What is delayed ejaculation?
Delayed ejaculation and anorgasmia are used to describe the inability to ejaculate at will, so that ejaculation takes much longer than desired, or does not happen at all. This might happen only with intercourse, or in all situations including self-stimulation (masturbation). “Orgasm” and “ejaculation” are often used interchangeably, but some men can experience orgasm even though they don’t ejaculate.
What causes delayed ejaculation?
Physical causes include spinal cord injury, major lymph node surgery, diabetes, multiple sclerosis and traumatic injury to the pelvic region, when there is disruption to the nerve supply. Delayed ejaculation is a well-documented side-effect of SSRI antidepressants. Whilst delayed ejaculation can be caused by relationship difficulties, persistent anorgasmia, where there is no medical cause, is very uncommon.
A change of antidepressant medication under supervision by a doctor may be needed for men who are concerned about this side-effect. Vibrator stimulation and electrical stimulation of the penis can be used to promote reflex ejaculation in men who can’t ejaculate, but want to father a baby. Men who are concerned about being unable to ejaculate when there is no medical reason for this difficulty may need long-term individual counselling.
Electro-stimulation is another option for men with spinal cord injury. An electrical charge is given to the back of the penis via the rectum. Sperm is then ejaculated and collected for use in assisted reproductive techniques. A qualified health professional experienced in these techniques must perform electro-stimulation treatment.
Alternatively, sperm can be isolated from the testis by needle biopsy and used in ICSI/IVF procedures.
 More information: Assisted Reproductive Technologies
What are the risks of ejaculation treatment?
The quality of the sperm collected using vibro- or electro-stimulation treatments for spinal cord injuries may not be good and the procedure may need to be repeated several times to collect enough quality sperm.
There are several risks associated with the electro-stimulation procedure, which should be discussed with a doctor. These can include severe rises in blood pressure and internal bleeding in the brain (cerebral haemorrhage). There is also a small risk of rectal burns.
General anaesthesia is sometimes needed if the man has some sensation or feeling in the lower part of the body. This also has some risks, which should be discussed with the doctor.
 Download: Sexual Difficulties fact sheet PDF (129kb)
|
