DELAYED EJACULATION: WHEN AND WHY EJACULATION DISAPPEARS
Delayed ejaculation is a violation of male sexual function, in which the body involuntarily suppresses the ejaculation reflex. Such pathology is quite rare (approximately 0.2% or 3-5% of men according to various data), which complicates the process of its study and treatment.
With delayed ejaculation, a man cannot finish sexual intercourse with ejaculation for a very long time, sometimes more than an hour. Sometimes the time interval can be several hours, but usually by this time the partners stop sexual intercourse without achieving ejaculation. In this case, an extreme form of delayed ejaculation is diagnosed – anejaculation.
Delayed ejaculation should not be confused with retrograde ejaculation, when seminal fluid is released into the bladder and then excreted together with urine.
WHAT IS THE DELAY OF EJACULATION
The delay of ejaculation is classified according to several criteria. Depending on when exactly the pathology manifested itself, primary and secondary delays are distinguished. In the first case, a man faces this problem from the very beginning of his sexual life, while the second is acquired and manifests itself over time.
Depending on the frequency of the observed problems, as well as the accompanying circumstances, there is a constant and situational delay in ejaculation.
Anejaculation is also divided into two types: absolute anejaculation (absence of ejaculation during sexual intercourse) and relative anejaculation (ejaculation only during masturbation, petting, oral stimulation of the penis, etc.).
CAUSES OF DELAYED EJACULATION
Delayed ejaculation is a complex phenomenon that is not officially considered a separate disease and is not included in the ICD-10 classification. There can be many reasons for this disorder, sometimes several factors manifest themselves in a complex. All the reasons provoking delayed ejaculation can be divided into physiological and psychological.
Physiological causes:
Age characteristics (after 40 years, most men have an increased period of time required for ejaculation).
Congenital malformations of the genitourinary system.
Infections of the genitourinary tract and other organs.
Cardiovascular and neurological diseases.
Damage to the pelvic nerves that control orgasm.
Inflammation of the prostate gland.
Surgical operations on the pelvic organs (for example, transurethral resection of the prostate).
Hormonal disorders (for example, thyroid diseases or low testosterone levels).
Taking medications (antidepressants, hypertension medications, diuretics).
Alcoholism and drug addiction.
Psychological reasons:
Depression and other disorders.
Experienced stress.
Low self-esteem, self-doubt, “male” complexes.
Religious prohibition or cultural restriction of sexual contact.
Problems in a relationship with a sexual partner.
The unattractiveness of a sexual partner.
Latent homosexuality or deviant sexual tendencies (sadism, masochism, etc.).
DIAGNOSIS OF THE CAUSES OF DELAYED EJACULATION
If the patient complains of delayed ejaculation, the doctor usually conducts an examination consisting of several stages. First of all, an examination of the external genitalia, palpation of the testicles and penis is carried out. Then it is necessary to make an analysis of the composition of blood and urine to determine the level of testosterone and check for the presence of infectious diseases. To study the possible psychological causes of pathology, you need to consult a psychotherapist or a psychiatrist.
THE MAIN METHODS OF TREATMENT
Treatment of delayed ejaculation is reduced to the treatment of the underlying disorder that caused it. This can be taking antidepressants, testosterone, psychotherapy, etc. A positive effect (especially when ejaculation is delayed, provoked by psychological problems) is provided by joint psychotherapy sessions with a partner, as well as special exercises recommended by a sexologist or a sex therapist.
