Ejaculatory Dysfunction


Premature ejaculation is the most common ejaculatory problem, and is experienced by one-third of American men. Other forms of ejaculatory dysfunction are anejaculation—the inability to ejaculate in males with or without orgasm—and/or the inability to climax.


Symptoms of Ejaculatory Dysfunction

  • Reduced sex drive
  • Reduced erectile function
  • Fatigue
  • Reduced lean muscle mass
  • Loss of body hair 
  • Symptoms of depression

Major Risk Factors

  • Age (20% of men over 60, 30% of men over 70, and 50% of men over 80 will suffer from ejaculatory dysfunction)
  • Obesity
  • Metabolic Syndrome (high blood pressure, high blood sugar, unhealthy cholesterol levels, and belly fat)

Premature Ejaculation

Also referred to as rapid ejaculation, early ejaculation, or premature climax—the incidence of ejaculation happening sooner than desired—is typically frustrating and disappointing. It can, however, have a significant negative impact on relationships and cause sex to be less enjoyable. If that is the case, a healthcare provider can help.

Anejaculation (Inability to Climax)

Anejaculation may present as either situational or total.

Situational anejaculation is frequently stress-induced, and the man may be able to ejaculate in some instances but not in others. Psychological conflicts may be a factor in such cases.

In total anejaculation, however, the man is unable to ejaculate in any situation, and he may or may not be able to achieve orgasm. Obviously, a scenario like this may result in strained relationships and a loss of sexual intimacy, either of which can add to psychological damage.

The causes of anejaculation are numerous—including some medications, underlying medical conditions, or psychosocial issues.

When to Seek Treatment

Numerous, reliable treatments exist for both premature ejaculation and anejaculation. Excepting conditions such as spinal paralysis or multiple sclerosis, there’s no reason any man should have to live with the psychological effects or loss of intimacy that frequently accompany ejaculatory dysfunction. An experienced urologist can help return one’s sex life to one that is satisfying and raises overall quality of life.


Testosterone Therapy

If testosterone levels are found to be abnormal, testosterone therapy can be administered in five different ways. Your physician will help choose which method is most useful for you and your specific needs. Some of the more common include:

  • Transdermal (Topical): Topical medicines are administered via gels, creams, liquids, and patches to the external of the skin. 
  • Injection: Testosterone injections are available in both short-acting and long-acting forms and administered either weekly, bi-weekly, or monthly.
  • Pellets: Testosterone Pellets are inserted under the skin of your upper hip or buttocks and dissolves slowly as the medication is released over the course of 3-6 months.


Non-Invasive Treatments for Premature Ejaculation

Behavioral Therapy

Behavioral therapies to help men overcome premature ejaculation (PE) generally focus on the use of physical techniques to delay ejaculation and improve sexual self-confidence, which is often a factor in instances of PE. The start-stop and squeeze techniques are simple physical behavior modifications that can make a big difference in one’s sex life. Both are intended to help a man recognize the feelings of arousal in order to also be able to delay ejaculation.

Specific exercises intended to strengthen the muscles of the pelvic floor may also impact ejaculatory control.

Psychological Therapy

Psychotherapy for premature ejaculation tends to focus on developing control over the psychological issues that may be the root causes of PE, and include the building of self-confidence, the lessening of anxiety, the development of better, more impactful means of communication. Individual or couples therapy may be recommended, and therapy with medication is accepted as a meaningful treatment as well.