Treatment of Ejaculation Problems
The treatment of ejaculation problems depends on the specific issue and its underlying cause. While ejaculation problems may feel overwhelming, most are treatable with a combination of medical, psychological, and behavioural approaches.
Premature Ejaculation
This condition often responds well to both therapy and medication. Treatment options include:
Behavioural techniques, such as the “stop-start” or “squeeze” method
Pelvic floor exercises to improve control
Topical anaesthetic creams to reduce penile sensitivity
Selective serotonin reuptake inhibitors (SSRIs) prescribed at low doses to delay ejaculation
Counselling, especially if anxiety or relationship issues are contributing
A combination of techniques often works best. Many men benefit from sexual therapy alongside physical interventions.
Delayed Ejaculation
This condition may be treated by:
Reviewing and adjusting medications, especially antidepressants
Psychotherapy for anxiety, depression, or past trauma
Improved sexual communication and partner involvement
Hormone therapy, if low testosterone is found
Encouraging self-awareness and changing patterns around arousal and stimulation can also help.
Retrograde Ejaculation
Treatment focuses on restoring the forward flow of semen. Options include:
Alpha-agonist medications, which help close the bladder neck
Treating underlying causes such as diabetes or nerve damage
Addressing post-surgical complications where possible
For men trying to conceive, fertility specialists may extract sperm from urine or use assisted reproductive techniques.
Painful Ejaculation
Pain during or after ejaculation may be due to infection, inflammation, or nerve sensitivity. Treatment includes:
Antibiotics or anti-inflammatories if prostatitis or urethritis is diagnosed
Pelvic floor physiotherapy
Pain management through medication or local therapies
In rare cases, surgery may be considered if an obstruction or structural issue is identified.
Anejaculation
Treatment depends on whether the issue is psychological or physical. Options include:
Medication changes
Penile vibratory stimulation or electroejaculation (in specialised fertility settings)
Counselling and couple’s therapy
Treatment of Ejaculation Problems
Only major centres or private fertility clinics in South Africa typically offer specialised treatments like electroejaculation, limiting access in other areas. However, basic treatment and counselling are available through most GPs and urologists.
The treatment of ejaculation problems requires patience, openness, and often a combined approach. With proper care, many men experience full recovery or significant improvement.
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