When a couple faces challenges with conception, it's important to remember that infertility can affect both partners. Both male and female factors can contribute to these difficulties. One such often-overlooked male factor is ejaculatory dysfunction, which can significantly impact fertility. Continue reading to know everything about it.
To know what ejaculatory dysfunction is, it is important to know what ejaculation is. Ejaculation is the expelling of the sticky, whitish-grey fluid called semen, containing spermatozoa, from the penis after a sexual release or orgasm. Ejaculatory dysfunction signs and symptoms start when a male has issues with ejaculating the semen properly. It can involve ejaculating too late, too soon, into the bladder instead of outside the penis, or even the absence of ejaculation. Such issues can negatively impact a man's life in several ways, such as causing relationship problems, emotional turmoil, and fertility issues.
The ejaculation mechanics are similar to a sneeze: both are reflexes that cannot be reversed once initiated. Ejaculation problems are called aspermia and can be caused by primary (problem at birth) and secondary (acquired dysfunctions) reasons. In a normal ejaculation, there is an emission step where the semen is present in the penis near the prostrate, and there is an ejaculation step when the semen is pushed out of the penis. In an ejaculation dysfunction, there can be problems in either one or both steps.
The ejaculation disorder can happen in many forms and affect fertility in various ways. Some common types are:
This is a type of dysfunction where the man has an orgasm, and semen is ejaculated very quickly within a few moments of starting sexual activity. It is the most common type of ejaculation dysfunction and is very frustrating for couples. It may also cause fertility issues as the sperm may not reach the egg for fertilisation.
In this type of dysfunction, a man takes more time to ejaculate or may not ejaculate at all during sexual intercourse. This can happen due to nerve damage, certain medications, or psychological issues.
In this case, the semen, instead of coming out of the penis, enters the bladder. This is because the bladder muscles malfunction during orgasm.
This is the absence of ejaculation, and here, men do not produce any semen.
Many factors cause ejaculatory dysfunction, and knowing these helps to find the correct treatment. Some ejaculatory dysfunction causes are:
Surgeries to the pelvic area or enlarged prostrate can alter or obstruct the ejaculation mechanism, making it hard to ejaculate manually.
Health conditions like multiple sclerosis, diabetes, or spinal cord injuries can cause damage to the nerves that control ejaculation. This can obstruct the ejaculation process.
Certain medications, especially those to treat anxiety, depression, other mental health issues, or high blood pressure, may have side effects that include ejaculation problems. These drugs may alter the blood flow or normal nerve functioning, causing ejaculation issues.
Anxiety and stress or other such mental or emotional health issues can affect the sexual performance of a male. When a male is distressed mentally, it can affect ejaculation during intercourse.
The first step to addressing ejaculatory dysfunction is to understand the cause, as it helps the healthcare provider provide appropriate treatment.
There is a connection between ejaculatory dysfunction and fertility. For natural conception, the sperm must be lodged into the vagina. The sperm then travels through the fallopian tube to fertilise the egg. If the ejaculation does not happen properly or a male cannot ejaculate, there is no release of sperm, or the sperm is unable to reach the egg in time, causing fertility issues.
If a couple has difficulty conceiving and it is suspected that the man has ejaculatory issues, then the foremost thing to do is to meet a doctor. The diagnosis involves:
Discussing the medical history and symptoms to get clues as to the cause of fertility problems.
● A physical examination of the testicles and the genitalia is done to determine any physical abnormalities.
● Urine analysis is prescribed to detect problems, and also a semen analysis is done to assess the ejaculation status and sperm health.
● Hormone testing.
● TRUS (transrectal ultrasound) is done to check structural problems
Effective treatment of this condition depends on identifying the underlying root cause. Here are some recommended treatment options.
The ejaculatory dysfunction treatment starts with medications and lifestyle changes. Specific medications are recommended for ejaculatory dysfunction, such as delayed or premature ejaculation, to manage the symptoms. For those having retrograde ejaculation, drugs to enhance the bladder muscles functioning may be used.
If the problem is because of physical issues like anatomical abnormalities or obstructions in the ejaculatory mechanism, surgery may be the preferred choice to correct the problem.
Behavioural counselling and therapy may be recommended if anxiety, stress, or other psychological factors are the cause. Behavioural techniques, like the stop-start method and the squeezing technique, may also help manage premature ejaculation.
For couples with fertility issues because of ejaculatory dysfunction, ART (Assisted Reproductive Technology) is useful. IVF (In-vitro Fertilization) and IUI (Intrauterine Insemination) are two such ART techniques that offer alternative ways of conception. These methods bypass the normal ejaculation process and enhance the conception chances.
Ejaculatory dysfunction is a major but often overlooked cause of fertility problems in men. It can be caused due to various physiological and physical issues. Diagnosing it and treating it is essential for couples to conceive. With proper treatment and care, many men can overcome ejaculatory dysfunction and father a child. While ejaculatory dysfunction is a challenging male reproductive health issue, it is not a permanent barrier to fatherhood. Thanks to medical advances, there are many ways to address it and offer hope to the impacted couples.
Ejaculating early, taking long to ejaculate or not at all, ejaculating into the bladder and not out of the body, ejaculating with less than normal force, and pain while ejaculating are some of the symptoms of ejaculatory dysfunction.
If you have an erection and cannot ejaculate, it may be because of a type of ejaculation dysfunction called delayed ejaculation. The causes for it can be stress, medical conditions like nerve damage from previous surgery, multiple sclerosis, medications, or old age.
Addressing the underlying cause, which can be side effects of medication, anxiety, stress, health issues, etc., can help overcome ejaculation difficulties. By consulting a qualified doctor, you will be able to get appropriate treatment, which may include medications, lifestyle changes, and therapy.
