Ejaculation Disorders

Too fast, too slow, or not at all? An estimated 1 in 3 men has faced premature ejaculation, while up to 4% of men experience delayed ejaculation.

Here are the common types of ejaculation disorders:

Premature Ejaculation

Men with premature ejaculation find that their ejaculations always or nearly always occur too rapidly within a minute or so of vaginal penetration. They have difficulty delaying this ejaculation in most instances of vaginal penetration. This causes them and their partners significant distress and frustration. It can then lead to avoidance of sexual intimacy.

Premature ejaculation can be classified as acquired or lifelong. Men can acquire the condition at some point in their life, such as after a significant event or change. It can also be a lifelong issue, where they struggle with having very short duration of vaginal penetrative sex from the first time they engage in penile-vaginal sex.

Delayed Ejaculation

There are 2 types of delayed ejaculation, primary and secondary.

Primary delayed ejaculation applies to men who have always had difficulty ejaculating.

Secondary delayed ejaculation occurs in men who previously had no issues with intercourse but along the way developed this problem.
Delayed ejaculation can be caused by physical and psychological factors.

Physical factors include:
• Side effects from medications, especially antidepressants
• Alcohol and illicit drug use
• Nerve damage
• Pelvic injury
• Hormonal deficiencies like low testosterone

Psychological factors include:
• Mood disorders
• Relationship strains
• Performance anxiety
• Innate beliefs about sex – cultural or religious taboos

Don’t keep your ejaculation problems to yourself

If you’re struggling with ejaculation issues, don’t keep it to yourself and don’t continue to engage in intercourse that distresses you. Talk to us together with your partner so that the issue can be identified and addressed early.

Whether you’re suffering from premature or delayed ejaculation, the journey to recovery begins with treating the underlying cause, which may include assessment of:

Medication History

Masturbation Habits

Relationship

Hormones

Treatment For Ejaculation Disorders

Pills

For those who are undergoing treatment for erectile dysfunction, medication like Cialis, Viagra and Levitra can actually alleviate some of the problems with premature ejaculation.

Otherwise, dapoxetine and tramadol can be used to target premature ejaculation, while cabergoline (the same drug to help mothers to stop producing breast milk) has been used to treat delayed ejaculation.

Sex Therapy

There is increasing data showing that sex therapy can be more effective than medication to manage ejaculation disorders. This can help men and their partners work on psychological, emotional, and relationships issues that are either long-standing or a recent result stemming from the distress of ejaculation disorders.

Do note that this requires a longer term commitment to resolve this problem.

Testosterone Replacement Therapy

If your ejaculation disorders are caused by a shortage of testosterone, you may benefit from testosterone replacement therapy, which can take place in the form of injections or gels.

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FAQ

How is premature ejaculation diagnosed?

If couples define sex as the time period between penetration and ejaculation (also known as the latency period), then it might last just a few minutes when there is an issue of premature ejaculation. But if they include foreplay and other sexual activities such as massage and oral sex etc, the experience can last for a much longer period.

If the individuals are satisfied with the duration of vaginal penetrative sex, even if it lasts for just over a few minutes, then the couple does not have an issue as they are both satisfied with that duration of penetrative sex and it does not cause them distress or frustration.

However, in a couple setting where penetrative vaginal sex mostly occurs under a few minutes (eg 2-3 mins), and one or both partners are unsatisfied, bothered and negatively affected by this, then this can be classified as premature ejaculation.

It is helpful to have realistic expectations – typically, the normal time to ejaculation is between 5 to 7 mins.

Do drugs like Viagra help to manage premature ejaculation?

Yes! Common drugs for erectile dysfunction like Cialis, Viagra and Levitra can actually alleviate some of the problems with premature ejaculation. As these drugs provide men with stronger vigour of erection, they also reduce what many men call ”performance anxiety”. Since anxiety is often a concern for men with premature ejaculation, a man using drugs like Viagra, Cialis and Levitra then find that not only are their erections stronger, they may also ‘last longer’.

Can delayed ejaculation be circumstantial?

Yes. Sometimes, it only occurs in specific circumstances, such as only with specific sex partners or it occurs with sexual intercourse with a partner but not with masturbation. A man who masturbates a certain way, with a specific intensity or speed that gets him off, might not reach that required threshold of stimulation during intercourse with a partner.

Does not ejaculating cause any problem?

For some men who suffer from delayed ejaculation, ejaculation cannot be achieved at all. While this condition does not pose any serious medical risks, it can be a source of stress and may create problems in your sex life and personal relationships.

Dr Jessherin Sidhu

Affectionately known to her patients as Dr Jess, Dr Jessherin Sidhu adopts a holistic approach to patient care. She is a firm believer that relationships, sexuality and sexual behaviour are factors that have a significant impact on overall health.

With her sex-positive and health-focused approach, Dr Jess encourages safe and open discussions of sexual health issues that extend beyond just treating diseases.

See what our patients have said about us

Brandon Chee

August 21, 2019 via Google

When I first saw Dr Jess for my issue, I was afraid and apprehensive. Moreover, I wasn't exactly keen in talking to a female doctor as I wasn't sure if she would judge me or be empathetic towards my case. I soon realised that I could not be more wrong. What made the difference was that she was extremely patient and took the time to listen to me, and would sort out every single one of my concerns. She conducts her clinical sessions with extreme professionalism and I always feel comfortable around her. The best part was that she was never judgemental, and never made me incur any unnecessary costs. There are many doctors out there, but most do not take the time to really hear their patients out. I would highly recommend her if you are on the fence about seeing a doctor for your condition, because Dr Jess is a medical practitioner who truly cares about her patients' well being!

Brian Morris

July 23, 2019 via Google

Dr. Jess is that excellent (and very rare) combination of big-hearted warmth and extreme clinical competency. She's interested and curious, has a deep desire to help, and always remembers what we discussed and done in the past. Also, her new space is comfortable and beautiful! I can't overrecommend this experience... check it out!

Neil Armstrong

September 5, 2019 via Google

I'd spent a while trying to find a general practitioner in Singapore with some very, very mixed results (although I will admit to being a difficult patient sometimes). Dr. Jess was recommended to me when I suffered an acute condition and I can't believe how lucky I am to have found her when I did. She has that fantastic ability to be both amazingly friendly and approachable whilst still being incredibly knowledgeable, professional and focused on getting the best outcome possible for your health needs at the same time. As someone who has a background history in medical research and teaching medical students, I'm constantly impressed with the way Dr. Jess has always used both trusted, conservative methods whilst also being up to date with new techniques and the latest knowledge, and will research for answers and present it in a manageable, down-to-earth and tailored way - or recommend excellent specialists when required. I cannot recommend her highly enough, and she would be my doctor of choice no matter where I lived in Singapore. Also worth mentioning is that her staff are always very polite, friendly, competent and go out of their way to be helpful. I don't write reviews very often, but five incredibly well deserved stars.

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