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Mar 2, 2017
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Sex is like a tag team race, and when one of you shows poor sexual performance, you both lose. There are several problems that could lead to this tragic loss of a “happy ending,” but on the part of a man, nothing can be more painful (figuratively and literally) than failing to reach that grand finish line: ejaculation.

Unlike erectile disorders (where a dose of Viagra can get your manoy up and running), ejaculatory problems can’t simply be treated through medication. The shame and the other psychological implications can be much harder to address, and the causes of these problems can vary so much that they make the whole ordeal #complicated.

Check out these five ejaculatory disorders. Hopefully, you don't suffer from any (or even worse, all) of these:

1) Premature Ejaculation (You come too early.)

It’s become a funny scene in that epic American Pie movie and a joke in many other fictional settings. However, premature ejaculation or PE, where it’s over for a man within a minute or less, should not be taken lightly.

Karen Gless, Ph.D., a Licensed Marriage and Family Therapist, explains that there are four phases of sex: The Arousal Phase, The Plateau Phase, The Orgasmic Phase, and The Resolution Phase. Men with PE slip into the orgasm and skip toward the resolution phase, where you’re intensely relaxed, usually sleepy, and silently beg that your partner doesn’t want more for a little while. All the while, your partner might have been frustrated and may be reeling for more. In short, bitin.

“As a man moves from arousal to orgasm there is a point where the feelings become so intense that it is almost impossible to stop the orgasm from happening. This is called the point of inevitability. It is also called the point of no return. Treatments for PE focus on keeping a man in the arousal phase and delaying the point of inevitability. One way is to try to reduce the intensity of sexual feelings,” says Dr. Gless.

The key to treat PE? Practice. “One way to [help delay the onset of the point of inevitability] is to practice masturbating without trying to have an orgasm right away,” advises Dr. Gless. “Most men try to come as quickly as possible when they masturbate. In this exercise, a man gets turned on and then stops before he has an orgasm. Doing this several times in a row and concentrating on the feelings of pleasure helps a man learn the difference between staying in the Plateau Phase versus suddenly slipping into the Orgasmic Phase.”

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If PE is already taking a toll on your sex life, that masturbation exercise is worth a shot, right? Aside from that, you also have to learn to relax and enjoy the ride—and it’s something you and your partner can have fun perfecting. You might just be pleasantly surprised, and your girl might love a good challenge.

2) Delayed Ejaculation (You come too late.)

Dr. Gless defines how late is too late. “Delayed ejaculation (DE), which is also known as retarded ejaculation, is usually defined as a man needing 30 to 45 minutes of sexual activity to have an orgasm and ejaculate. In severe cases, a man with this problem may be unable to ejaculate during sexual activity with a partner.”

Again, this problem can leave you and your partner frustrated. “Men with DE suffer from anxiety about their ability to climax while engaged in sex. Then toward the end of the sexual encounter it requires a lot of effort to have an orgasm and even then it may not happen. He may last longer in bed, but his partner can be left puzzled and confused,” according to Dr. Gless.

In her 20 years of practice, she has seen how couples end up distancing themselves from each other and eventually lose their connection. "The man faces the same quandary that a woman has to deal with who has trouble climaxing. He can explain that he didn’t have an orgasm but the sex was very satisfying without it. The other option is to fake an orgasm, withdraw and cuddle up. The whole situation can be very frustrating.”

Unlike PE, DE can be more than a psychological thing. However, aside from psychological and emotional problems (like anxiety, depression, and relationship problems), men may experience DE as a side effect of drugs (such as antidepressants and meds for high blood pressure) and as a symptom of medical conditions (including nerve damage, heart disease, urinary tract or prostate infections, and blockages in the seminal ducts).

Beyond that, men with DE must also learn to think of himself and to “let go.” Too often in such cases do men consider pleasuring a woman his job—not something both of them should enjoy. So again, learn to relax, and just face that point of inevitability head on.

3) Painful Ejaculation (Obviously, masakit.)

Ejaculating is supposed to feel good, and it’s supposed to signal an orgasm that will make you moan or even scream from pleasure. Unfortunately, some men may groan or scream in pain during the process. There may be a burning sensation between his anus and genitals, in his testicles, or along the urethra (the passage where semen passes through).

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In the worst scenarios, there may even be blood in the semen arising from an injury somewhere within your package. 

This will obviously create an aversion to the sexual activity and create a rift in your relationship if the disorder isn’t treated. It could be linked to an erectile disorder that needs to be addressed. It could also be the inflammation or enlargement of the prostate, which needs to be healed.

When you experience it with other symptoms like pain when you take a leak or tingling sensations (not the fun kind), it could even signal a urinary tract infection (UTI) or a sexually transmitted infection (STI). Don’t let embarrassment or hesitance get the best of you in any case. See a urologist to get checked and treated as soon as possible.

4) Retrograde Ejaculation (In Tagalog, bumabalik.)

Yup, retrograde ejaculation isn’t cool at all—it can be quite painful and destructive, in fact. Here, the semen doesn’t pass effectively along the urethra, makes a U-Turn toward the opposite direction, and ends up in the bladder.

It’s a slim chance, but it might happen if you had prior prostate or urethral surgery or if you have diabetes. It can also be a side effect of some medications, including some drugs used to treat high blood pressure and some mood-altering drugs.

The good news is that semen in the bladder (which can be detected with a simple urine study) is harmless. The bad news is that when retrograde ejaculation worsens, it can cause infertility. All your boys end up getting flushed when you do number one, and so little or none of them end up cooking a bun in your partner’s oven.

5) Anejaculation (You can’t come at all.)

What’s worse: having trouble with ejaculation or not experiencing it at all? They say you won’t know the value of a good thing till it’s gone, and when you’re afflicted with anejaculation, it can certainly be depressing. Again, this can stem from various causes. It can be psychological if it happens occasionally or biological (such as when there is a blockage in the urethra) if it happens all the time.

Some experts suggest that the latter can even happen because of a certain medications and nerve disorders (which may be acquired by frequently riding a bike with a narrow saddle for a long time). Again, this isn’t common, but it’s better to be safe, right? 

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No matter which problem you face, you have to realize how important it is to act fast. The physical and psychological causes of these conditions could go on a lot longer, but each one of them has to be examined and treated as soon as possible. Dr. Gless notes, “When a man comes to me with a sexual problem such as DE or erectile difficulties, I have him see a physician for a complete evaluation of possible physical causes of his condition. He may need a combination of psychotherapy and medical care, but it’s important to address the physical causes first.”

None of these are funny, even if they’re treated as katatawanan, it will do you good to take care of your entire body, and not just your package. 

Karen Gless, Ph.D., is a Licensed Marriage and Family Therapist and a registered nurse with over 20 years in a successful psychotherapy practice. Her specialties include couples therapy, sex therapy, hypnotherapy, EMDR and EFT. Reach her via email at karengless@gmail.com or send her a message on facebook.com/SexTherapyDoctor.

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