Ejaculation is release of seminal fluid from urethra in men with sexual intercourse or forms of sexual activity, that replace it. It is complex reflex act, center of which is located in lumbar spinal cord. Lets talk about ejaculation problems and treatment methods.
Ejaculatory disorders causes
Causes of early ejaculation are poorly understood, since there isn`t enough data for truly scientific conclusion. In hypotheses, role is assigned to various biological and psychological factors, including penile hypersensitivity, anxiety disorders, dysfunction of serotonin receptors. Quick ejaculation is often combined with erectile dysfunction, but it doesn`t depend on age. The following risk factors are assumed:
- Poor overall health.
- Prostate inflammation.
- Thyroid hormones imbalance.
- Emotional problems, stress.
- Traumatic sexual experience.
Delayed ejaculation in men develops against background of following diseases and conditions:
- Thyroid disease.
- Hypothalamic-pituitary system diseases (Cushing’s disease and others).
- Prostate surgery.
- Trauma to pelvis nerves.
- Taking certain drugs (antihypertensives, sedatives) or drugs (opiates).
Some men report lack of sensitivity of glans penis. Well-known role is played by lifestyle factors and psychological moments.
Retrograde ejaculation may be due to:
- Balance disorder of autonomic nervous system.
- Prostate surgery.
- Somatic diseases (diabetes, multiple sclerosis).
Diagnosis of ejaculatory disorders
Diagnosis is largely based on patient’s sexual history. Doctor conducts detailed inquiry, trying to determine whether disorder is permanent or situational, whether any circumstances affect it, or whether it depends on partner. For various violations of ejaculation there are specific diagnostic methods.
Basic diagnostic tools for rapid ejaculation:
- Time of intravaginal ejaculatory delay – man himself calculates duration of sexual contact. Doctors don`t recommend using stopwatch to determine this indicator, it’s enough how man himself evaluates this time. They are also asked to evaluate, how effectively control over ejaculation was given on scale from zero to four.
- Questionnaires. Many evidence-based medicine has chosen two main ones. Diagnostic Tool for Premature Ejaculation (DTPE). It determines minimum stimulation required, level of patient depression and interpersonal problems. 11 points scored in this test indicate premature ejaculation, 9-10 points indicate its high probability.
- Arab Index of Premature Ejaculation (AIPE). Developed in Saudi Arabia for sexual desire study, sufficiency of erection for sexual contact, time before ejaculation, satisfaction of both partners, level of anxiety and depression. A score of 7-13 points in favor of severe disorder.
Medical examination is primarily focused on possible detection of neurological or endocrine pathologies in order to determine causative factors of problem. These may include prostatitis, urethritis, Peyronie’s disease. Set of laboratory tests will depend on doctor’s “findings”; standard tests recommended for all patients don`t exist.
Treatment of ejaculation disorders
Unfortunately, many men don`t reach doctor. This is connected not only with modesty, but also with conviction, that ejaculation problems aren`t treated. This is misconception, in case of such pathologies, visit to andrologist or sex therapist can correct situation.
Main pharmacological treatment methods for premature ejaculation, according to the European Guidelines for Male Sexual Disorders:
- Dapoxetine. It is antidepressant, approved in many countries specifically to treat this problem.
- Other antidepressants.
- Local anesthetics.
- Tramadol. This strong pain killer is recommended in many countries.
- Phosphodiesterase inhibitors of type 5.
So, if you have any problem, visit your doctor. That is the best way to prevent the disease or its spreading.