Ejaculation Disorder

Too fast, too slow, or not at all? An estimated 1 in 3 men has faced premature ejaculation, while up to 4% of men experience delayed ejaculation.

The two main types of Ejaculatory Disorders

Premature Ejaculation

In simple words, premature ejaculation (PE) is when a person ejaculates sooner than he or his partner expects, during sexual intercourse. Although some might feel embarrassed talking about it or seeking help, PE is actually a relatively common and very treatable condition. It is estimated that almost 1 out of every 3 men will experience this problem in some time of their life.

As long as it does not happen persistently, it is not alarming. However, you might be diagnosed with PE if you:-

  • Always or nearly always ejaculate within one minute of penetration
  • Are unable to delay ejaculation during intercourse all or nearly all the time
  • Experience emotional distress, and are frustrated from the outcome of the intercourse.

Many factors come into play when talking about PE- factors that can mainly be divided into psychological and biological factors. The good news is that there are many treatment methods for PE, such as medications, topical anaesthetics, counselling and behavioural techniques that dan delay ejaculation.

Symptoms

The hallmark of PE is the inability to delay ejaculation for more than one minute after penetration. However, the problem might occur in all sexual situations, even during masturbation.

 

PE can further be classified into:

  • Lifelong (Primary) PE:

Lifelong PE that has happened all the time and even since your first sexual encounter.

  • Acquired (Secondary) PE:

Acquired PE develops some time throughout your life and persisted.

Many people might feel that they have symptoms of PE, however, the symptoms do not qualify or meet the diagnostic criteria for PE. Instead, they might have natural variable Premature ejaculation, which is a period of rapid ejaculation as well as period of normal ejaculation.

Delayed Ejaculation

The two types of delayed ejaculations are Primary and Secondary delayed ejaculation.

Similary to PE, primary delayed ejaculation happens to men who have always had difficulty ejaculating.

Secondary delayed ejaculation, on the other hand, happens to who have previously no issues with intercourse but have newly developed this. The causes to this can be divided into physical and psychological factors.

Physical factors include:

  • Side effects from medications, in particular anti-depressants
  • Alcohol and ilicit drug use
  • Nerve damage or mechanical pelvic injury
  • Hormonal defeciencies such as low testosterone

Psychological factors include:

  • Mood disorders
  • Relationship problems
  • Performance anxiety
  • Existing culture or religious taboos regarding sexual intercourse
How then do we treat it?

 

Of course it involves treating the underlying cause. This may involve changing masturbation habits, getting partner involved in sex therapy to evaluate sex beliefs and how threshold of stimulation can be reached, assessment of all medication taken whether prescribed or over the counter pills and perhaps also replacement of testosterone if deemed necessary.

Point is if you find the situation with delayed ejaculation stressful, don’t keep it to yourself, don’t continue to engage in intercourse that distresses you, come in together with your partner so the issue can be identified and addressed early.

Don’t Keep Your Ejaculation Problems To Yourself

If you’re struggling with ejaculation issues, don’t keep it to yourself and don’t continue to engage in intercourse that distresses you. Talk to us together with your partner so that the issue can be identified and addressed early.

Whether you’re suffering from premature or delayed ejaculation, the journey to recovery begins with treating the underlying cause, which may include assessment of:

Medication History
Relationship
Masturbation Habits
Hormonal Imbalance

Treatment For Ejaculation Disorder

For those who are undergoing treatment for erectile dysfunction, medication like Cialis, Viagra and Levitra can actually alleviate some of the problems with premature ejaculation.

Otherwise, dapoxetine and tramadol can be used to target premature ejaculation, while cabergoline (the same drug to help mothers to stop producing breast milk) has been used to treat delayed ejaculation.

If your ejaculation disorders are caused by a shortage of testosterone, you may benefit from testosterone replacement therapy, which can take place in the form of injections or gels.

Frequently Asked Questions

Men with premature ejaculation have ejaculations that are persistently occurring to rapidly within a minute or so of penetration. This leads to significant distress/frustration of either you or your partner, compromising sexual intimacy.

The period between penetration and ejaculation (also known as latency period) is within just a few minutes.

The problem must be persistent, either since the beginning of sexual experience, or newly developed.

The problem has been causing emotional distress or sexual dissatisfaction among either you or your partner.

Yes, it is estimated 1 in 3 men have premature ejaculation some time in their life.

Yes, with either interventions such as behavioural therapy, pelvic floor exercise, decreasing sensitivity and oral medications, or a combination of them.

There is a spectrum of delayed ejaculation (DE) disorders ranging from increased latency (time from penetration to ejaculation) to absent ejaculation, retrograde ejaculation, and anorgasmia. While there is no firm criteria for the diagnosis of DE, men with latencies more than 25-30 minutes are considered having DE.

DE can be tempororay or a lifelong problem. Similarly to Premature ejaculation (PE), DE is also divided into lifelong vs acquired DE. With lifelong DE, the problem is present from the time of sexual maturity. Acquired DE is preceeded by a period of normal sexual functioning.

DE can result from medications, certain chronic health conditions, and surgeries. It can even be cause by substance abuse or a mental issue, such as anxiety or depression. In many cases, it is a combination of many factors, leading to DE.

Medication

Oral medications is a method to reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis.

Although they work in similar ways, each oral medication has a slightly different chemical makeup. These minor differences affect the way each medication works, such as how quickly it takes effect and wears off, and the potential side effects. Your doctor will consider these factors as well as other conditions you have and possible interactions with other medications you take.

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Sildenafil (Viagra)

This medication is most effective when taken on an empty stomach one hour before sex. It's effective for four to five hours or more if you have mild to moderate erectile dysfunction.

Duration of effectiveness/half-life: 4 hours Dosage: 25mg, 50mg, 100mg Common side effects: Hot flushing, headache, abnormal vision (changes in colour vision), muscle pain, uncomfortable stomach
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Tadalafil (Cialis)

Duration of effectiveness/half-life: 17.5 hours Dosage: 2.5mg, 5mg, 10mg, 20mg Common side effects: Hot flushing, headache, stomach upset, back pain, stuffy nose, dizziness

Duration of effectiveness/half-life:
17.5 hours

Dosage:
2.5mg, 5mg, 10mg, 20mg

Common side effects:
Hot flushing, headache, stomach upset, back pain, stuffy nose, dizziness

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Vardenafil (Levitra)

Duration of effectiveness/half-life: 4.5 hours Dosage: 2.5mg, 5mg, 10mg, 20mg Common side effects: Hot flushing, headache, stomach upset, back pain, stuffy nose, dizzines, flu-like symptoms

Duration of effectiveness/half-life:
4.5 hours

Dosage:
2.5mg, 5mg, 10mg, 20mg

Common side effects:
Hot flushing, headache, stomach upset, back pain, stuffy nose, dizzines, flu-like symptoms

Treatment

Oral medications is a method to reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis.

Although they work in similar ways, each oral medication has a slightly different chemical makeup. These minor differences affect the way each medication works, such as how quickly it takes effect and wears off, and the potential side effects. Your doctor will consider these factors as well as other conditions you have and possible interactions with other medications you take.

Men's Health

Extracorporeal Shockwave Therapy (ESWT)

Principle of therapy:
Using mechanical shockwave to improve blood flow + formation of new blood vessels.

Duration of therapy:
16-17minutes per session.

Frequency of therapy: Recommended frequency of therapy would be 2-3 times per week, however flexible.

Pre-procedure preparation:
None.

Side effects:
Mild tingling sensation during procedure. Zero downtime post procedure.

Men's Health

Priapus Shot (P-shot)

Principle of therapy:
Using Platelet Rich Plasma (PRP) from our blood that contains proteins involved in healing and growth

Duration of therapy:
30 minutes per session.

Frequency of therapy: Recommended frequency of once a week

Pre-procedure preparation:
None.

Side effects:
Blood will be taken from arm via syringe and needle. PRP will be extracted from blood and injected back into penis. Mild pain or discomfort may be observed over site of injection, however not lasting as small needle is used for injection.

Men's Health

EMkegel

Principle of therapy:
Using electromagnetic waves to simulate kegel exercise, strengthening perineal muscles- muscles involved during erection and intercourse.

Duration of therapy:
30 minutes per session.

Frequency of therapy: Recommended frequency of therapy would be 2-3 times per week, however flexible.

Pre-procedure preparation:
None.

Side effects:
Mild tingling sensation during procedure. Zero downtime post procedure.

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