Man with wrench fixing pipes

Ejaculatory disorders can disrupt the plumbing–but they can also be treated.
Image: Shutterstock

With the popularity of ads for Viagra and similar products, it’s easy to think erectile dysfunction is the most common problem Mr. Happy can possibly face. In reality, ejaculatory disorders are the most prevalent, even if we’re still learning how and why they happen.

Ejaculatory disorders fall into four categories:

  • Delayed Ejaculation: it takes a prolonged period of stimulation to cause ejaculation
  • Premature Ejaculation: ejaculating too soon
  • Retrograde Ejaculation: the semen enters the bladder instead of exiting through the urethra during ejaculation
  • Anejaculation: the inability to ejaculate at all

As you might expect, none of these is fun for either partner!

The reasons behind these disorders can be both psychological and physical.

On the physical side, levels of neurotransmitters in the body can affect a man’s ability to ejaculate. Dopamine, for instance, facilitates the entire ejaculation process, with levels rising throughout sex and reaching their highest point right before ejaculation. If something interferes with dopamine levels—a spinal injury or an illness like multiple sclerosis, say—that can affect a man’s ability to ejaculate normally. Medications that interact with neurotransmitters like serotonin or oxytocin (think antidepressants) can also cause ejaculatory problems.

In addition, there are the natural processes of aging. Decreased penile sensitivity and a decline in fast-conducting peripheral nerves can both lead to ejaculatory disorders. This is why you often see ejaculation issues in older men.

It’s not just a physical thing, though. Psychology plays a big part when it comes to sex. You’ve heard how the brain is your biggest sex organ, right? Well, if your brain isn’t on board, the rest of your body has trouble following. Being caught up in intense emotion such as repressed anger or aggression can be enough to throw you off your sexytime groove. Your body can also react negatively to more long-term emotional issues, such as fears about having a child with your partner or feeling pressured to sexually perform in a certain way. Even your religious or spiritual beliefs can affect your sexual health.

Then there’s the one-two punch combo: both physical and psychological discomfort. This can happen when a man is used to achieving greater arousal from masturbation and has difficulty duplicating the feeling with a partner. While there’s nothing inherently wrong with masturbation, it can train you to respond to a very specific sort of stimulation (both mental and physical) that’s different from full-blown sex with a partner.

Now for some good news: The upside of ejaculatory disorders being common is that they come with a variety of potential solutions:

  • Selective serotonin reuptake inhibitors (SSRIs) have been shown to positively affect men suffering from premature ejaculation. Viagra, often used along with a cream to reduce sensitivity, can also help.
  • Behavioral therapy can help with the emotional/psychological side of things. It’s particularly helpful to have your partner join you in therapy so that you can improve your sex life together as a couple.
  • Penile Vibratory Stimulation (PVS) can increase sexual friction, making ejaculation at the right time easier to achieve. While PVS has been used by sex therapists for more than thirty years, it’s generally been applied in situations where a couple wants to increase their fertility, such as when the man has a spinal cord injury but the couple still wants to have a child.

Suffering from an ejaculatory disorder doesn’t mean you’ll never have enjoyable sex again! It does mean you should talk to your doctor about your symptoms and your treatment options. Together you can come up with a plan to get the plumbing working again in no time.