OVERVIEW
Ejaculatory dysfunction can either be classified as premature ejaculation (occurring very soon after penetration or sooner than you or your partner desires) or delayed/anejaculation (occurring after a prolonged period or time causing patient or partner distress).
Causes
Premature ejaculation can be lifelong or associated with erectile dysfunction, sexual performance anxiety, obesity or thyroid disorders. Delayed ejaculation or anejaculation can be associated with diabetes, anti-depressants/anti-psychotics, alpha-blockers (i.e. Flomax), testicular cancer surgery (RPLND), chemotherapy, thyroid disorders, abnormal testosterone levels or spinal cord injury.
Diagnosis/Evaluation
- What to know before your visit:
- During your visit, your doctor will ask you questions regarding your medical and surgical history, medications and will perform an exam with focused attention to the abdomen and genitalia. Information regarding situations when you have difficulty delaying or achieving orgasm is important for your visit.
- Tests that may be performed during or after your visit:
- Blood tests: Testosterone levels and thyroid function levels may be obtained amongst other possible laboratory studies
Treatment
NON-SURGICAL TREATMENT
Premature Ejaculation:
- Techniques to delay ejaculation: Stop-start technique, Pull-out technique, Penile squeezing technique
- Having an open conversation with your partner to determine ways to decrease performance anxiety and decrease over stimulation may be useful, sex therapy may also be helpful
- If erectile dysfunction (ED) is present, utilizing oral medications for ED treatment may improve your ability to maintain your erections
- Condom use
- Topical lidocaine creams can decrease the sensation associated with intercourse
- Oral therapy is typically utilized for life-long premature ejaculation and refractory premature ejaculation
- These medications include various antidepressants
SURGICAL TREATMENT
Delayed Ejaculation:
- Working with your partner to determine ways to improve sensation may be useful, sex therapy may also be helpful
- Switching medications in discussions with your primary care provider (i.e. changing antidepressant, antipsychotic)
- Electroejaculatory or vibratory ejaculation are utilized in those trying to conceive.
Schedule an appointment with a MidLantic Urology physician near you today!