不同類型的射精障礙

When men think about sexual problems, erectile dysfunction usually comes first. This is understandable, since millions of American men are unable to obtain and maintain an erection hard enough for sexual intercourse. But good sex is about more than just having an erection. In fact, success begins with sexual desire or sexual desire and ends with ejaculation and orgasm.

Doctors have made huge strides in treating erectile dysfunction. New developments are improving the lives of some men who suffer from abnormal ejaculation.

normal ejaculation

The male sexual response process usually involves several stages. It begins with desire and interest, followed by excitement triggered by erotic thoughts and sensory stimulation, causing the blood vessels in the penis to dilate and lead to an erection.

Ejaculation is the next stage and involves complex physiological functions. Firing occurs first, initiated by the autonomic nervous system, causing muscles to contract and release secretions. This is followed by the action of additional muscles that expel semen from the vas deferens and seminal vesicles into the urethra.

Orgasm is the ejaculation event itself. The muscles close to prevent entry into the bladder and other muscles begin rhythmic contractions to expel semen out of the urethra. Ejaculation is usually accompanied by the pleasure of orgasm.

After ejaculation, as the blood vessels adjust, the penis will reduce swelling and return to a relaxed state. Sexual response depends on the interaction of the psychological, neurological, vascular and reproductive systems. Given its complexity, problems may arise that affect ejaculation.

Premature ejaculation

Biologically speaking, the purpose of sex is reproduction. In most animals, intercourse is brief and ejaculation occurs shortly after penetration. However, for humans, sex involves a wide range of psychological and interpersonal factors. Therefore, premature ejaculation is defined by the desire and satisfaction of both parties, not by time.

Premature ejaculation occurs before need or shortly after penetration before mutual satisfaction. Some men experience this occasionally, while others experience it repeatedly. Large surveys show that it is the most common male sexual dysfunction, affecting up to 30% of men, and is most common in young, inexperienced men but can occur at any stage of life. Most affected men are healthy; others have psychological, health problems, such as diabetes or urinary problems. Premature ejaculation can be treated with or without associated problems. Treatment uses behavioral techniques, medications, or a combination.

Behavioral therapy involves three techniques - pause and squeeze, start-stop and Kegel exercises. When orgasm occurs, pause and squeeze to interrupt activity, apply gentle pressure to the penis for 20 seconds, then resume. Start and stop bringing about orgasm through self or partner stimulation, then stop delaying orgasm. Kegels identify and strengthen the pelvic muscles through controlled movements.

Behavioral therapy is safe, simple, and helps 60-90% of men, but it takes a lot of time and works best with therapist supervision and partnership, as relapse is common. Therefore, drugs now play an important role.

Medication was started inadvertently due to the antidepressant side effects of delayed ejaculation. The use of antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), as a routine or single precoital dose to treat premature ejaculation has yielded good results. Non-responders often see good results when adding an erectile dysfunction drug such as sildenafil to an SSRI.

While treatment progresses, antidepressant medications can have side effects and are expensive. For this reason, some men prefer to use desensitizing condoms with mild anesthetic benzocaine.

delayed ejaculation

Premature ejaculation is rarely caused by disease. However, delayed ejaculation or lack of ejaculation may be caused by psychological or physical problems. Common causes of delayed or inhibited ejaculation include alcohol, medications such as SSRIs, tricyclic antidepressants and some antihypertensive medications, and diabetes. When a medication is the cause, changing the prescription often solves the problem. Some men who must continue taking SSRIs to treat depression or anxiety may benefit from Viagra, Levitra, or Cialis. Psychological problems often respond well to behavioral techniques or sex therapy.

retrograde ejaculation

During normal ejaculation, the muscles in the bladder neck prevent semen from entering the bladder. During retrograde ejaculation, the bladder muscles are unable to perform this function normally. As a result, semen flows into the bladder and nocturnal emissions do not occur. Retrograde ejaculation is a common complication after transurethral resection of the prostate (TURP), with approximately 50% to 75% of men experiencing retrograde ejaculation after surgery. It is also common in people with diabetes. When caused by diabetes or surgery, the problem is permanent. However, if a medication is the cause (such as certain medications used to treat benign prostatic hyperplasia and high blood pressure), switching to an alternative may improve the problem. Although retrograde ejaculation can impair fertility, it does not eliminate the pleasure of orgasm.

Decreased or no ejaculation

As men age, sexual function naturally changes over time. Healthy men can usually maintain erectile function and even fertility throughout their lives. However, there may be a gradual decrease in their sexual desire, penis hardness, ejaculate volume, sperm count and motility, and orgasm intensity. According to one study, ejaculate volume decreases by approximately 0.03 ml with each additional year of age. Although the amounts are small, this reduction adds up over time.

Spinal cord injury or disease may also cause an inability to ejaculate. Many men who undergo radical prostatectomy to treat prostate cancer are still able to orgasm. However, ejaculation is not possible because the surgery removes the structures required for this function.

Pain or blood during ejaculation

Ejaculation is usually pleasurable, but sometimes it can be uncomfortable or even painful. When this happens, men should see a urologist to be evaluated for conditions such as prostatitis, urinary tract infections, and other urinary tract conditions.

Semen is usually colorless. However, if blood enters semen (hemospermia), it will appear brown (old blood) or red (fresh blood). Although worrisome, hematospermia is usually not serious. Prostate disorders (such as prostatitis, benign prostatic hyperplasia, and rarely cancer), stones, cysts, and blood vessel abnormalities may be causes. However, the specific cause is often not determined. Nonetheless, men with hematospermia should seek medical evaluation.

Review

All comments are moderated before being published

HealthyPIG Magazine

View all
無人機醫療配送:低空經濟下的香港新契機

無人機醫療配送:低空經濟下的香港新契機

  無人機醫療配送:低空經濟下的香港新契機 —— 從健康、醫療金融到商業模式的全球比較與啟示 在香港「低空經濟」監管沙盒下,無人機由數碼港跨海至長洲醫院,約 12 公里航線僅需 18–20 分鐘,相比傳統 45–65 分鐘大幅提速。本文聚焦醫療價值、醫療金融回報與商...
醫管局普通科門診改名「家庭醫學門診」——香港基層醫療新里程?

醫管局普通科門診改名「家庭醫學門診」——香港基層醫療新里程?

  基層醫療 家庭醫學 健康政策 醫管局普通科門診改名「家庭醫學門診」:利與弊、國際比較與香港基層醫療的下一步 醫務衞生局宣佈由 2025 年 10 月 11 日起,將「普通科門診」與「家庭醫學專科門診」統一命名為「家庭醫學門診服務」,74 間普通科門診...
基孔肯雅熱:被伊蚊叮咬後的劇痛病毒 — 病毒、傳播、症狀與防治全解析

基孔肯雅熱:被伊蚊叮咬後的劇痛病毒 — 病毒、傳播、症狀與防治全解析

什麼是基孔肯雅熱? 基孔肯雅熱(Chikungunya Fever)是一種由**基孔肯雅病毒(Chikungunya virus, CHIKV)**引起的急性傳染病,屬於 Togaviridae 家族 Alphavirus 屬。這種病毒最早於 1952 年在坦桑尼亞被發現,其名稱來自當地馬孔德...
登革熱:全球爆發中的熱帶威脅與防護全解析

登革熱:全球爆發中的熱帶威脅與防護全解析

登革熱係乜嘢? 登革熱(Dengue fever)係一種由登革熱病毒(Dengue virus)引起嘅急性傳染病,主要經由伊蚊(Aedes mosquito)叮咬傳播,特別係白紋伊蚊(Aedes albopictus)同埃及伊蚊(Aedes aegypti)。呢啲蚊喺日間最活躍,因此唔似瘧疾嗰...
流感點樣會引致腦病變、心肌炎同休克?——從「感冒」變成致命風暴

流感點樣會引致腦病變、心肌炎同休克?——從「感冒」變成致命風暴

近排有新聞報導,一名原本健康嘅中學生感染乙型流感(Influenza B)之後,出現腦病變、心肌炎同休克,情況危殆。好多家長都會問:「流感唔就係普通感冒?點解可以嚴重到影響腦同心臟?」其實,流感背後嘅機制比我哋想像中複雜得多。 一、流感病毒唔止攻擊呼吸道 流感病毒(包括甲型同乙型)主要透過飛...
牛骨湯食譜大全|Instant Pot 壓力煲 & 傳統老火湯版本

牛骨湯食譜大全|Instant Pot 壓力煲 & 傳統老火湯版本

牛骨湯食譜係香港家庭常見嘅煲湯之一,牛骨湯香濃滋補,配合中藥材更具養生功效。本文介紹肉骨類選擇、牛骨湯建議配搭、常見中藥材分類,以及Instant Pot壓力煲與傳統老火湯版本食譜,並引用科學研究支持。
澳洲飲用水發現「食腦變形蟲」:全球風險與地區對策(含各國/各州實用指南)

澳洲飲用水發現「食腦變形蟲」:全球風險與地區對策(含各國/各州實用指南)

澳洲飲用水發現「食腦變形蟲」:全球風險與地區對策(含各國/各州實用指南) 澳洲飲用水發現「食腦變形蟲」:全球風險與地區對策(含各國/各州實用指南) 重點:事件本身不代表飲水會感染;主要風險來自水經鼻腔進入。 目錄 ...
如何判斷雞翅是否變壞?

如何判斷雞翅是否變壞?

重點摘要 雞翅會變質嗎? 如何判斷雞翅是否變壞? 過期雞翅還能食嗎? 雞翅可存放多久? 如何儲存雞翅? 雞翅可以冷凍嗎? 結論 雞翅會變質嗎? 會。皮脂較多、表面不潔或溫度過高時,細菌繁殖更快。 如何判斷雞翅是否變壞? 外觀:皮色發黃、出黑斑或血水。 觸感:表面黏滑、軟爛。 氣...
如何判斷雞蛋是否變壞?

如何判斷雞蛋是否變壞?

重點摘要 雞蛋會變質嗎? 如何判斷雞蛋是否變壞? 過期雞蛋還能食嗎? 雞蛋可存放多久? 如何儲存雞蛋? 雞蛋可以冷凍嗎? 結論 雞蛋會變質嗎? 會。殼面有微孔,溫差及濕度變化會令細菌入侵。 如何判斷雞蛋是否變壞? 水測:沉底=較新鮮;浮起=多半變壞。 打開觀察:蛋白渾濁水樣、蛋黃...