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Retarded ejaculation and anorgasmia

  • The resulting problems from retarded ejaculation aren´t smaller than their causes.

    Retarded ejaculation (RE) is probably the less frequent and less understood of men´s sexual dysfunctions, reaching 3% of sexual active men.
    This type of pathology is characterized by an excessive lasting time between the beginning of sexual intercourse and the time of orgasm, a situation that goes against the will of one or both of the partakers.

    The most serious form of retarded ejaculation is anorgasmia, the man´s inability of reaching an orgasm, even in cases where there is enough stimulus and appropriate sexual relations.
    Patients suffering from retarded ejaculation seldom present difficulties in initiating and maintaining erections. Nevertheless, they present low levels of sexual satisfaction together with a great amount of anxiety related with this condition.

    Retarded ejaculation can be designated as primary or secondary. In the first case it´s something that accompanies the patient all throughout his sexual life; the second case happens when it starts manifesting after a certain age. Besides the age where it begins, some patients with secondary retarded ejaculation can reach orgasm through masturbation.

    Causes of retarded ejaculation and anorgasmia
    There are two existing causes to these pathologies: Organic causes and psychological.

    Organic causes
    By our experience, the most common organic cause of retarded ejaculation is prostatitis (whether it is or not associated with urethritis). However, systemic diseases like diabetes (particularly in decompensation phases) or multiple sclerosis can cause alterations or even loss of sensibility in the pelvic area.

    These outcomes can be due to medullary traumatisms and surgeries in the pelvic area. The decrease of innervation and/or sympathetic conducting (responsible for ejaculation) is another cause for retarded ejaculation.

    These causes are more easily identified through the patient´s clinical history and by a physical exam, in particular the Rectal Touch. By correcting and compensating these pathologies the progression of sexual dysfunction can be stopped and even reverted.

    Medical drug causes
    Anti-depressant drugs, mainly the inhibitors of serotonin, have the secondary effect of elongating the time towards ejaculation. In order to lessen this effect, the doctor who prescribed this type of drug can change it, reduce its dosage or withdraw it during the weekends.

    Psychological Causes
    Psychological issues are one of the important causes associated with retarded ejaculation.
    History of sexual abuse during childhood, religious dogmas or the fear of getting the partner pregnant, can sometimes explain retarded ejaculation.
    Also some patients confess losing interest in their partner (who can´t make them achieve an orgasm) and in consequence, they only seem to find sexual pleasure in masturbation.
    Another pertinent question is the mutual loss of interest in long term relationships (particularly those that are non-gratifying), together with the aging process of both members of the couple.
    Performance anxiety is another cause associated with retarded ejaculation, that is, the patient is so worried and fixed on controlling his ejaculation that he induces a blockage in the orgasm.

    Treatment
    The treatment – and whenever possible its cure – of Prostatitis and Urethritis is an unavoidable step, independently of the fact that there may be other physical and/or psychological conditions associated.
    The use of a Low Level LASER Therapy associated with antibiotics and prostatic massage has been the most effective form of intervention to the majority of patients we helped so far.
    In the existence of concomitant clinical situations – like for example the case of decompensated Diabetes – it is mandatory the endorsement of all the processes that can recover metabolic balance together with the compensation of diabetes.
    Naturally, each clinical situation identified by the medical doctor deserves his full attention and pertinent care towards a respective mitigation, even if it is only temporary recovery.
    If during the initial clinical evaluation or during medical treatment, a set of emotional, psychological or relational factors that might be influencing the patient´s complaints is identified, we advise that a psychological assessment is done, followed by an eventual psychotherapeutic process either individually, in couple or in family. This same principle also applies in any other situation of Sexual Health.

    Although not well known, retarded ejaculation brings suffering for the man and for the couple, particularly in its most serious form – anorgasmia. There are multiple causes, but the cure is possible.