty or inability of a male to reach an orgasm and ejaculate semen. Both physical and psychological issues can cause someone to be unable to climax. […] Delayed ejaculation can have a psychological or biological cause. There can also be an overlap between the two. It can be a lifelong condition, where a person has always had difficulty reaching an orgasm. […] Physical causes of delayed ejaculation include the following: Medication side effects can be a reason. Delayed ejaculation may be an adverse effect of: antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), antianxiety drugs, blood pressure medication, painkillers, other medications. […] Some psychological factors that may contribute to delayed ejaculation include: early life history, including abuse, difficulties bonding, neglect by parents, or a negative sexual upbringing, unexpressed anger, inability to enjoy pleasure, religious belief, perhaps that sexual activity is a sin, fear of, for instance, semen or female genitalia, or fear of somehow hurting or defiling a partner through ejaculation, fear of pregnancy, issues of lost confidence or performance anxiety for example, anxiety about body image that interrupts the process of sexual stimulation. […] Certain types of masturbatory behavior may play a role in developing delayed ejaculation. […] The specialist observed that most men with delayed ejaculation reported no problems reaching an orgasm or ejaculating via masturbation.

• #40 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Generally, anejaculation shares similar aetiological factors with DE and retrograde ejaculation. […] The process of ejaculation requires complex co-ordination and interplay between the epididymis, vas deferens, prostate, seminal vesicles, bladder neck and bulbourethral glands. […] Any factor that disrupts this reflex and inhibits contraction of the bladder neck may lead to retrograde passage of semen into the bladder. These can be broadly categorised as pharmacological, neurogenic, anatomic and endocrinal causes of retrograde ejaculation. […] The aetiology of haemospermia has been acknowledged and can be classified into idiopathic, congenital malformations, inflammatory conditions, obstruction, malignancies, vascular abnormalities, iatrogenic/trauma and systemic causes.

• #41 Ejaculatory Dysfunction and Male Infertility — Male Infertility Guide

  https://www.maleinfertilityguide.com/ejaculatory-dysfunction

  Retrograde ejaculation can result from incomplete closing of the bladder neck […] Alpha-blockers are medications used for the treatment of benign enlargement of the prostate (benign prostatic hyperplasia, or BPH) as well as hypertension. Alpha-blockers treat BPH by relaxing the prostatic capsule and bladder neck, thereby enlarging the channel through which the urine flows. However, when the bladder neck is relaxed, retrograde ejaculation can result. […] Advanced diabetes can result in nerve damage throughout the body. This nerve damage can affect the bladder neck, leading to retrograde ejaculation. Good blood sugar control can help prevent retrograde ejaculation in diabetic patients. […] Any neurologic disease affecting the pelvic nerves can result in bladder neck dysfunction and subsequent retrograde ejaculation.

• #42 The 3 types of ejaculation problems (yes, 3!)

  https://www.numan.com/premature-ejaculation/causes/3-types-of-ejaculation-problems

  Causes of retrograde ejaculation include: Surgery (to the prostate or bladder), Medication (such as medication to treat high blood pressure, prostate enlargement or depression), Nerve damage (you might be at risk if you have diabetes, multiple sclerosis, spinal cord injury or Parkinsons disease). […] There are 3 different types of ejaculation that men might encounter: premature ejaculation, delayed ejaculation, and retrograde ejaculation. Premature ejaculation and delayed ejaculation can be caused by both physical and psychological conditions, whereas retrograde ejaculation is a physical condition.

• #43 Ejaculation Problems: Retrograde Ejaculation, Inhibited Ejaculation Symptoms and Home Treatment

  https://www.webmd.com/sexual-conditions/mens-sexual-problems

  Retrograde ejaculation is common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backward and into the bladder. […] In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation.

• #44 Ejaculation Disorders Infertility Causes, Types & Treatment

  https://www.artfertilityclinics.com/en/male-infertility/ejaculation-problems

  Ejaculation problems are a significant cause of infertility in young males. […] Sometimes premature ejaculation can cause difficulty in achieving successful pregnancy as ejaculation may not occur intravaginally. Semen quality is also reduced in premature ejaculation, which may lead to infertility. […] Men with retrograde ejaculation and anejaculation may experience infertility during their reproductive period. […] Ejaculation problems impact the semen quality of infertile men, which results in lower ejaculate volumes. […] Hence, routine investigation of ejaculate volume is necessary to identify and manage the low semen volume of ejaculation problems related to infertility.

• #45 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Acquired PE may occur due to psychological problems – such as sexual performance anxiety, and psychological or relationship problems and/or co-morbidity, including ED, prostatitis, hyperthyroidism and poor sleep quality. […] A significant proportion of men with ED also experience PE. […] High levels of performance anxiety related to ED may worsen PE, with a risk of misdiagnosing PE instead of the underlying ED. […] Other reported risk factors for PE include genetic predisposition, poor overall health status and obesity, prostate inflammation, hyperthyroidism, low prolactin levels, high testosterone levels, vitamin D and B12 deficiency, diabetes, MetS, lack of physical activity, emotional problems and stress, depressive symptoms, and traumatic sexual experiences. […] The aetiology of DE can be psychological, organic (e.g., incomplete spinal cord lesion or iatrogenic penile nerve damage), or pharmacological (e.g., SSRIs, antihypertensive drugs, or antipsychotics).

• #46 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Acquired PE may occur due to psychological problems – such as sexual performance anxiety, and psychological or relationship problems and/or co-morbidity, including ED, prostatitis, hyperthyroidism and poor sleep quality. […] A significant proportion of men with ED also experience PE. […] High levels of performance anxiety related to ED may worsen PE, with a risk of misdiagnosing PE instead of the underlying ED. […] Other reported risk factors for PE include genetic predisposition, poor overall health status and obesity, prostate inflammation, hyperthyroidism, low prolactin levels, high testosterone levels, vitamin D and B12 deficiency, diabetes, MetS, lack of physical activity, emotional problems and stress, depressive symptoms, and traumatic sexual experiences. […] The aetiology of DE can be psychological, organic (e.g., incomplete spinal cord lesion or iatrogenic penile nerve damage), or pharmacological (e.g., SSRIs, antihypertensive drugs, or antipsychotics).

• #47 Premature ejaculation: Causes, Symptoms, Treatment & Cure PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number

  https://www.pacehospital.com/premature-ejaculation-causes-symptoms-treatment-cure

  Premature ejaculation is a multifactorial disorder caused by a variety of physical, psychological, and environmental factors. Understanding these risk factors is critical for understanding probable causes and establishing effective treatment options to manage and overcome this widespread problem. […] Hormonal imbalances: Irregular hormone levels, particularly those involving testosterone and serotonin, have been linked to premature ejaculation. Some males with premature ejaculation have elevated testosterone levels, whereas low prolactin levels have also been linked to the illness. […] Yes, Peyronie’s disease can cause premature ejaculation. Peyronie’s disease is a condition in which scar tissue forms, making it difficult to achieve or sustain an erection. This can lead to tension and anxiety which can result in secondary sexual dysfunctions such as premature ejaculation.

• #48 Premature ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/premature-ejaculation

  Premature ejaculation is the most common sexual problem to affect males. […] Premature ejaculation is normally considered when you ejaculate within one minute of your penis entering your partner. […] What causes premature ejaculation? […] Sometimes premature ejaculation is a lifelong problem that starts the first time you have sex. This may be due to: abnormal hormone levels, genetic causes that affect the signalling between nerves. […] Premature ejaculation can also develop after a period of normal ejaculation. It’s usually due to another problem like: performance anxiety, generalised anxiety, stress, erectile dysfunction about 1 in 3 people with premature ejaculation also have erectile dysfunction, psychological or relationship problems. […] You should talk to your doctor if you are experiencing premature ejaculation. They can help work out the cause and offer you treatment options.

• #49 Ejaculatory Dysfunction and Male Infertility — Male Infertility Guide

  https://www.maleinfertilityguide.com/ejaculatory-dysfunction

  The impact of diabetes on ejaculation depends upon the degree of nerve involvement, and can take one of several forms, including: 1) Retrograde ejaculation (from incomplete closing of the bladder neck) […] 2) Anejaculation (from paralysis of smooth muscle in the reproductive tract, which is replaced by fibrotic tissue) […] 3) Failure of emission (sperm not deposited into urethra) […] 4) Erectile dysfunction (impacts approximately 35-75 percent of men with type 1 diabetes) […] 5) Calcification of the seminal vesicles (makes them unable to contract and propel sperm into the urethra; EEJ does not work well in these patients).

• #50 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  A significant number of men on medical treatment for LUTS associated with BPH report EjD. […] Chronic pain following various injuries or as a sequela of illnesses or medical treatment for illnesses such as chronic pain among cancer patients, can all cause EjD and DE. […] Autonomic neuropathy and microvascular disease of the ejaculatory apparatus are common sequelae in patients with long-standing diabetes mellitus and may play a major role in the development of the secondary EjD in general and DE in particular.

• #51 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis. […] Retrograde ejaculation happens when the neck of the bladder does not close and semen passes into the bladder. […] Causes of retrograde ejaculation include prostate gland surgery, bladder surgery, diabetes, multiple sclerosis, and a class of medicines known as alpha blockers.

• #52 Painful ejaculation: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/320470

  Painful ejaculation can happen as a result of prostate disorders, medication, sexually transmitted infections (STIs), and more. […] Painful ejaculation may be linked to issues with the prostate. […] Most of the medical literature on painful ejaculation focuses on problems with the prostate. Prostatitis is one common cause. […] Men with prostatitis have swelling and inflammation of the prostate. […] A condition called benign prostatic hyperplasia (BPH), which causes the prostate to enlarge, may also affect ejaculation. […] Some medications can cause painful ejaculation. Antidepressants may cause a range of sexual issues, including changes in libido, erectile dysfunction (ED), and painful ejaculation. […] Depression, anxiety, and stress can radically change a man’s sex life. […] A wide range of sexually transmitted infections (STIs) can make ejaculation painful. […] Disorders that affect the nervous system, such as diabetes, can damage the nerves associated with orgasm and ejaculation. […] Some case reports link mercury poisoning, often due to contaminated fish, with painful ejaculation.

• #53 What Causes Painful Ejaculation?: Alex Lesani, MD: Robotic Surgeon

  https://www.drlesani.com/blog/what-causes-painful-ejaculation

  Painful ejaculation is a lot more common than youd think. Based on a PubMed search, somewhere between 1-25% of men around the world experience painful ejaculation, either alone or with other symptoms. […] If ejaculation causes pain in your penis, scrotum, rectum, or pelvic area, you may dread sex and masturbation. […] Below are a few of the most common reasons for this distressing condition, and recommendations for treatment. […] If you have BPH, painful ejaculation is probably only one of several symptoms. […] Urinary tract infections (UTIs) and sexually transmitted infections (STIs) can inflame your urethra and other pelvic organs, leading to painful ejaculation. […] If the tubes in your reproductive tract are obstructed, the pressure from an ejaculation could cause tremendous pain. […] One of the symptoms of chronic pelvic pain is painful ejaculation. […] Some kinds of medications, such as antidepressants and muscle relaxants, may also cause painful ejaculation, as can underlying medical conditions.

• #54 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  Ejaculatory duct damage may follow correction of an imperforate anus. […] Different surgical modalities for the treatment of lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) are associated with variable adverse effects on ejaculatory function. […] Neurological disorders, either functional or organic, that affect the brain and spinal cord may cause DE, depending on the level and extent of the pathology. […] Although hormonal regulation of all aspects of male reproduction is well established, the role of endocrine control on the ejaculatory process is still not completely clarified. […] UTI, pelvic inflammation and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have all been recognized as etiologic factors for EjD, including DE. […] The medical treatment for many conditions can be the reasons for DE.

• #55 Symptoms and Causes of Premature Ejaculation – ROC Clinic

  https://rocclinic.com/en/premature-ejaculation/symptoms-and-causes/

  The main symptom of premature ejaculation is the inability to control the moment of orgasm associated with low intercourse time. […] The causes are diverse. It can be caused by both psychological and biological factors and is usually diagnosed by the patient himself. […] The causes of premature ejaculation depend basically on the type of premature ejaculation: […] Men with primary premature ejaculation appear to have some congenital propensity for low intercourse time. […] Men with prostate problems are at increased risk for ejaculatory problems such as premature ejaculation, anorgasmia, painful orgasm and hemospermia. […] Erectile dysfunction affects 50% of men in their 50s. […] Certain changes in a man’s life can produce stress or performance anxiety, such as job changes, family stressors, a new relationship. […] As for natural variable premature ejaculation and premature pseudoejaculation, they are considered variants of normality and are usually resolved satisfactorily with a series of general sex education measures and with a series of tips on how to delay the moment of orgasm.

• #56 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can have physical or psychological causes. […] There are physical and psychological (mental and emotional) causes for delayed ejaculation. […] Physical causes may include conditions that affect your nervous system, such as a stroke, spinal cord injury or multiple sclerosis (MS) nerve damage may also occur as a complication of diabetes or surgery. […] Psychological causes may include feeling guilty about sexual intercourse, possibly due to your upbringing or religious background. […] Many men have delayed ejaculation issues as they get older. […] It depends. The hormone testosterone is essential for sperm production and enhances your sex drive. […] Delayed ejaculation can affect anyone.

• #57 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  Given the fundamental role of hormonal regulation in the physiology of orgasm, multiple endocrinopathies have been identified in patients with DO. […] Hyperprolactinemia also leads to DO as increased levels of prolactin (PRL) result in suppression of T production. […] Psychogenic DO results from feelings of fear, anxiety, hostility, relationship difficulties associated with sexual intercourse and encounters. […] Hyperstimulation of the penis is another factor that has been identified to contribute to DO. […] Orgasmic dysfunction has been demonstrated among patients who undergo pelvic surgeries. […] There is no standardized treatment plan for DO. Treatment plans are often multidisciplinary, involving urologists, primary care providers and mental health professionals to adequately address biopsychosocial factors.

• #58 Premature ejaculation: Causes, Symptoms, Treatment & Cure PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number

  https://www.pacehospital.com/premature-ejaculation-causes-symptoms-treatment-cure

  Premature ejaculation is a multifactorial disorder caused by a variety of physical, psychological, and environmental factors. Understanding these risk factors is critical for understanding probable causes and establishing effective treatment options to manage and overcome this widespread problem. […] Hormonal imbalances: Irregular hormone levels, particularly those involving testosterone and serotonin, have been linked to premature ejaculation. Some males with premature ejaculation have elevated testosterone levels, whereas low prolactin levels have also been linked to the illness. […] Yes, Peyronie’s disease can cause premature ejaculation. Peyronie’s disease is a condition in which scar tissue forms, making it difficult to achieve or sustain an erection. This can lead to tension and anxiety which can result in secondary sexual dysfunctions such as premature ejaculation.

• #59 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Acquired PE may occur due to psychological problems – such as sexual performance anxiety, and psychological or relationship problems and/or co-morbidity, including ED, prostatitis, hyperthyroidism and poor sleep quality. […] A significant proportion of men with ED also experience PE. […] High levels of performance anxiety related to ED may worsen PE, with a risk of misdiagnosing PE instead of the underlying ED. […] Other reported risk factors for PE include genetic predisposition, poor overall health status and obesity, prostate inflammation, hyperthyroidism, low prolactin levels, high testosterone levels, vitamin D and B12 deficiency, diabetes, MetS, lack of physical activity, emotional problems and stress, depressive symptoms, and traumatic sexual experiences. […] The aetiology of DE can be psychological, organic (e.g., incomplete spinal cord lesion or iatrogenic penile nerve damage), or pharmacological (e.g., SSRIs, antihypertensive drugs, or antipsychotics).

• #60 Delayed ejaculation – Wikipedia

  https://en.wikipedia.org/wiki/Delayed_ejaculation

  Neurogenic causes (diabetic autonomic neuropathy, spinal cord or nerve root injury from trauma or disc prolapse, multiple sclerosis, etc.). DE can be due to the injury to pelvic nerves responsible for orgasm from trauma as a result of pelvic surgery (viz., prostate surgery including transurethral resection of prostate and bladder neck incision, proctocolectomy, bilateral sympathectomy, abdominal aortic aneurysmectomy, para-aortic lymphadenectomy etc.). […] Some researchers believe that circumcision has a negative effect on men’s ejaculation during sex, while others believe that circumcision has no effect. […] Endocrine (hypogonadism, pituitary disorders such as hyperprolactinaemia and Cushing’s disease, thyroid disorders, etc.). […] Delayed ejaculation is a possible side effect of alcohol and certain medications, including antipsychotics, antidepressants including selective serotonin reuptake inhibitors (SSRIs), opiates such as morphine or oxycodone, many benzodiazepines such as Valium or Xanax, and certain antihypertensives including thiazide diuretics, alpha-adrenergic blockers and ganglion blockers.

• #61 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  Delayed ejaculation (DE) occurs when a man needs more than 30 minutes of sexual stimulation to reach orgasm and ejaculate. […] DE has multiple causes, including anxiety, depression, neuropathy, and reactions to medications. […] There are many potential causes of DE, including psychological concerns, chronic health conditions, and reactions to medications. […] Psychological causes of DE can occur due to a traumatic experience. Cultural or religious taboos can give sex a negative connotation. Anxiety and depression can both suppress sexual desire, which may result in DE as well. […] Certain chemicals can affect the nerves involved in ejaculation. This can affect ejaculation with and without a partner. […] Surgeries or trauma may also cause DE. The physical causes of DE may include damage to the nerves in your spine or pelvis, certain prostate surgeries that cause nerve damage, heart disease that affects blood pressure to the pelvic region, infections, especially prostate or urinary infections, neuropathy or stroke, low thyroid hormone, low testosterone levels, and birth defects that impair the ejaculation process.

• #62 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  Ejaculatory duct damage may follow correction of an imperforate anus. […] Different surgical modalities for the treatment of lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) are associated with variable adverse effects on ejaculatory function. […] Neurological disorders, either functional or organic, that affect the brain and spinal cord may cause DE, depending on the level and extent of the pathology. […] Although hormonal regulation of all aspects of male reproduction is well established, the role of endocrine control on the ejaculatory process is still not completely clarified. […] UTI, pelvic inflammation and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have all been recognized as etiologic factors for EjD, including DE. […] The medical treatment for many conditions can be the reasons for DE.

• #63 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  A common cause is pudendal neuropathy, caused by a crush to the perineum such as from bike riding with a narrow saddle. […] If the delayed ejaculation is situational is is probably psychologic; if it is generalized the problem is probably biologic. […] The patient must be checked to see if there are reversible causes before being given medication.

• #64 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  The psychological definition of delayed ejaculation refers to the inability to have an ejaculation during sexual intercourse. […] Problems of delayed ejaculation tend to be somewhat rare and not well understood by psychologists and sex therapists. […] For many men, finding the right professional, who has experience and realizes the seriousness of the problem may be one of the most difficult aspects in the treatment process. […] Unfortunately however, problems such as delayed ejaculation seldom disappear without professional intervention. […] In spite of the lack of information regarding delayed ejaculation, the most successful approach, for sex therapists, is to engage both members of the couple into addressing the problem. […] Ejaculatory problems can have a devastating affect on self-esteem.

• #65 Delayed Ejaculation Disorder | Symptoms, Causes, Diagnosis

  https://firstlightpsych.com/delayed-ejaculation-disorder/

  Physical causes include: Certain birth defects disturb the male reproductive system, Injury to the nerves of the pelvic floor that regulate orgasm, Urinary tract infections, Prostate surgery, Diabetic neuropathy, nerve damage to the spinal cord, or stroke, The lower level of thyroid hormone or lower level of testosterone, Retrograde ejaculation, i.e. passing of semen backward into the bladder rather than coming out of the penis. […] In some men, a physical issue that may delay ejaculation can lead to anxiety about ejaculation during sexual activity. This anxiety in turn may further worsen the ejaculation problem. […] Delayed ejaculation negatively impacts self-esteem and creates feelings of inadequacy, insufficiency, disappointment, and negativity. […] Other complications may include: Absent or minimal sexual pleasure, Anxiety about sex, Male infertility, Lower libido, Stress and Depression.

• #66 Ejaculation Disorders Infertility Causes, Types & Treatment

  https://www.artfertilityclinics.com/en/male-infertility/ejaculation-problems

  Ejaculation problems are a significant cause of infertility in young males. […] Sometimes premature ejaculation can cause difficulty in achieving successful pregnancy as ejaculation may not occur intravaginally. Semen quality is also reduced in premature ejaculation, which may lead to infertility. […] Men with retrograde ejaculation and anejaculation may experience infertility during their reproductive period. […] Ejaculation problems impact the semen quality of infertile men, which results in lower ejaculate volumes. […] Hence, routine investigation of ejaculate volume is necessary to identify and manage the low semen volume of ejaculation problems related to infertility.

• #67 Ejaculatory Problems and Male Infertility : Causes and Solutions

  https://www.artfertilityclinics.com/in/en/art-blog/ejaculatory-problems-causes-solutions

  Ejaculatory problems refer to difficulties in the process of releasing semen during sexual activity. Such issues directly affect male fertility, as they can hinder the delivery of sperm to the female reproductive system. The main ejaculatory problems associated with male infertility include premature, retrograde, and anejaculation. […] Premature ejaculation refers to the condition in which a person is unable to control their ejaculation, causing them to release semen quickly during sexual activity, usually within 1 minute. Although it is primarily a sexual dysfunction issue, it can also affect fertility by lowering the chances of sperm reaching the fallopian tubes to fertilize an egg. […] Retrograde ejaculation is a medical condition where semen does not come out of the penis during ejaculation and instead enters the urinary bladder. This happens when the bladder neck muscles, or the opening of the bladder fail to function correctly. As a result, less sperm is available for fertilization during intercourse.

• #68 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Mental health conditions and psychological factors can also be related to delayed ejaculation. These can include anxiety, depression, relationship issues, performance anxiety, fears of pregnancy or intimacy, and stress. […] The treatment for delayed ejaculation depends on the cause. […] If any medicines you take could be causing delayed ejaculation, you should discuss with your doctor if it is possible to change your medicines. […] Your doctor may recommend medicines, depending on the cause of your delayed ejaculation. […] Delayed ejaculation can’t be prevented if the cause is physical, such as nerve damage. […] Delayed ejaculation might make it more difficult to conceive a baby. […] Delayed ejaculation might also increase stress, lead to anxiety or depression, contribute to low self-esteem, and lead to relationship issues.

• #69 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  The psychological definition of delayed ejaculation refers to the inability to have an ejaculation during sexual intercourse. […] Problems of delayed ejaculation tend to be somewhat rare and not well understood by psychologists and sex therapists. […] For many men, finding the right professional, who has experience and realizes the seriousness of the problem may be one of the most difficult aspects in the treatment process. […] Unfortunately however, problems such as delayed ejaculation seldom disappear without professional intervention. […] In spite of the lack of information regarding delayed ejaculation, the most successful approach, for sex therapists, is to engage both members of the couple into addressing the problem. […] Ejaculatory problems can have a devastating affect on self-esteem.

• #70 Premature ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/premature-ejaculation

  It’s important to remember that ejaculation problems are common and nothing to be embarrassed about. […] The treatment for premature ejaculation depends on the cause. […] Exercise has been reported to help prevent premature ejaculation. Kegel exercises are exercises to strengthen your pelvic floor muscles. These can also help to improve your control over ejaculation. […] Premature ejaculation might also increase: stress, anxiety, depression, low self-esteem, relationship issues.

• #71 Premature Ejaculation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546701/

  Hostility against women […] Other underlying mental health issues. […] Premature ejaculation that has been present for one year or more has a significant effect on the couple and tends to lead to clinical depression, relationship issues, and other problems. […] Approximately 30% of men ages 18 to 59 years old have problems with premature ejaculation; however, shame and embarrassment prevent many from discussing this sensitive topic with their physicians.

• #72 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  Ejaculation problems may also contribute to a low libido and lack of interest in sexual activity. […] For some men, there may be additional psychological issues that underlie an ejaculatory dysfunction. […] Traditional behavioral sex therapy for delayed ejaculation is as follows: the man begins by masturbating, then starts intercourse when he is almost ready to ejaculate. […] In July 2003, the World Health Organization recommended that the term pre-mature ejaculation be replaced by the more neutral phrase early ejaculation. […] By definition, early ejaculation is an ejaculation that occurs before it is desired. […] A significant amount of distress from the man or his partner almost always accompanies an early ejaculation. […] Psychologists and sex therapists tend to view ejaculatory control as a skill that is mastered via masturbation during adolescence and early adulthood.

• #73 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  A temporary ejaculation problem can cause anxiety and depression. This can lead to recurrence, even when the underlying physical cause has been resolved. […] Low Testosterone can contribute to DE and low testosterone supplements could help fix your DE issue. […] DE can generally be resolved by treating the mental or physical causes. Identifying and seeking treatment for DE sometimes exposes an underlying medical condition. Once this is treated, DE often resolves. […] The same is true when the underlying cause is a medication. However, don’t stop taking any medication without your doctor’s recommendation.

• #74 Delayed Ejaculation Disorder | Symptoms, Causes, Diagnosis

  https://firstlightpsych.com/delayed-ejaculation-disorder/

  Delayed ejaculation can also give rise to conflicts in relationships, often stemming from misinterpretations on the part of both partners. […] The treatment of delayed ejaculation is dependent upon the underlying cause, but it might include taking medication, making changes to currently prescribed medications, and psychological counseling. […] If you are currently taking any medication that might be causing delayed ejaculation, switching the medications may fix the problem. […] There are not any specific drugs that have been specifically approved for the treatment of delayed ejaculation. Medications, however, are used to treat and help with distressing symptoms.

• #75 Causes of Premature Ejaculation – Men’s Health Solutions Center

  https://www.mhs-hk.com/en/sexual-dysfunction/premature-ejaculation/premature-ejaculation-cause/

  Uncontrollable ejaculation / premature ejaculation (PE) is also known as rapid ejaculation, premature climax or early ejaculation. PE is a very common male sexual disorder. […] Uncontrollable / premature ejaculation has profound impact on a persons quality of life. It does not only mean a loss of sexual satisfaction, but also creates adverse effects on intimate relationships. […] The ultimate goal of the uncontrollable ejaculation / PE treatment is to help both patients and their partners to regain sexual satisfaction. […] Mixture Therapy was first introduced in early 1980s and has been widely used by doctors around the USA, Europe, Latin America, Australia for decades. […] Our Center provides oral medication for the treatment of uncontrollable / premature ejaculation in men between 18 to 64 years old.

• #76 Ejaculatory Problems and Male Infertility : Causes and Solutions

  https://www.artfertilityclinics.com/in/en/art-blog/ejaculatory-problems-causes-solutions

  Conflicts, unresolved emotional issues, or lack of intimacy within a relationship can affect sexual function and ejaculatory control. […] With correct diagnosis and treatment, couples can overcome ejaculatory problems, which significantly impact male fertility. Seeking medical assistance and exploring various interventions, including medical, behavioral, and assisted reproductive technologies, can help fulfill their dreams of parenthood.

• #77 Understanding Ejaculatory Dysfunction – Causes, Treatment and More

  https://www.cloudninecare.com/blog/all-you-need-to-know-about-ejaculatory-dysfunction

  If the ejaculation does not happen properly or a male cannot ejaculate, there is no release of sperm, or the sperm is unable to reach the egg in time, causing fertility issues. […] The first step to addressing ejaculatory dysfunction is to understand the cause, as it helps the healthcare provider provide appropriate treatment. […] Effective treatment of this condition depends on identifying the underlying root cause. Here are some recommended treatment options. […] If the problem is because of physical issues like anatomical abnormalities or obstructions in the ejaculatory mechanism, surgery may be the preferred choice to correct the problem. […] Behavioural counselling and therapy may be recommended if anxiety, stress, or other psychological factors are the cause. […] For couples with fertility issues because of ejaculatory dysfunction, ART (Assisted Reproductive Technology) is useful. IVF (In-vitro Fertilization) and IUI (Intrauterine Insemination) are two such ART techniques that offer alternative ways of conception. These methods bypass the normal ejaculation process and enhance the conception chances.

• #78 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  An age-dependent increase in the prevalence of DE was reported in various studies. […] These findings have led to the hypothesis that genetic factors can affect a person’s predisposition to DE/AE. […] The significant heterogeneity in the occurrence and the presentation of SSRI-related sexual dysfunction may suggest underlying genetic factors. […] The list of organic causes possibly leading to DE/AE is extensive and is outlined in Table 1, 2, 3. […] Complaints of DE/AE in patients taking medications are not uncommon. Different medications may interfere with either central or peripheral control of ejaculation, potentially affecting the IELT.

• #79 Weak Ejaculation: Symptoms, Causes, Treatment, and Home Remedies

  https://www.healthline.com/health/mens-health/weak-ejaculation

  Some causes of weak ejaculation may include aging, stress, low testosterone levels, and erectile conditions, among others. […] Weak ejaculation is when you dont ejaculate with as much force or volume as you used to. […] A problem during the emission stage may reduce the amount of semen you ejaculate, while a problem during the expulsion stage could reduce the force with which semen is expelled. […] Weak ejaculations are most commonly related to getting older. Just as age may weaken your eyesight, it can also reduce both the strength and volume of your ejaculation. […] Age also has a significant impact on testosterone levels, which is a male hormone that plays a key role in sex drive, sperm production, and sperm quality. […] However, testosterone levels start to decrease by up to 2% each year after age 30 years. Over time, this could lead to weak ejaculations and other sex-related problems.

• #80 Premature Ejaculation: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/435884-overview

  As noted (see Pathophysiology, above), the cause of premature ejaculation is considered psychological, although this has not been definitively confirmed. […] One psychological explanation for premature ejaculation is that males are conditioned by societal pressures to reach climax quickly because of fear of discovery when masturbating as teenagers or during early sexual experiences with others. […] In patients with lifelong premature ejaculation, in which the male has never experienced sexual relations without also experiencing premature ejaculation, a deep-seated emotional disturbance may be present, and the causes may be multiple. […] With regard to acquired premature ejaculation, some type of performance anxiety is often a major factor. […] Performance pressure (ie, fear of failure to satisfy the partner) can arise from various precipitating events.

• #81 Disorders of ejaculation – Harvard Health

  https://www.health.harvard.edu/mens-health/disorders-of-ejaculation

  When men think about sexual woes, they usually put erectile dysfunction at the top of the list. […] Doctors have made great progress in treating erectile dysfunction. And new developments are improving life for some men plagued by abnormal ejaculations. […] The sex act is instinctive and automatic, but it depends on the complex interaction of psychological functions, the nervous system, blood vessels, and the genital tract itself. With so much involved (and so much at stake), a lot can go wrong. And many of these problems involve abnormal ejaculations. […] Many men experience premature ejaculation from time to time, but for some it’s a recurrent problem. In large surveys, premature ejaculation is the most frequent form of male sexual dysfunction, affecting up to 30% of men. It is most common in young and sexually inexperienced males but can strike at any time of life. Most men with premature ejaculation are perfectly healthy; others have psychological disturbances, medical conditions like diabetes, or urologic problems such as prostatitis.

• #82 Symptoms and Causes of Premature Ejaculation – ROC Clinic

  https://rocclinic.com/en/premature-ejaculation/symptoms-and-causes/

  The main symptom of premature ejaculation is the inability to control the moment of orgasm associated with low intercourse time. […] The causes are diverse. It can be caused by both psychological and biological factors and is usually diagnosed by the patient himself. […] The causes of premature ejaculation depend basically on the type of premature ejaculation: […] Men with primary premature ejaculation appear to have some congenital propensity for low intercourse time. […] Men with prostate problems are at increased risk for ejaculatory problems such as premature ejaculation, anorgasmia, painful orgasm and hemospermia. […] Erectile dysfunction affects 50% of men in their 50s. […] Certain changes in a man’s life can produce stress or performance anxiety, such as job changes, family stressors, a new relationship. […] As for natural variable premature ejaculation and premature pseudoejaculation, they are considered variants of normality and are usually resolved satisfactorily with a series of general sex education measures and with a series of tips on how to delay the moment of orgasm.

• #83 Premature ejaculation – Wikipedia

  https://en.wikipedia.org/wiki/Premature_ejaculation

  Premature ejaculation (PE) is a male sexual dysfunction that occurs when a male expels semen (and most likely experiences orgasm) soon after beginning sexual activity, and with minimal penile stimulation. […] The causes of premature ejaculation are unclear. Many theories have been suggested, including that PE was the result of masturbating quickly during adolescence to avoid being caught, performance anxiety, passive-aggressive behavior or having too little sex; but there is little evidence to support any of these theories. […] Several physiological mechanisms have been hypothesized to contribute to causing premature ejaculation, including serotonin receptors, a genetic predisposition, elevated penile sensitivity and nerve conduction atypicalities. […] The nucleus paragigantocellularis of the brain has been identified as having involvement in ejaculatory control.

• #84 How Do You Fix Ejaculation Problems? 3 Causes & 5 Methods

  https://www.medicinenet.com/how_do_you_fix_ejaculation_problems/article.htm

  Age: Its common for ejaculation problems to occur as you age. Your erection may not last as long before you ejaculate. […] There are no oral medications approved to treat ejaculation problems. Still, some doctors prescribe antidepressants to address ejaculation problems. Because these medications help with your bodys chemical balance, they may increase your serotonin levels.

• #85 Weak Ejaculation: Symptoms, Causes, Treatment, and Home Remedies

  https://www.healthline.com/health/mens-health/weak-ejaculation

  Some causes of weak ejaculation may include aging, stress, low testosterone levels, and erectile conditions, among others. […] Weak ejaculation is when you dont ejaculate with as much force or volume as you used to. […] A problem during the emission stage may reduce the amount of semen you ejaculate, while a problem during the expulsion stage could reduce the force with which semen is expelled. […] Weak ejaculations are most commonly related to getting older. Just as age may weaken your eyesight, it can also reduce both the strength and volume of your ejaculation. […] Age also has a significant impact on testosterone levels, which is a male hormone that plays a key role in sex drive, sperm production, and sperm quality. […] However, testosterone levels start to decrease by up to 2% each year after age 30 years. Over time, this could lead to weak ejaculations and other sex-related problems.

• #86 Causes of Male Infertility: Sexual Dysfunction | Male Infertility | Infertility treatment, IVF, artificial insemination|Oak Clinic Inc. Osaka/Tokyo

  https://www.oakclinic-group.com/en/male_sterility/cause02/

  When there is an abnormality in the function of sending out sperm, it is called „sexual dysfunction”. […] Causes of male infertility fall into three main categories: spermatogenesis dysfunction, sexual dysfunction, and obstructive spermatic tract disorder. Of these, according to a 2014 survey by the Ministry of Health, Labor and Welfare, the number of patients with sexual dysfunction has more than quadrupled since the 1996 survey results. Sexual dysfunction includes „sexual intercourse disorder (erectile dysfunction)” and „ejaculation disorder.” […] Ejaculation disorder is the inability to ejaculate properly, although an erection is achieved. […] Ejaculation dysfunction is classified into the following table according to its symptoms. […] Generally, ejaculatory function declines with age.

• #87 Disorders of ejaculation – Harvard Health

  https://www.health.harvard.edu/mens-health/disorders-of-ejaculation

  Whereas premature ejaculation is rarely caused by disease, delayed (or absent) ejaculation can result from either psychological or physical problems. Alcohol, medications (including SSRIs and tricyclic antidepressants, and some antihypertensives), and diabetes are among the most frequent causes of delayed or inhibited ejaculation. […] During normal ejaculation, semen flows out of the penis because the muscles at the neck of the bladder prevent the semen from reaching the bladder. In retrograde, or dry, ejaculation, the bladder muscles fail to do their job, so semen flows into the bladder and no emission occurs. […] Most bodily functions change with age, and sex is no exception. […] Diseases of the spinal cord are often responsible for absent ejaculation. […] When that occurs, men should be evaluated for inflammation of the prostate (prostatitis), urinary tract infections, and other urologic disorders. […] It’s an alarming symptom, but it’s usually not at all serious.

• #88 Weak Ejaculation: Symptoms, Causes, Treatment, and Home Remedies

  https://www.healthline.com/health/mens-health/weak-ejaculation

  Any condition that affects the muscles and nerves controlling ejaculation can lead to a weaker-than-normal orgasm. […] Perceived ejaculate volume reduction (PEVR) is another common type of ejaculation dysfunction in males that could cause weak ejaculation. […] Several psychological factors have been associated with conditions that may cause ejaculation problems, such as weak ejaculation. […] Some causes of weak ejaculation include aging, low testosterone levels, retrograde ejaculation, psychological stressors, and lifestyle factors like smoking, having obesity, and drinking alcohol. […] Having an orgasm with little or no semen is known as anejaculation. Some causes of anejaculation may include prostate surgery, conditions like diabetes and multiple sclerosis, and medications like alpha-blockers. […] Problems with ejaculation are common in males, particularly as you get older.

• #89 Painful ejaculation: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/320470

  Painful ejaculation can happen as a result of prostate disorders, medication, sexually transmitted infections (STIs), and more. […] Painful ejaculation may be linked to issues with the prostate. […] Most of the medical literature on painful ejaculation focuses on problems with the prostate. Prostatitis is one common cause. […] Men with prostatitis have swelling and inflammation of the prostate. […] A condition called benign prostatic hyperplasia (BPH), which causes the prostate to enlarge, may also affect ejaculation. […] Some medications can cause painful ejaculation. Antidepressants may cause a range of sexual issues, including changes in libido, erectile dysfunction (ED), and painful ejaculation. […] Depression, anxiety, and stress can radically change a man’s sex life. […] A wide range of sexually transmitted infections (STIs) can make ejaculation painful. […] Disorders that affect the nervous system, such as diabetes, can damage the nerves associated with orgasm and ejaculation. […] Some case reports link mercury poisoning, often due to contaminated fish, with painful ejaculation.

• #90 Painful Ejaculation (dysorgasmia/orgasmalgia) – what are the causes? – Sexologists in Chennai treating Men’s Infertility (Premature Ejaculation, Erection Problems etc) since 28 years

  https://www.metromaleclinic.com/painful-ejaculation-dysorgasmia-orgasmalgia-what-are-the-causes/

  Painful Ejaculation, also called dysorgasmia or orgasmalgia refers to the pain in the penis or scrotum or in the perineum area during ejaculation. […] Common conditions that can cause painful ejaculation include problems with the prostate gland, presence of cysts or stones, antidepressants, surgical errors, pudendal neuropathy, sexually transmitted infections, and radiation therapy. […] Problems with the prostate gland include prostatitis, enlarged prostate or Benign Prostatic Hyperplasia, and prostate cancer. […] The presence of cysts or stones in the urethra can also result in painful ejaculation. […] Certain antidepressants can cause erectile dysfunction and painful ejaculation. […] Surgeries in the pelvis region such as repair of inguinal hernia or removal of prostate carry a risk of injury to the nerves or tissues in the surrounding regions, which can lead to erectile dysfunction or painful ejaculation.

• #91 Painful Ejaculation (dysorgasmia/orgasmalgia) – what are the causes? – Sexologists in Chennai treating Men’s Infertility (Premature Ejaculation, Erection Problems etc) since 28 years

  https://www.metromaleclinic.com/painful-ejaculation-dysorgasmia-orgasmalgia-what-are-the-causes/

  Damage to nerve(s) in the pelvis region is called pudendal neuropathy, which can cause genital pain and/or rectal pain. […] STIs or STDs such as Chlamydia, Gonorrhoea or Trichomoniasis can cause painful urination or burning sensation during urination and pain during ejaculation. […] Radiation therapy in any of the pelvis region can cause temporary erectile dysfunction and pain during ejaculation.

• #92 Ejaculatory Dysfunction and Male Infertility — Male Infertility Guide

  https://www.maleinfertilityguide.com/ejaculatory-dysfunction

  Anejaculation occurs when a man experiences the feelings of orgasm but no seminal fluid comes out, either antegrade (out the penis) or retrograde (into the bladder). […] Potential causes of anejaculation include: 1) Alpha-blocker (prostate) medications. […] 2) Antidepressant medications. […] 3) 5-alpha reductase inhibitors (finasteride, dutasteride). […] 4) PDE5 inhibitors (sildenafil, tadalafil, etc.) […] 5) Diabetic neuropathy. […] 6) Neurologic disorders. […] 7) Pelvic or abdominal surgery. […] 8) Hypogonadism. […] Pain with ejaculation can have multiple possible causes, including: 1) Seminal vesicle inflammation […] 2) Ejaculatory duct obstruction […] 3) Seminal vesicle or prostate stones […] 4) Prostatitis, urethritis, or epididymitis […] 5) Psychological issues.

• #93 Inability to Ejaculate – Men’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/men-s-health-issues/sexual-function-and-dysfunction-in-men/inability-to-ejaculate

  Inability to ejaculate (anejaculation) is usually caused by inability to reach orgasm (anorgasmia). It usually occurs as part of erectile dysfunction. […] The cause is usually prostate surgery because […] Other conditions that damage the nerves of the penis, as well as some mental conditions and some medications that are used to treat them, may also affect the ability to ejaculate. […] Depending on the cause, anejaculation may occur with or without orgasm. […] Treatment of anejaculation depends on the cause and may include stopping any medications that may be causing the problem, engaging in psychotherapy, or helping trigger ejaculation using oral medications such as pseudoephedrine and/or imipramine. […] There is no treatment when anejaculation is due to removal of the prostate and seminal vesicles.

• #94 Ejaculatory Dysfunction and Male Infertility — Male Infertility Guide

  https://www.maleinfertilityguide.com/ejaculatory-dysfunction

  Anejaculation occurs when a man experiences the feelings of orgasm but no seminal fluid comes out, either antegrade (out the penis) or retrograde (into the bladder). […] Potential causes of anejaculation include: 1) Alpha-blocker (prostate) medications. […] 2) Antidepressant medications. […] 3) 5-alpha reductase inhibitors (finasteride, dutasteride). […] 4) PDE5 inhibitors (sildenafil, tadalafil, etc.) […] 5) Diabetic neuropathy. […] 6) Neurologic disorders. […] 7) Pelvic or abdominal surgery. […] 8) Hypogonadism. […] Pain with ejaculation can have multiple possible causes, including: 1) Seminal vesicle inflammation […] 2) Ejaculatory duct obstruction […] 3) Seminal vesicle or prostate stones […] 4) Prostatitis, urethritis, or epididymitis […] 5) Psychological issues.

• #95 Ejaculatory Dysfunction | Urology Associates | Denver Metro

  https://www.denverurology.com/mens-fertility-sexual-health/ejaculatory-dysfunction/

  The cause of retrograde ejaculation is a fault in the muscle at the neck of the bladder that usually prevents ejaculate from flowing back into the bladder through the tube carrying ejaculate from the prostate to the urethra. The fault may be due to nerve damage from a medical condition (diabetes, spinal cord injury), reaction to certain medications or surgery (bladder, prostate). […] Reactions to certain medications can cause anejaculation, as can surgical procedures that affect the nerves involved in ejaculation. Most likely, the cause is a psychological issue that may involve upbringing and lack of affection.

• #96 Ejaculation Problems: Common Ejaculatory Dysfunctions and Disorders Impacting Orgasm and Sensation – Priority Men’s MedicalAsset 2

  https://prioritymensmedical.com/blog/ejaculation-problems-ejaculatory-dysfunctions-disorders/

  There are many causes of delayed ejaculation, ranging from medications, excessive alcohol use, diuretics, high blood pressure, and sexual performance anxiety. DE can also be caused by hormonal imbalances and low self-esteem. […] Retrograde ejaculation (RE) also known as dry ejaculation, is when some or all of the ejaculate goes backwards (retrograde). During climax, instead of coming out penis, the ejaculate travels back into the bladder. It eventually exits during urination. […] This ejaculation problem can lead to infertility. RE is typically caused by a faulty bladder neck muscle. […] Anejaculation can also be caused by certain surgical procedures, including prostate and testicular cancer surgery. […] Perceived ejaculate volume reduction (PEVR) causes a man to produce less ejaculate than normal. PERV can be caused by aging, diabetes, certain medications, and problems with the testes that cause low or no testosterone production. […] Lack of male orgasm can be caused by medical problems, psychological problems, and certain medications, especially SSRIs.

• #97 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  Generally, anejaculation shares similar aetiological factors with DE and retrograde ejaculation. […] The process of ejaculation requires complex co-ordination and interplay between the epididymis, vas deferens, prostate, seminal vesicles, bladder neck and bulbourethral glands. […] Any factor that disrupts this reflex and inhibits contraction of the bladder neck may lead to retrograde passage of semen into the bladder. These can be broadly categorised as pharmacological, neurogenic, anatomic and endocrinal causes of retrograde ejaculation. […] The aetiology of haemospermia has been acknowledged and can be classified into idiopathic, congenital malformations, inflammatory conditions, obstruction, malignancies, vascular abnormalities, iatrogenic/trauma and systemic causes.

• #98 Disorders of ejaculation – Harvard Health

  https://www.health.harvard.edu/mens-health/disorders-of-ejaculation

  Whereas premature ejaculation is rarely caused by disease, delayed (or absent) ejaculation can result from either psychological or physical problems. Alcohol, medications (including SSRIs and tricyclic antidepressants, and some antihypertensives), and diabetes are among the most frequent causes of delayed or inhibited ejaculation. […] During normal ejaculation, semen flows out of the penis because the muscles at the neck of the bladder prevent the semen from reaching the bladder. In retrograde, or dry, ejaculation, the bladder muscles fail to do their job, so semen flows into the bladder and no emission occurs. […] Most bodily functions change with age, and sex is no exception. […] Diseases of the spinal cord are often responsible for absent ejaculation. […] When that occurs, men should be evaluated for inflammation of the prostate (prostatitis), urinary tract infections, and other urologic disorders. […] It’s an alarming symptom, but it’s usually not at all serious.

• #99 Symptoms and Causes of Premature Ejaculation – ROC Clinic

  https://rocclinic.com/en/premature-ejaculation/symptoms-and-causes/

  The main symptom of premature ejaculation is the inability to control the moment of orgasm associated with low intercourse time. […] The causes are diverse. It can be caused by both psychological and biological factors and is usually diagnosed by the patient himself. […] The causes of premature ejaculation depend basically on the type of premature ejaculation: […] Men with primary premature ejaculation appear to have some congenital propensity for low intercourse time. […] Men with prostate problems are at increased risk for ejaculatory problems such as premature ejaculation, anorgasmia, painful orgasm and hemospermia. […] Erectile dysfunction affects 50% of men in their 50s. […] Certain changes in a man’s life can produce stress or performance anxiety, such as job changes, family stressors, a new relationship. […] As for natural variable premature ejaculation and premature pseudoejaculation, they are considered variants of normality and are usually resolved satisfactorily with a series of general sex education measures and with a series of tips on how to delay the moment of orgasm.

• #100 Disorders of ejaculation – Harvard Health

  https://www.health.harvard.edu/mens-health/disorders-of-ejaculation

  Whereas premature ejaculation is rarely caused by disease, delayed (or absent) ejaculation can result from either psychological or physical problems. Alcohol, medications (including SSRIs and tricyclic antidepressants, and some antihypertensives), and diabetes are among the most frequent causes of delayed or inhibited ejaculation. […] During normal ejaculation, semen flows out of the penis because the muscles at the neck of the bladder prevent the semen from reaching the bladder. In retrograde, or dry, ejaculation, the bladder muscles fail to do their job, so semen flows into the bladder and no emission occurs. […] Most bodily functions change with age, and sex is no exception. […] Diseases of the spinal cord are often responsible for absent ejaculation. […] When that occurs, men should be evaluated for inflammation of the prostate (prostatitis), urinary tract infections, and other urologic disorders. […] It’s an alarming symptom, but it’s usually not at all serious.

• #101 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  Although less common, some men develop early ejaculatory problems later in life. […] As mentioned, the most effective approach is a combination of psychological assistance and medical intervention. […] The most common behavioral approach taught by sex therapists is either the squeeze technique or an approach described as start and stop. […] The most important lesson to be learned by men and their partners is that there is hope and there are therapies that can help resolve the distress of ejaculatory difficulties. […] The most common sexual dysfunction for men is ejaculatory disorder. […] Treatment is usually with SSRIs and Sildenafil (Viagra). […] The disorder may be lifelong or acquired, global or situational, with different treatments. […] It can be biogenic, psychogenic or mixed.

• #102 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  Given the fundamental role of hormonal regulation in the physiology of orgasm, multiple endocrinopathies have been identified in patients with DO. […] Hyperprolactinemia also leads to DO as increased levels of prolactin (PRL) result in suppression of T production. […] Psychogenic DO results from feelings of fear, anxiety, hostility, relationship difficulties associated with sexual intercourse and encounters. […] Hyperstimulation of the penis is another factor that has been identified to contribute to DO. […] Orgasmic dysfunction has been demonstrated among patients who undergo pelvic surgeries. […] There is no standardized treatment plan for DO. Treatment plans are often multidisciplinary, involving urologists, primary care providers and mental health professionals to adequately address biopsychosocial factors.

• #103 The pathophysiology of delayed ejaculation – Chen – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10617/11776

  Delayed ejaculation (DE) is probably least studied, and least understood of male sexual dysfunctions, with an estimated prevalence of 14% of the male population. Pathophysiology of DE is multifactorial and including psychosexual-behavioral and cultural factors, disruption of ejaculatory apparatus, central and peripheral neurotransmitters, hormonal or neurochemical ejaculatory control and psychosocial factors. […] Although knowledge of the physiology of the DE has increased in the last two decades, our understanding of the different pathophysiological process of the causes of DE remains limited. […] The pathophysiological etiology of DE should be established thorough medical, psychosexual and psychosocial history. The etiology of DE is usually multidimensional, resulting from the man’s biologic ejaculatory latency being affected by multiple organic biological, or psychogenic factors in varying combinations during his life. It can be of the primary (lifelong) or secondary (acquired) origin.

• #104 Understanding Ejaculatory Dysfunction – Causes, Treatment and More

  https://www.cloudninecare.com/blog/all-you-need-to-know-about-ejaculatory-dysfunction

  If the ejaculation does not happen properly or a male cannot ejaculate, there is no release of sperm, or the sperm is unable to reach the egg in time, causing fertility issues. […] The first step to addressing ejaculatory dysfunction is to understand the cause, as it helps the healthcare provider provide appropriate treatment. […] Effective treatment of this condition depends on identifying the underlying root cause. Here are some recommended treatment options. […] If the problem is because of physical issues like anatomical abnormalities or obstructions in the ejaculatory mechanism, surgery may be the preferred choice to correct the problem. […] Behavioural counselling and therapy may be recommended if anxiety, stress, or other psychological factors are the cause. […] For couples with fertility issues because of ejaculatory dysfunction, ART (Assisted Reproductive Technology) is useful. IVF (In-vitro Fertilization) and IUI (Intrauterine Insemination) are two such ART techniques that offer alternative ways of conception. These methods bypass the normal ejaculation process and enhance the conception chances.

• #105 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  Though there are no drugs approved by the U.S. Food and Drug Administration (FDA) at this time due to the absence of conclusive data, several pharmacological therapies show promise in treatment of DO including cabergoline, bupropion, oxytocin, and recently amphetamine/dextroamphetamine (AdderallTM).

Zobacz więcej