Ejaculation Disorders

Be yourself again.

Ejaculatory disorders are common sexual conditions that can lead to frustration, anxiety, and a significant emotional impact for both the man and his partner.
They are often experienced in silence, accompanied by shame or a sense of loss of control, affecting self-esteem and the quality of the relationship. The good news is that these conditions are treatable, and with proper evaluation, it is possible to restore sexual balance and intimate well-being.

WHAT IS EJACULATION DISORDERS?

A process to reconnect with your well-being and confidence.

Ejaculatory disorders are male sexual dysfunctions that affect control, timing, and enjoyment of sexual activity, often leading to frustration, insecurity, and emotional distress for both the man and his partner. Although they can present in different ways, there are primarily two well-defined types, each with specific causes and treatment approaches.

Premature Ejaculation.

Premature or early ejaculation is a type of male sexual dysfunction, very frustrating for the man and his partner, in which he ejaculates before desired, without full enjoyment on his part, and with concern about the partner’s dissatisfaction who did not achieve orgasm. Ejaculation usually occurs within the first minute of penetration, but in more severe cases it can occur before or immediately after penetration, generating significant personal and relationship distress.

Delayed Ejaculation.

Delayed ejaculation is a male sexual dysfunction in which much more stimulation time than usual is required to reach orgasm, or orgasm and ejaculation may not occur at all.
Like premature ejaculation, it is also extremely frustrating for the man and very distressing for his partner.

IT IS NOT A LACK OF DESIRE OR ATTRACTION: IT IS A TREATABLE CONDITION.

When to Seek Professional Help

Premature ejaculation

When there is consistent difficulty controlling ejaculation timing, affecting sexual satisfaction. Ejaculation occurs before desired and it happens frequently, in different situations.

Retrograde ejaculation

When there is absence of semen upon ejaculation (the semen may ends in the bladder instead of being released by the penis).

Delayed ejaculation

When you consistently experience difficulty ejaculating during sexual relations, despite being aroused and receiving stimulation.

Emotional and psychological impact

If you feel significant anxiety, depression, or stress in your sexual and emotional life related to the ejaculatory response phase.

If you recognize one or more of these signs, early evaluation can make a significant difference.

Most Common Causes

The prevalence of causes affecting sexual and ejaculatory response may vary according to studies, population, and context. However, below are approximate figures based on recent medical and sexological research reflecting how different lifestyle and psychological factors can influence ejaculation disorders.

Psychological Factors:

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It is estimated that 20-30% of men experience performance-related anxiety that affects their ability to ejaculate. Around 10-15% of men with sexual dysfunction issues, including ejaculation, present symptoms of depression.
Past negative experiences or learned behaviors that create a habitual pattern when masturbating that is not entirely healthy also affects sexual response. Other causes are unresolved conflicts in the relationship, pressure to “finish,” or lack of emotional connection.

40-60%

Factores médicos:

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It is estimated that around 30-50% of men with diabetes experience some type of sexual dysfunction, including ejaculation problems. Approximately 60-70% of men with multiple sclerosis and up to 40% of men with Parkinson’s disease report sexual dysfunctions, including delayed ejaculation.
Diabetic neuropathy, hormonal imbalances, previous surgeries, and some medications, especially SSRI antidepressants, also affect this phase of sexual response.

30-40%

Factores del estilo de vida:

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Between 10-20% of men with sexual problems attribute their difficulties to excessive alcohol consumption. It is estimated that around 30-40% of male smokers experience erectile dysfunction, which may be associated with ejaculation problems. Approximately 20-30% of overweight or obese men also report sexual difficulties, including ejaculation issues. Both sleep deprivation and stress affect approximately 15-25% of men in their ability to maintain arousal and ejaculate.

20-30%

Comprehensive Medical Evaluation

Ejaculation problems affect not only sexual function but also the emotional health and the quality of a men’s life. These dysfunctions can generate a significant impact on intimate relationships, causing frustration, anxiety, and decreased sexual satisfaction for both the individual and their partner. Additionally, these problems are often related to underlying factors that may include medical conditions, psychological influences, or unhealthy lifestyle habits.

Addressing and explicitly treating these disorders is essential to improve overall sexual health. Early intervention cannot only restore proper sexual function but also foster better communication in relationships, reduce anxiety, and increase self-esteem.

1. Detailed clinical history

2. Evaluation of associated factors

3. Hormonal and metabolic checkup

4. Use of specific questionnaires

5. Follow-up evaluations

Medical and Sexological Treatment

Ejaculatory disorders are treatable conditions, and the most effective approach combines medical evaluation with sexological intervention. While the medical approach focuses on identifying and correcting possible physical, hormonal, or neurological causes, the sexological approach addresses confidence, sexual anxiety, emotional response, and relationship dynamics. Combining both allows for the recovery of ejaculatory control, intimate connection, and overall well-being.

Medical Treatment

Premature Ejaculation:

Medications: Selective serotonin reuptake inhibitors (SSRIs)
Treatment adapted to the underlying cause: Medication adjustment and management of comorbidities.
Use of topical anesthetics (lidocaine-prilocaine) applied to the penis reduce sensitivity and can be effective, although they require barrier protection during intercourse

Delayed Ejaculation:

Phosphodiesterase type 5 inhibitors (sildenafil, tadalafil) improve erectile function and may facilitate ejaculation.
Adrenergic agents such as pseudoephedrine.
For anejaculation due to neurological causes, high-frequency vibratory stimulators are used, which are particularly useful in post-surgical ejaculatory dysfunction.

Sexological Treatment

Sexual education and counseling about sexual physiology, sexual response cycle, and realistic expectations. Exploration of cultural myths, limiting beliefs, and religious beliefs that generate guilt or inhibition.
Couples sex therapy to reduce pressure and expectation of ejaculation within the relationship. Sensate focus exercises focused on mutual enjoyment without ejaculation demand. Open communication about what stimulation is most exciting. Variations in positions, rhythm, and duration to find optimal conditions.
Behavioral Therapies: For premature ejaculation, techniques such as “stop-start,” “squeeze,” and pelvic floor exercises (Kegel) are useful.
Sexual anxiety management: Relaxation techniques, mindfulness, and gradual desensitization.

INTEGRATED APPROACH

Men choose Prada & Ortiz Men’s Sexual Health Center because our programs work.

Reclaim your vitality.

📞 Contact us today for a confidential consultation.

Bilingual Services: We provide services in both Spanish and English, ensuring clear and respectful communication.

Prada & Ortiz Men’s Sexual Health Center employs an integrated approach to Sexual Dysfunction treatment combining medical, psychological and sexological expertise to achieve lasting results.

We believe strongly that sexual dysfunctions require care addressing the medical, psychological, and sexological aspects to restore biological functions, rebuild connection, confidence, and increased pleasure in both you and your partner’s sexual life.

Our specialists — Dr. Ortiz and Dr. Yaz — offer discreet, evidence-based care with compassion and expertise.

TAKE THE FIRST STEP:

Comprehensive evaluation of biological and emotional factors
Personalized treatment plan (Sexual medicine + Sex therapy)
Professional guidance from a multidisciplinary team
Confidential, judgment-free environment

FREQUENTLY ASKED QUESTIONS

We want you to experience this process with peace of mind.

Do men who ejaculate very quickly have more desire for their partner?

Not necessarily. Premature ejaculation is NOT a reliable indicator of desire or attraction to your partner. This is a common misconception that is scientifically incorrect.Premature ejaculation is a neurobiological and behavioral control issue, not an indicator of how much a man loves or desires his partner. It’s like saying someone with high blood pressure “loves too much”—it simply doesn’t work that way.The important things to understand are: (1) It is treatable, (2) You can seek help without feeling shame, (3) Working together as a couple is beneficial, and (4) Be patient with the treatment process.

I ejaculate but without pleasurable sensation, and sometimes I have a very little semen. Is this common?

Ejaculation without pleasurable sensations is called Sexual Anhedonia. It is not dangerous to your physical health, and some men experiences it. The most common causes include depression (General Anhedonia), certain medications, emotional disconnection from your partner, inadequate stimulation, diabetic neuropathy, and traumatic events. Treatment depends on the underlying causes.
Low semen volume (Hypospermia) does not affect the ability to ejaculate or experience pleasure in most cases. Some causes include dehydration, frequent ejaculation (insufficient recovery time between ejaculations), advanced age, surgical procedures and certain medications.

Why can I ejaculate normally when masturbating and not during intercourse?

This is a very common presentation of Situational Delayed Ejaculation (occurring only with a partner, not during masturbation).
There are several possible causes, including: the way your body learned to respond to a specific masturbatory stimulus, performance anxiety (“I have to ejaculate to satisfy her”), masturbation being more vigorous than vaginal penetration, mental disconnection during penetration, lack of specific attraction, or the effects of certain medications (SSRIs). There are highly effective interventions using sex therapy and sex medicine. Visit our Center to identify the causes and receive appropriate treatment.

How long should I last before I ejaculate during intercouse? What’s normal?

According to scientific data: There is no universal “correct” time for ejaculation. The normal range is very broad—between 5 minutes and 45+ minutes. Some men never ejaculate specifically during penetration but do ejaculate only with manual or oral stimulation. There is significant normal variability among men.Twenty minutes is not “strange.” It may simply be your physiological pattern. What matters is whether both partners are comfortable, satisfied, and free from pressure. If you are concerned about lasting too long or not long enough, schedule an appointment with our doctors and counselors for evaluation.

Do I have to ejaculate every time I have sex? Can I enjoy sex without ejaculating?

No, you don’t have to ejaculate every time. Many men have satisfying sexual encounters without ejaculating during intercourse. They may ejaculate in other ways (manual, oral) or not ejaculate during that encounter but do so in the next. This is normal.
Yes, you can enjoy sex without ejaculating. Sexual pleasure does not depend solely on ejaculation. HOWEVER: If there is Clinical Delayed Ejaculation (marked inability or difficulty ejaculating), the therapeutic goal is generally to restore the ability to ejaculate when desired. Professionals at the Prada & Ortiz Men’s Sexual Health Center evaluate, diagnose and treat to restore your ability to ejaculate during intercourse and other sexual activity. Contact us for more information.

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