Ejaculation problems 

Introduction 

Involve your partner

If you are having problems with your sex life and are seeking treatment, it is usually recommended you involve your partner as much as possible.

Communicating your concerns can often go a long way to helping to resolve them. And in some cases your partner may also have their own problems that are contributing towards problems with your sex life.

For example some women are unable to reach climax during ‘normal’ intercourse and require manual or oral stimulation.

Read more about why talking about sex is important.

Blood in your semen

Finding blood in your semen (haematospermia) can be alarming. However, in most cases it's not serious and will pass within a few days.

The most likely cause is infection of your urethra (urethritis) and prostate (prostatitis).

See your GP if the symptoms persist, or visit your local genito-urinary medicine (GUM) clinic because the causes may be more serious.

Read more about blood in the semen.

The male midlife crisis

The male midlife crisis is something people joke about, but it can be distressing for those going through it

Ejaculation problems, such as premature ejaculation, are common sexual problems in men.

The three main problems are:

These are described in more detail below.

Premature ejaculation

Premature ejaculation is the most common ejaculation problem. It is where the male ejaculates too quickly during sexual intercourse.

Many men are unsure about how long ‘normal’ sex should last before ejaculation. A study looking at 500 couples from five different countries found the average time between a man putting his penis into his partner’s vagina and ejaculation was around five-and-a-half minutes.

However, it's up to the individual and his partner to decide whether or not they're happy with the time it takes for him to ejaculate. There is no definition of how long intercourse should last.

Occasional episodes of premature ejaculation are common and not a cause for concern. However, if you're finding that around half of your attempts to have intercourse result in premature ejaculation, it might help to get treatment.

Most men with this problem won't have always had it – they'll have previously ejaculated normally. This may be referred to as 'secondary' premature ejaculation.

It's less common for the man to have always experienced premature ejaculation (since becoming sexually active) – this is known as 'primary' or lifelong premature ejaculation. It affects around one in 50 men in England. In most cases of lifelong premature ejaculation:

  • there is an inability to delay ejaculation during sex every time or most times
  • the condition causes feelings of shame or frustration and impacts on quality of life, causing the man to avoid sexual intimacy

Delayed ejaculation

Delayed ejaculation (male orgasmic disorder) is classed as either:

  • experiencing a significant delay before ejaculation is possible
  • being unable to ejaculate at all even though the male wants to and his erection is normal

There is no set definition to describe ‘how long is too long’, but a persistent (and unwanted) delay of ejaculation that lasts for 30 to 60 minutes may suggest delayed ejaculation.

Alternatively, if you are unable to achieve ejaculation at least half the times you have sex, you may have delayed ejaculation.

As with premature ejaculation, delayed ejaculation can be either acquired or lifelong. Lifelong delayed ejaculation is less common and affects an estimated one in 1,000 men.

Delayed ejaculation can occur in all sexual situations, or just in certain situations – for example, you may be able to ejaculate normally when masturbating, but not during sex. When delayed ejaculation only happens in certain situations, there's usually a psychological cause.

Retrograde ejaculation

Retrograde ejaculation is a rarer type of ejaculation problem. It happens when sperm travels backwards and enters the bladder instead of coming out of the end of the urethra (the tube through which urine passes).

The main symptoms of retrograde ejaculation include:

  • producing no semen, or only a small amount, during ejaculation
  • producing cloudy urine (because of the semen in it) when you first go to the toilet after having sex

Men with retrograde ejaculation still experience the feeling of an orgasm and the condition does not pose a danger to health. However, it can affect the ability to father a child (read about infertility).

Treating ejaculation problems

Premature ejaculation can be treated with medication, such as the selective serotonin reuptake inhibitors (SSRIs) type of antidepressant, which can help delay ejaculating.

Couples therapy, a form of counselling, can be useful in coming up with techniques for partners to practice to help delay ejaculation.

Recommended treatments for delayed ejaculation depend on the underlying cause. If it is thought to be a side effect of medication, switching to an alternative medication will help. However, if the cause is thought to be psychological, counselling may be recommended.

Most men do not require treatment for retrograde ejaculation because they are still able to enjoy a healthy sex life and the condition does not affect their health. In some cases, medication may be used to help restore normal ejaculation.

However, if you want to have children, you may need fertility treatment to extract a sample of sperm.

Read more about treating ejaculation problems.

What causes ejaculation problems?

Ejaculation problems are complex and can be caused by a number of things, including:

  • stress
  • relationship problems
  • anxiety – such as a man being anxious that he will lose his erection (erectile dysfunction), causing him to ‘rush’ the intercourse
  • previous traumatic sexual experiences
  • depression
  • some medical conditions or medicines – for example, diabetes can cause delayed ejaculation

Some researchers think certain men are more prone to premature ejaculation because of their biological make-up, such as having an unusually sensitive penis.

Retrograde ejaculation is caused by damage to nerves or muscles that surround the neck of the bladder (the point where the urethra connects to the bladder). This damage can often occur as a complication of prostate or bladder surgery.

Read more about the causes of ejaculation problems.

Who is affected

Premature ejaculation is the most common type of ejaculation problem.

A number of surveys have found around one in three men reported being affected by premature ejaculation. The true figure is probably much higher as many men are reluctant to admit they have this problem.

While less common, delayed ejaculation is probably more of a problem then most people realise. One study found around one in 20 people had problems achieving an orgasm over the course of a month during the past year.

Although retrograde ejaculation is rare, it can be a common complication of some types of surgery, such as prostate surgery, or in men with certain health conditions that can damage the nerves, such as diabetes or multiple sclerosis.




Page last reviewed: 15/07/2014

Next review due: 15/07/2016

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Comments

The 8 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Michael Rotthayer said on 17 February 2014

I can remember my first time with my girlfriend it was horribleeee and shameless off course... butttt i started to use prolong and it slowely began to show some progress. in the first weeks it was still horrible for me but at the end i can finally have a normalll sex

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Chipie2206 said on 18 September 2013

I need some advice. I am in a relationship and we have had intercourse several times over our 2 and half years together. I suffer from premature ejaculation and it has now got to a stage where my girlfriend would rather avoid physical contact with me, rather then trying to help me overcome this issue. I have previously been married and we had a very active sex life, but it all ended pretty badly. I have become overweight and suffer clinical depression and anxiety. I also suffer from Sleep apnoea which unfortuneatly creates a barrier in itself as its tough to get physical and even just cuddle when I have to wear the mask. I am on alot of medication for severe Knee pain due to an accident I had at work prior to my previous marriage collapsing. I know I am under alot of pressure and stress and I know that these are contributing factors. I just need to know if there is anything that can be done to help as at the moment I feel my girlfriend is going to look elsewhere as I can't give her the satisfaction she desires through penetrative sex. Please Help!!!

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cure_pe said on 26 November 2012

One of the more effective processes to delay ejaculation is always to actually process ejaculating all by your self. You actually have to practice starting after which stopping, and, by the time you’re on a sexual act together with your partner, likely to surely notice a noticable difference.

There are many methods that men can try to be able to stop premature ejaculation naturally. Remember too that there is actually absolutely no magic pill or cream that may instantly stop pre adult ejaculation.

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thundercloud said on 31 July 2012

My problems started about 18 months ago, starting with erectile dysfunction, went to the doctor and explained to him and ended up taking viagra which really did not work, then I was given Cialis, works sometimes, however the other problem in the inability to ejaculate, i had a vasectomy many years ago, so there is nothing arriving from my testicals, but again nothing from the prostate, I have had prods and probes up and down everwhere, next is a scan of my prostate and kidneys, I forgot about 6-8 weeks ago I did ejaculate but most of it was blood, any ideas people.
I ave bought and used with my wife many implements designed to help get erections and ejaculate, while this has been fun for both of us it was of limited success :-(
My age a young 60

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valtemar said on 16 July 2012

I have a sexual problem at least one year since it started so I never got to have sexual intercourse, because I felt terrible pain after ejaculation, I went to the GP several times I took drugs, but did not make any difference. I wonder how do I get help because I do not feel well and my life is very bad the way I'm living with this problem. Thanks waiting
in touch

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nickinworcs22 said on 01 January 2011

i have mentioned this problem i have on 2 occasions concerning delayed ejaculation, with my doctor, he doesnt seem to give me the advice i need nor treatment concerning ejaculation can anyone direct me in advice to a more realistic aproach

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devoted husband said on 22 April 2010

this is indeed helpfull, it links in with other symptoms to give me a rounded idea of what to, and how to, tell my Doctor, to enable treatment to be given...

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User289212 said on 09 July 2009

I'm pleasantly surprised that the NHS have addressed this issue with a video and even more surprised that people were willing to talk about it on camera.
Well Done - a lot of me suffer from premature ejaculationand don't realise there that it is a common problem and that there is help out there...

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