The 3 types of ejaculation problems (yes, 3!)

It’s not uncommon for a man to run into a problem with ejaculation, but most men don’t realise that there are actually 3 distinct types of ejaculation problems. Although it can be a frustrating experience, there’s good news - ejaculation issues are almost always treatable.

Here’s everything you need to know about the types, causes, and treatments for each ejaculation problem.

Premature ejaculation

What is premature ejaculation?

If a man ejaculates in less than a minute, it’s considered premature. Another way to define premature ejaculation is by measuring the satisfaction for you or your partner. If you or your partner feel consistently unsatisfied with the time taken to ejaculate, then it’s worth exploring your options to help you last longer in bed.

There’s a general misconception that sex should last longer than it does. A large study on 500 couples across 5 different countries found that the average time taken from penetration to ejaculation was 5.4 minutes. So lasting just a few minutes in bed is nothing to worry about, but if you find you lack control over ejaculation and consistently climax quicker than desired, it’s worth treating it.

What causes premature ejaculation?

The root cause of your premature ejaculation can be either psychological or physical.

Physical causes of premature ejaculation include:

• Prostate problems such as prostatitis (inflammation of the prostate)

• Thyroid issues (an overactive or underactive thyroid gland)

• Problem with nerves

• Recreational drugs or prescription medication

• Biological predisposition (having a particularly sensitive penis)

Psychological causes of premature ejaculation include:

• Relationship issues

• Stress

• Depression

• Performance anxiety

• Guilty feelings about sex (this could be brought on by a strict upbringing with specific beliefs about sex)

• Fear of sex

• Early sexual experiences that encouraged quick ejaculation (such as a fear of being caught masturbating by parents)

• Sexual trauma (such as sexual abuse or an uncomfortable sexual experience)

Premature ejaculation treatment:

For a long-term solution, it’s important to get to the bottom of what’s causing your premature ejaculation. In the meantime, there are plenty of premature ejaculation treatments. For some people whose premature ejaculation is psychological, the treatment gives them back the confidence they need to gain greater control, even without the use of medication.

Treatment for the condition include:

• Premature ejaculation pills (Priligy): this clinically proven treatment should be taken 1-2 hours before sex and helps you to gain control over ejaculation

• Delay Spray: you can take this easy-to-use treatment just a few minutes before planned sexual activity by applying a few sprays to the head and shaft of your penis

• Delay Wipes: an extremely fast way to help with premature ejaculation, use one of these wipes on your penis a few seconds before sex

You might also want to try out more natural methods for premature ejaculation, such as the ‘start-stop’ technique or Kegel exercises for men.

Delayed ejaculation

What is delayed ejaculation?

Also known as male orgasmic disorder, delayed ejaculation occurs when a man can’t ejaculate for a prolonged period, or at all, despite wanting to. If you’re often unable to ejaculate during sex or repeatedly last 30 to 60 minutes, then you may have delayed ejaculation.

What causes delayed ejaculation?

Delayed ejaculation can be caused by physical or psychological conditions.

Physical causes of delayed ejaculation include:

• Pelvic nerve injury

• Urinary tract infection

• Birth defect 

• Hormone deficiencies such as hypothyroidism (low thyroid hormone level) or hypogonadism (low testosterone level)

• Diabetes

• Prostate or bladder surgery

• Spinal cord injury

• Multiple sclerosis

• Neurological diseases

• Old age

• Medications such as antidepressants (sometimes used to treat premature ejaculation), high blood pressure medication, muscle relaxants, painkillers or diuretics

• Recreational drugs or excessive alcohol intake

The root cause of delayed ejaculation can also be psychological, such as:

• Relationship problems

• Anxiety or depression

• Stress

• Early sexual trauma

• Strict upbringing

Delayed ejaculation treatment:

The best method of treatment depends on what’s causing your delayed ejaculation. Once you’ve considered this, there are several methods you can try:

• If your condition is psychological, you may want to speak to a sex therapist about any trauma or past experience that’s triggered your delayed ejaculation. 

• If your condition is caused by relationship issues, you should communicate the problem to your partner and could consider couples therapy.

• If your condition is caused by medication, you should speak to your doctor about the possible side effect and ask if there are any suitable alternatives. You mustn’t stop taking your medication until you’re told it’s safe to do so.

• If your condition is caused by alcohol and drugs, you should speak to a charity or your GP for support on quitting.

Retrograde ejaculation

What is retrograde ejaculation?

Retrograde ejaculation is the least common form of ejaculation out of the 3, but it is a problem for some men. When you ejaculate, the semen should travel through the urethra (the same tube that you urinate from). When retrograde ejaculation occurs, the semen travels in the wrong direction, back into the bladder.

The warning signs of retrograde ejaculation include producing no semen or a very small amount despite ejaculating or noticing semen in your urine after having sex.

The condition in itself isn’t harmful or painful and it doesn’t affect your ability to climax but it is problematic when it comes to fertility.

What causes retrograde ejaculation?

Unlike premature ejaculation and delayed ejaculation, retrograde ejaculation is a physical condition and has no psychological triggers.

Retrograde ejaculation indicates that the nerves or muscles that connect the urethra to the bladder are damaged in some way. When a man orgasms, this muscle is supposed to tighten, which prevents the semen from going into the bladder. Retrograde ejaculation occurs when this mechanism fails and the muscle is not tight enough to prevent the semen from entering the bladder instead of the urethra.

Causes of retrograde ejaculation include:

• Surgery (to the prostate or bladder)

• Medication (such as medication to treat high blood pressure, prostate enlargement or depression)

• Nerve damage (you might be at risk if you have diabetes, multiple sclerosis, spinal cord injury or Parkinson’s disease)

Retrograde ejaculation treatment:

If you aren’t trying for a baby, retrograde ejaculation is usually nothing to worry about, although you should speak to your doctor to rule out any other conditions.

There are several treatment options if you want to father a child. If your retrograde ejaculation is caused by your medication, speak to your GP about the side effect. They might be able to prescribe you a different medication. You mustn’t stop taking your prescribed medication until you’re told it’s safe to do so.

Pseudoephedrine is a medication used to treat congestion and has been found to be effective when retrograde ejaculation is caused by diabetes or surgery.

If treatment isn’t possible, you can have semen extracted from your urine to make a baby via artificial insemination or IVF.

The bottom line

There are 3 different types of ejaculation that men might encounter: premature ejaculation, delayed ejaculation, and retrograde ejaculation. Premature ejaculation and delayed ejaculation can be caused by both physical and psychological conditions, whereas retrograde ejaculation is a physical condition. It’s important to get to the root of what’s causing your ejaculation problem so that you can find the treatment that works best for you. Whichever treatment you settle on, make sure to read the Patient Information Leaflet before taking anything. It's always best to keep things safe.