How to Treat Ejaculatory Disorders
Our urologists have the expertise to diagnose and treat the root cause of your ejaculation disorder. Anything from psychological barriers to nerve damage may lead to ejaculation issues. We offer treatments for a range of causes, including the following:
- Premature ejaculation
- Delayed ejaculation
- Retrograde ejaculation
- Spinal cord injuries
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Premature Ejaculation Treatment
Several psychological, behavioral, and physical therapies can treat premature ejaculation. We recommend a few treatments:
Masters and Johnson Method
This treatment helps you learn to identify or regain control over your point of climax. We recommend practicing this technique by yourself or with a caring partner. You follow several steps to practice the Masters and Johnson technique:
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Start by stimulating your penis without penetration, such as masturbation or oral sex.
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Allow yourself to gradually reach the point just before you ejaculate.
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Stop just before you ejaculate.
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Allow yourself to partially lose your erection and relax. Then start again.
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Bring yourself closer and closer to orgasm each time until you can’t hold back.
Lie on your back and ask your partner to be on top when you are ready to try intercourse. Ask your partner to stop as soon as you are about to climax. Relax for a couple of minutes, then start the process again.
Squeeze Technique
This is a variation of the Masters and Johnson method. You or your partner squeezes the tip or base of your penis just before orgasm. This reduces blood flow in your penis and softens your erection. You can use the squeeze technique alone or along with the Masters and Johnson method.
Anesthetic Topicals
Over-the-counter gels, creams, and sprays may help decrease sensation so you can last longer. But these topicals may make intercourse less pleasurable. Topicals can also transfer to your partner during sex and decrease their sensations as well.
Medications
Some medications can delay or slow down orgasms:
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Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs)
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Tramadol, a mild painkiller
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Viagra® or Cialis® for men diagnosed with both premature ejaculation and erectile dysfunction
Condoms
Condoms may stimulate your penis less during sex. You might use more than one condom along with gels, creams, or sprays that desensitize feeling in your penis. You may even try condoms pre-treated with desensitization agents.
Premature Ejaculation Treatments to Avoid
You might research other ways to treat premature ejaculation that don’t work. Be careful with your research and consult your urologist before self-treating. There is little evidence that the following treatments work:
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Acupuncture
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Botox injections
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Herbal medicines
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Hormone therapy
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Over-the-counter medications
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Penile nerve ablation
Delayed Ejaculation Disorder Treatment
The way we treat delayed ejaculation can vary widely based on the underlying cause. Consult with a urologist if you have never ejaculated with any stimulation. A urologist can evaluate whether there are underlying physical causes.
You may find that other treatments work for you:
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Participating in sex/couples’ therapy
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Switching or stopping certain kinds of medications
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Using devices like high-speed vibrators
Possible Side Effects of Delayed Ejaculation
You may experience several problems over time if you don't treat your delayed ejaculation or inability to ejaculate:
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Avoiding sexual contact
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Difficulty conceiving
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Inhibited sexual desire
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Sexual dissatisfaction
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Stress in your romantic relationships
Treating Premature or Delayed Ejaculation
Retrograde Ejaculation Treatments
You don’t always need to treat retrograde ejaculation. We will usually only treat your condition if you’re trying to conceive or don’t like the way retrograde ejaculation feels. There are several ways to treat this condition:
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Stopping medications that may cause retrograde ejaculation
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Taking medicines such as pseudoephedrine or imipramine if surgery or diabetes has caused the condition
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Removing semen from your bladder to use in assisted reproductive procedures such as in vitro fertilization
Spinal Cord Injury & Male Fertility
Sometimes a spinal cord injury can cause an ejaculatory disorder. There are three ways to treat an ejaculatory disorder if you have a spinal cord injury:
- Vibratory stimulation: We will apply a vibratory device to the base of your penis to make you ejaculate. We will perform this during a clinic visit. This is so we can observe blood pressure in case you develop autonomic dysreflexia. You can get autonomic dysreflexia when too much stimulation raises your blood pressure to a dangerous level. You will need to ejaculate more than once to produce high-quality sperm.
- Electro ejaculation: We will put you to sleep with general anesthesia. Then we will insert a probe into your rectum to stimulate your nerves and make you ejaculate. You will need to ejaculate more than once to produce high-quality sperm.
- Surgical treatment: The third alternative is more invasive and requires one trip to the operating room. Here, the surgeon will perform either testicular sperm extraction (TESE) or microsurgical testicular sperm extraction (microTESE) to get sperm.
Why Choose University of Utah Health?
We provide you with the quality care and support to help you reach your best sexual health. We understand that ejaculatory disorders can be uncomfortable to talk about. We treat you with sensitivity, compassion, and dignity every step of the way.
We are the Mountain West’s only academic medical center. Our cutting-edge research often gives us early access to new and promising therapies. Our urologists use the latest treatments designed to promote the best outcomes.
Make an Appointment
Call to schedule an appointment with one of our expert urologists. We can evaluate your condition and offer the best treatment for your ejaculation disorder.
