The process of ejaculation is normally inextricably linked with the occurrence of an erection and is the result of frictions during intercourse. It takes place in two phases.
The first phase is the allocation of the contents of the tail of the appendage into the proximal part of the urethra, where there are sperm and the secretion of seminal vesicles. The second phase is the allocation of the proximal part of the contents of the prostate into the lumen. With this phase, there is an active contraction of the striated muscles of the penis, perineum, due to which the ejaculate is thrown out. Regulation of ejaculation is carried out by the autonomic nervous system.
The main types of ejaculation disorders are:
- Premature ejaculation.
- Delay (retardation) of ejaculation.
- Aspermatism – lack of ejaculation.
- Pain during ejaculation.
1. Premature ejaculation is the most common form of sexual dysfunction and occurs in one form or another in 30% of men.
Details on the treatment of premature ejaculation.
2. Delay in ejaculation is much less common and is manifested by an extremely long sexual intercourse without ejaculation. Sexual intercourse with active frictions can take a long time, while the man does not feel the urge to ejaculate.
- Improper development of the neck of the bladder – cyst of the Müller duct, anomalies of the Wolf duct.
- Infectious: prostatitis, urethritis, genitourinary tuberculosis.
- Iatrogenic (consequences of operations): operations on the pelvic organs.
- Neurogenic: multiple sclerosis, diabetic polyneuropathy, spinal cord injuries, Parkinson’s disease.
- Endocrine: hypogonadism, diabetes mellitus, hypothyroidism.
- Medications: tricyclic antidepressants, serotonin reuptake inhibitors (used in the treatment of depression), thiazide diuretics (diuretics).
Depending on the causes of the disorder, the following medications are prescribed:
- Yohimbine (for a wide range of sexual disorders).
- 5HT1A receptor agonists (used for anxiety disorders).
- Antagonists of 5-H receptors of serotonin.
- Dopamine reuptake inhibitors (used in cases of anejaculation with antidepressants).
3. Aspermatism – a condition in which sexual intercourse does not end with ejaculation. Depending on the reasons for the absence of ejaculate, aspermatism is divided into two types: true and false .
- With true aspermatism, ejaculation is absent due to a violation of its production. This is primarily due to dysfunction of the testes, responsible for the formation of sperm, and the adnexal glands, responsible for the production of seminal fluid.
- With false aspermatism, the patency of the urethra for the ejaculate is impaired, or the functional relationship of the bladder neck and ejaculatory fluxes is disturbed. With this pathology, seminal fluid is ejected into the cavity of the bladder (retrograde ejaculation).
4. Pain during ejaculation most often indicates an inflammatory process in the seminal tubercle or prostate. Latent inflammatory processes, for example, after suffering epididymitis, can also cause pain within a few minutes after sexual intercourse. This case requires taking tests to determine the causes of discomfort.
Possible causes of ejaculation disorders
Violation of ejaculation cause a wide range of causes for each type of pathology. Of the common possible causes, there are:
- inflammatory diseases (prostatitis, vesiculitis, colliculitis, urethritis, etc.);
- consequences of surgery, trauma;
- psychological disorders;
- neurological disorders.
The primary treatment is a urologist;
Secondary treatment – psychotherapist / sexologist, neurologist, andrologist.
Read about ejaculation disorders.