The Science Behind Delayed Ejaculation

It happens when semen travels backwards into the bladder instead of through the urethra (the tube that urine passes through). The main symptoms of retrograde ejaculation include: producing no semen, or only a small amount, during ejaculation producing cloudy urine (because of the semen in it) when you first go to the toilet after having sex Men with retrograde ejaculation still experience the feeling of an orgasm and the condition does not pose a danger to health. However, it can affect the ability to father a child.

• Explore prescription medications like Dapoxetine.
• Practice gradual exposure therapy techniques.
• Engage in cognitive-behavioral therapy to reduce anxiety.
• Use herbal supplements with caution and medical approval.
• Implement lifestyle changes to improve overall health.
• Avoid illicit drugs that impair sexual function.
• Incorporate regular exercise into your routine.
• Prioritize stress relief activities daily.
• Use timed masturbation to increase control.
• Restrict or delay alcohol consumption before sex.
• Focus on emotional intimacy, not just performance.
• Maintain patience and realistic expectations.

Retrograde ejaculation happens when the neck of the bladder does not close and semen passes into the bladder. Usually when you ejaculate, semen is pushed out of your urethra. It is prevented from entering your bladder by the muscles around the neck of the bladder, which close tightly at the moment of orgasm. However, damage to the surrounding muscles or nerves can stop the bladder neck closing, causing the semen to move into the bladder rather than up through the urethra.

• Recognize signs of performance anxiety and address them.
• Use distraction techniques to divert focus from orgasm.
• Combine treatments like behavioral therapy and medication.
• Limit caffeine intake which can increase arousal.
• Practice deep, slow breathing to relax before sex.
• Consider topical anesthetics to desensitize.
• Use distraction and timing techniques to improve control.
• Educate yourself about normal sexual response.
• Attend couple's therapy to improve communication.
• Keep a positive attitude and avoid shame.
• Explore different positions to find what prolongs pleasure.
• Stay committed to a treatment plan for the best results.

Causes of retrograde ejaculation include prostate gland surgery, bladder surgery, diabetes, multiple sclerosis, and a class of medicines known as alpha blockers, which are often used to treat high blood pressure (hypertension). Most men do not need treatment for retrograde ejaculation because they are still able to enjoy a healthy sex life and the condition does not have adverse effects on their health.

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thyroid problems – an overactive thyroid or an underactive thyroid anxiety about sexual performance (particularly at the start of a new relationship, or when a man has had previous problems with sexual performance) It's possible for a man to have experienced premature ejaculation since becoming sexually active. A number of possible causes for this are: conditioning – it's possible that early sexual experiences can influence future sexual behaviour. For example, if a teenager conditions himself to ejaculate quickly to avoid being caught masturbating, it may later be difficult to break the habit a previous traumatic sexual experience – this can range from being caught masturbating to sexual abuse a strict upbringing and beliefs about sex Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant, but they also delay ejaculation. Another type of antidepressant called clomipramine is also sometimes used. Some men may experience an improvement a few days after treatment begins.

Side effects of premature ejaculation treatment

However, you'll usually need to take the medicine for 1 to 2 weeks before you notice the full effects. Side effects of SSRIs are usually mild and should improve after 2 to 3 weeks. Read more about the side effects of antidepressants. An SSRI specifically designed to treat premature ejaculation, known as dapoxetine (Priligy), has been licensed in the UK. Local NHS authorities can choose to prescribe it on the NHS.

2. Magnesium

It acts much faster than the other SSRIs used for premature ejaculation and can be used "on demand". You'll usually be advised to take it between 1 and 3 hours before sex, but not more than once a day. Your response to the treatment will then be reviewed after 4 weeks (or after 6 doses), and again every 6 months. Dapoxetine is not suitable for all men diagnosed with premature ejaculation. For example, it is not recommended for some men with heart, kidney and liver problems. But if treatment is required (usually because of wanting to father a child), there are options to try.

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For example, pseudoephedrine (commonly used as a decongestant) has proved effective in treating retrograde ejaculation caused by diabetes or surgery. If retrograde ejaculation is caused by using a certain medicine, then normal ejaculation will usually return once medicine is stopped.

What treatments are available?

Delayed ejaculation (male orgasmic disorder) is classed as either: being unable to ejaculate at all, even though the man wants to and his erection is normal You may have delayed ejaculation if you're unable to ejaculate more than half the times you have sex. Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation – for example, relationship problems, stress or depression. surgery to the bladder or prostate gland Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) medicines to treat high blood pressure, such as beta-blockers antipsychotics, used to treat episodes of psychosis Delayed ejaculation can suddenly start to happen after previously having no problems, or (less commonly) the man may have always experienced it. Sex therapy is a form of counselling that uses a combination of psychotherapy cenforce d 160 and structured changes in your sex life.

Can premature ejaculation be cured?

This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live. The College of Sexual and Relationship Therapists website provides information about private sex therapists and how to find a therapist in your local area. The relationship counselling service Relate also offers sex therapy at a number of its centres.

When to see a doctor

You'll need to pay for each session. During sex therapy, you'll have the opportunity to discuss any emotional or psychological issues related to your sexuality and relationship, in a non-judgemental way. Activities may also be recommended for you to try at home while you're having sex with your partner (you should never be asked to take part in any sexual activities during a session with the therapist). erotic fantasies and "sex games" to make your lovemaking more exciting using sexual aids, such as vibrators, to increase pleasure Read more information about what a sex therapist can do. There are a number of medicines that can be used if it's thought SSRIs are responsible for causing delayed ejaculation. Speak to your GP before stopping any prescribed medicine. However, if the retrograde ejaculation has been caused by significant muscle or nerve damage, treatment may not be possible. Men who want to have children can have sperm taken from their urine or testicles for use in intrauterine insemination or in-vitro fertilisation (IVF).

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amantadine – originally designed to treat viral infections bupropion – usually prescribed to help people quit smoking yohimbine – originally designed to treat erectile dysfunction These help block some of the chemical effects of SSRIs that may contribute towards delayed ejaculation. Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. Read more about getting help with alcohol-use disorder and drug use. Pseudoephedrine tablets may be tried, but these will need to be prescribed "off-label". This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant). If you're having problems with your sex life and are seeking treatment, it is usually recommended you involve your partner as much as possible. Communicating your concerns can often go a long way to helping to resolve them.

Product	Onset of Action	Duration of Effect	Side Effects
Lidocaine Cream	10-15 minutes	30-60 minutes	Numbness, temporary loss of sensation
Benzocaine Gel	10-20 minutes	30-45 minutes	Allergic reactions in some
Spray (Lidocaine-based)	5-10 minutes	20-30 minutes	Tingling, temporary numbness

And, in some cases, your partner may also have their own problems that are contributing towards problems with your sex life. For example, some women are unable to reach climax during "normal" intercourse and require manual or oral stimulation. Finding blood in your semen can be alarming. However, in most cases it's not serious and will pass within a few days. It can be caused by an infection of your urethra (urethritis) or prostate (prostatitis).

21. Does Viagra delay climax?

It can also interact with other medicines, such as other antidepressants. Phosphodiesterase-5 inhibitors, such as sildenafil (sold as Viagra), are a class of medicine used to treat erectile dysfunction. Research has found that they may also help with premature ejaculation. You can get sildenafil on prescription, or buy it from a pharmacy after a discussion with the pharmacist to make sure it's safe for you to take. Read more about sildenafil including information on how and when to take it.

How does Premature Ejaculation Occur?

The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Condoms can also be used and are effective, particularly when combined with local anaesthesia. There are also a number of things you can try yourself. masturbate an hour or 2 before having sex use a thick condom to help decrease sensation have sex with your partner on top (to allow them to pull away when you are close to ejaculating) You may benefit from having psychosexual counselling, where a therapist can help you, and a partner if you have one, with sex related problems. encourage you to explore any relationship issues you may have, and give advice about how to resolve them show you techniques that can help you "unlearn" the habit of premature ejaculation (these include the "squeeze" and "stop-go" techniques) In the squeeze technique, you masturbate but stop before the point of ejaculation and squeeze the head of your penis for between 10 to 20 seconds.

Definition of Premature Ejaculation

Then let go and wait for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur. The stop-go technique is similar, but you do not squeeze your penis. Once you feel more confident about delaying ejaculation, you could try this technique during sex, stopping and starting as required. These techniques may sound simple, but they require lots of practice. See your GP if you have blood in your semen.

Supplement / Remedy	Possible Benefit	Notes
Ginseng	May improve sexual stamina	Consult physician before use
Zinc Supplements	Supports testosterone levels	Dosage as per guidelines
Ashwagandha	Reduces stress, enhances stamina	Not scientifically conclusive
Kegel Exercises	Strengthen pelvic floor muscles	Daily routine

They can check if you need further tests or treatment. Read more about blood in the semen. Page last reviewed: 09 February 2023 Next review due: 09 February 2026 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.

Change	Expected Benefit	Implementation Tips
Regular Exercise	Reduces stress, improves circulation	3-5 times/week
Balanced Diet	Supports hormonal health	Focus on fruits, vegetables, lean proteins
Reducing Alcohol Intake	Decreases performance anxiety	Limit to moderate levels
Quitting Smoking	Improves overall vascular health	Seek support if needed