Ejaculation is a term that generally refers to the release of seminal fluid from the penis. For men, ejaculation is the final part of orgasm. Orgasm is the ultimate expression of sexual arousal that occurs as a result of stimulation of the erogenous zones and genitals.
What is the mechanism of ejaculation?
Ejaculation occurs after adequate sexual stimulation. The sympathetic nervous system controls the release of sperm from the penis. The latter, via the so-called pudendal nerve, stimulates the bulbospongiosus and pubococcygeus muscles to perform rhythmic contractions capable of moving sperm along the urethra all the way to the urinary tract located on the head of the penis. Typically, there are ten or slightly more contractions that characterize classical ejaculation: the first are clearly more noticeable than the terminal ones, and also coincide with a large ejaculation of sperm.
If before the onset of contractions a man is able to more or less effectively control the release of sperm, then after the first contraction ejaculation takes on the contours of an involuntary process. In other words, after the first contraction, it is impossible to voluntarily stop ejaculation.
Anomalies of the act of sperm ejection
The most well-known and common disorders that affect the process of sperm ejaculation are: premature ejaculation, delayed ejaculation and retrograde ejaculation,
Premature ejaculation is an ejaculatory disorder that causes a man to reach orgasm in a short period of time and after only a short period of sexual stimulation. This is due to the inability to control his ejaculatory reflex. Premature ejaculation can be caused by a combination of emotional (stress, anxiety, fatigue, etc.) and/or physical (alcoholism, short frenulum, erectile dysfunction, urethritis, etc.) factors. Premature ejaculation is a cause of discomfort and low self-esteem for men, as it prevents them from sexually satisfying their partner.
Delayed ejaculation is when the ejaculatory reflex occurs too late or does not occur at all. In other words, delayed ejaculation can be compared to delayed orgasm. Delayed ejaculation can be caused by organic factors – including diabetes, hypothyroidism, Parkinson's disease, drug use, antidepressants and antipsychotics, and cannabinoid use – and psychological factors – such as anxiety, stress.
Retrograde ejaculation is a medical term that describes an abnormality of ejaculation characterized by the release of ejaculate into the bladder instead of toward the urethra. In other words, during the act of retrograde ejaculation, the sperm flows in the opposite direction to normal and ends up in the bladder. Retrograde ejaculation is most likely caused by a malfunction of the mechanism that closes the opening of the bladder at the moment of ejaculation. Retrograde ejaculation is a problem that mainly affects diabetics (there is a link with diabetic neuropathy ), men with prostate dysfunction, men with specific disorders of the autonomic nervous system, and patients who have undergone endoscopic resection of the prostate.
What to do?
Treatment of ejaculation abnormalities begins with determining their causes. To diagnose the condition, a urologist may prescribe clinical tests (general blood and urine tests, hormone tests) and Doppler ultrasound . Treatment methods for ejaculation abnormalities: medication; psychotherapeutic; surgical. In the presence of inflammation or infection of the genitourinary tract, a urologist at the Bogolyuby Medical Center may prescribe anti-inflammatory or antibacterial drugs. The psychotherapeutic method includes a consultation with a psychotherapist and teaching the patient techniques for controlling ejaculation. Surgical treatment is indicated for increased sensitivity of the glans penis.
