Understanding and Addressing Ejaculation Problems

Dinesh Patel
Medically reviewed by
Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
Dr. Akansha is a licensed Clinical Pharmacologist. She possesses remarkable knowledge in Pharmacovigilance, prescription analysis, drug information, and drug safety services. Additionally, she is a keen learner and an educator.

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ejaculation problems

Ejaculation problems are common sexual issues that many men and women may face at some point in their lives. 

These issues can affect one’s sexual satisfaction and can have a significant impact on one’s partner. 

There are three primary types of ejaculation problems in men—Premature ejaculation, Delayed ejaculation, and Retrograde ejaculation. 

In women, delayed orgasms, or the inability to reach orgasm, can significantly impact their sexual satisfaction and overall well-being.

This article will give an in-depth exploration of these ejaculation problems, their causes, and available treatments.

Premature ejaculation

Premature ejaculation is one of the most prevalent ejaculation problems. 

It occurs when a man ejaculates earlier than he or his partner desires during sexual activity. 

While occasional episodes are normal, persistent Premature ejaculation can be concerning. 

Common causes of Premature ejaculation are psychological factors like depression, stress, relationship problems, or anxiety about sexual performance. 

Physical causes may include prostate problems, thyroid issues, and the use of recreational drugs.

Treatment options for Premature ejaculation include:

  • Antidepressants:  Selective Serotonin Reuptake Inhibitors (SSRIs) like Paroxetine, Sertraline, and Fluoxetine have been shown to delay ejaculation
  • Dapoxetine (Priligy): It is a specific SSRI designed to treat Premature ejaculation. It acts quickly and can be taken on demand

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  • Phosphodiesterase-5 inhibitors: Medications like Sildenafil (Viagra), primarily used for ED, may also help with Premature ejaculation
  • Topical anesthetics and condoms: Lidocaine or Prilocaine-based topical anesthetics can decrease sensitivity. Condoms can also be effective, especially when combined with local anesthetics
  • Self-help techniques: Masturbating before sex, using a thick condom, or having your partner on top can help manage Premature ejaculation
  • Psychosexual counseling: Therapy can help address relationship issues, unlearn Premature ejaculation habits, and teach techniques like the “squeeze” and “stop-go” methods
Premature ejaculation is one of the common sexual disorders in men, affecting 1 in 3 men at some point in their lives.

Delayed ejaculation

Addicted to alcoholSource: Syda_Productions
Alcohol can be a cause of delayed ejaculation

Delayed ejaculation involves experiencing a significant delay before ejaculation or being unable to ejaculate despite desiring to do so. 

Its causes may be psychological, including relationship problems, stress, depression, or physical, such as Diabetes, spinal cord injuries, or medication side effects.

Treatment options for Delayed ejaculation include:

  • Sex therapy: A combination of psychotherapy and changes in sexual activity can increase enjoyment during sex and improve ejaculation
  • Switching medication: If medications like SSRIs are causing Delayed ejaculation, alternative medications like Amantadine, Bupropion, or Yohimbine may be considered
  • Addressing alcohol and drug misuse: Alcohol or drug abuse can be underlying causes of Delayed ejaculation, and addressing these issues may help resolve the problem
  • Pseudoephedrine: Sometimes, Pseudoephedrine tablets may be prescribed off-label to treat Delayed ejaculation

Retrograde ejaculation

Retrograde ejaculation is a less common condition where semen travels back into the bladder instead of through the urethra during ejaculation. 

Causes may include prostate or bladder surgery, Diabetes, Multiple sclerosis, or certain medications like alpha blockers used for Hypertension.

Treatment options for Retrograde ejaculation include:

  • Pseudoephedrine: Pseudoephedrine has been effective in treating Retrograde ejaculation caused by Diabetes or surgery
  • Stop or switch medications: Discontinuing medications that contribute to Retrograde ejaculation may lead to a return to normal ejaculation
  • Sperm retrieval: For men wishing to have children, sperm can be extracted from urine or testicles for procedures like Intrauterine Insemination or In-Vitro Fertilization
Retrograde ejaculation can result in infertility, as the semen is redirected into the bladder instead of being expelled from the body. If you suspect or experience Retrograde ejaculation, seeking medical attention is important.

Anorgasmia and ejaculation problem

Anorgasmia is a term that encompasses the spectrum of issues related to female orgasms. 

This includes experiencing delayed orgasms, an absence of orgasms, fewer orgasms, or less intense orgasms. 

When a woman experiences issues with orgasm, it can also lead to difficulties with ejaculation, as ejaculation typically coincides with a woman reaching orgasm.

Anorgasmia can further be categorized into different types:

  • Lifelong Anorgasmia: This occurs when a woman has never experienced an orgasm
  • Acquired Anorgasmia: When a woman encounters new difficulties in achieving orgasms, this is referred to as acquired Anorgasmia
  • Situational Anorgasmia: In some cases, orgasm difficulties are situational, happening only in specific situations, with particular types of stimulation, or with certain partners
  • Generalized Anorgasmia: When a woman faces problems with orgasm in any situation, it is classified as generalized Anorgasmia

Causes of Anorgasmia or delayed orgasms

Multiple factors can contribute to Anorgasmia or delayed orgasms in women. These factors include:

Personal and psychological factors

Past experiences, lack of knowledge about sexual stimulation, poor body image, guilt or embarrassment about sex, and cultural or religious beliefs can cause delayed orgasms. 

Mental health conditions such as anxiety or depression can also influence a woman’s ability to reach orgasm.

Relationship factors

Relationship issuesSource: nd3000_from_Getty Images
Relationship issues

Problems in a sexual relationship, such as a lack of emotional intimacy, unresolved conflicts, or poor communication about sexual needs, can hinder orgasm.

Physical causes

Various health conditions, gynecological treatments, medications, alcohol consumption, smoking, and age-related changes in the body can all affect a woman’s orgasm.

Treatment of delayed orgasms

Treatment for delayed orgasm, also known as Anorgasmia, involves a variety of approaches:

  • Directed masturbation: Guided self-stimulation exercises can help you become more familiar with your body and achieve orgasm
  • Changes in sexual positions: Experimenting with different positions during sex can improve clitoral stimulation
  • Sexual enhancement devices: Devices like vibrators can aid in achieving orgasm. You may use these devices alone to understand your preferences and then incorporate them into partner activities
  • Cognitive-Behavioral Therapy (CBT): Individual or couples therapy to address psychological factors contributing to delayed orgasm
  • Estrogen therapy: May help improve sexual experiences, especially for menopausal individuals. Vaginal Estrogen Therapy can enhance blood flow and lubrication
  • Testosterone therapy: Considered for postmenopausal women with low Testosterone levels, as it may improve arousal and orgasms


Ejaculation problems, whether experienced by men or women, can be sources of distress and discomfort, affecting an individual’s sexual satisfaction. 

It is important to recognize that these issues are common and can arise from various factors, be it psychological, physical, or relational.

For men, Premature ejaculation, Delayed ejaculation, and Retrograde ejaculation are three primary concerns. 

However, treatments, from medications and self-help techniques to therapy and lifestyle adjustments, are available, providing hope and relief.

In women, delayed orgasms or Anorgasmia may create similar concerns. 

Understanding the underlying causes, which can stem from personal, psychological, or physical factors, is a crucial step toward finding solutions.

The path to overcoming ejaculation problems, regardless of gender, often begins with open communication with healthcare professionals and partners.

Frequently Asked Questions

What are the most common ejaculation problems in men and women?

The most common ejaculation problems in men include Premature ejaculation (rapid ejaculation), Delayed ejaculation (significant delay in ejaculation or inability to ejaculate), and Retrograde ejaculation (semen traveling backward into the bladder). In women, the primary issue related to ejaculation problems is typically Anorgasmia.

Are there effective treatments for Premature ejaculation?

Yes, there are effective treatments for Premature ejaculation in men. These include medications like Selective Serotonin Reuptake Inhibitors (SSRIs), specific drugs designed for Premature ejaculation, Phosphodiesterase-5 inhibitors, topical anesthetics, self-help techniques, and psychosexual counseling.

What causes delayed ejaculation in men?

Delayed ejaculation often has psychological roots, such as relationship problems, stress, or anxiety. Medications, especially certain antidepressants, can also lead to Delayed ejaculation. Additionally, alcohol or drug misuse can contribute to this issue. Physical conditions like Diabetes, spinal cord injuries, or prostate problems may further play a role in delayed ejaculation.

What are the potential causes of Premature ejaculation in men?

Potential causes of Premature ejaculation in men include psychological factors like depression, anxiety, stress, or relationship problems. Inexperience of heightened penile sensitivity, hormonal imbalances, and genetic factors can also contribute to Premature ejaculation.

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