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Ejaculation problems

If you have a persistent problem with ejaculation, visit your GP, who will discuss the problem with you and may examine you or refer you to a specialist.

Premature ejaculation

Premature ejaculation is a common ejaculation problem. It’s where the male ejaculates sooner than he or his partner wishes during sexual arousal.

Occasional episodes of premature ejaculation are common and are not a cause for concern. However, if you’re finding that it happens more than you’d like, and it’s a problem for you, it might help to get treatment.

Causes of premature ejaculation

Various psychological and physical factors can cause a man to suddenly experience premature ejaculation.

Common physical causes include:

  • prostate problems
  • thyroid problems – an overactive thyroid or an underactive thyroid
  • using recreational drugs

Common psychological causes may include:

  • depression
  • stress
  • relationship problems
  • anxiety about sexual performance (particularly at the start of a new relationship, or when a man has had previous problems with sexual performance)

It’s possible for a man to have experienced premature ejaculation since becoming sexually active. A number of possible causes for this are:

  • conditioning – it’s possible that early sexual experiences can influence future sexual behaviour. For example, if a teenager conditions himself to ejaculate quickly to avoid being caught masturbating, it may later be difficult to break the habit
  • a previous traumatic sexual experience – this can range from being caught masturbating to sexual abuse
  • a strict upbringing and beliefs about sex

Treating premature ejaculation


Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant, but they also delay ejaculation. SSRIs used for this purpose include:

Another type of antidepressant called clomipramine is also sometimes used.

Some men may experience an improvement a few days after treatment begins. However, you’ll usually need to take the medicine for 1 to 2 weeks before you notice the full effects.

Side effects of SSRIs are usually mild and should improve after 2 to 3 weeks. They include:

  • feeling sick and being sick
  • diarrhoea
  • excessive sweating (hyperhidrosis)

Dapoxetine (Priligy)

An SSRI specifically designed to treat premature ejaculation, known as dapoxetine (Priligy), has been licensed in the UK. Local NHS authorities can choose to prescribe it on the NHS.

It acts much faster than the other SSRIs used for premature ejaculation and can be used «on demand». You’ll usually be advised to take it between 1 and 3 hours before sex, but not more than once a day.

Your response to the treatment will then be reviewed after 4 weeks (or after 6 doses), and again every 6 months.

Dapoxetine is not suitable for all men diagnosed with premature ejaculation. For example, it is not recommended for some men with heart, kidney and liver problems. It can also interact with other medicines, such as other antidepressants.

Common side effects include:

  • headaches
  • dizziness
  • feeling sick

Phosphodiesterase-5 inhibitors

Phosphodiesterase-5 inhibitors, such as sildenafil (sold as Viagra), are a class of medicine used to treat erectile dysfunction. Research has found that they may also help with premature ejaculation.

You can get sildenafil on prescription, or buy it from a pharmacy after a discussion with the pharmacist to make sure it’s safe for you to take.

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Topical anaesthetics and condoms

The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Condoms can also be used and are effective, particularly when combined with local anaesthesia.

Things you can try yourself

There are also a number of things you can try yourself. It can sometimes help to:

  • masturbate an hour or 2 before having sex
  • use a thick condom to help decrease sensation
  • have sex with your partner on top (to allow them to pull away when you are close to ejaculating)

Psychosexual counselling

You may benefit from having psychosexual counselling, where a therapist can help you, and a partner if you have one, with sex related problems. During these sessions, the therapist will:

  • encourage you to explore any relationship issues you may have, and give advice about how to resolve them
  • show you techniques that can help you «unlearn» the habit of premature ejaculation (these include the «squeeze» and «stop-go» techniques)

In the squeeze technique, you masturbate but stop before the point of ejaculation and squeeze the head of your penis for between 10 to 20 seconds. Then let go and wait for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

The stop-go technique is similar, but you do not squeeze your penis. Once you feel more confident about delaying ejaculation, you could try this technique during sex, stopping and starting as required.

These techniques may sound simple, but they require lots of practice.

Delayed ejaculation

Delayed ejaculation (male orgasmic disorder) is classed as either:

  • experiencing a significant delay before ejaculation
  • being unable to ejaculate at all, even though the man wants to and his erection is normal

You may have delayed ejaculation if you’re unable to ejaculate more than half the times you have sex.

Causes of delayed ejaculation

Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors.

Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation – for example, relationship problems, stress or depression.

Physical causes of delayed ejaculation include:

  • diabetes
  • spinal cord injuries
  • multiple sclerosis
  • surgery to the bladder or prostate gland
  • increasing age

Many medicines are known to cause delayed ejaculation, including:

  • antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs)
  • medicines to treat high blood pressure, such as beta-blockers
  • antipsychotics, used to treat episodes of psychosis

Delayed ejaculation can suddenly start to happen after previously having no problems, or (less commonly) the man may have always experienced it.

Treating delayed ejaculation

Sex therapy

Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier.

Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live.

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During sex therapy, you’ll have the opportunity to discuss any emotional or psychological issues related to your sexuality and relationship, in a non-judgemental way.

Activities may also be recommended for you to try at home while you’re having sex with your partner (you should never be asked to take part in any sexual activities during a session with the therapist).

These may include:

  • erotic fantasies and «sex games» to make your lovemaking more exciting
  • using sexual aids, such as vibrators, to increase pleasure

Read more information about what a sex therapist can do.

Switching medicine

There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include:

  • amantadine – originally designed to treat viral infections
  • bupropion – usually prescribed to help people quit smoking
  • yohimbine – originally designed to treat erectile dysfunction

These help block some of the chemical effects of SSRIs that may contribute towards delayed ejaculation.

Alcohol and drugs

Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.

Read more about getting help with alcohol misuse and drug use.


Pseudoephedrine tablets may be tried, but these will need to be prescribed «off-label». This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

Retrograde ejaculation

Retrograde ejaculation is a rarer type of ejaculation problem. It happens when semen travels backwards into the bladder instead of through the urethra (the tube that urine passes through).

The main symptoms of retrograde ejaculation include:

  • producing no semen, or only a small amount, during ejaculation
  • producing cloudy urine (because of the semen in it) when you first go to the toilet after having sex

Men with retrograde ejaculation still experience the feeling of an orgasm and the condition does not pose a danger to health. However, it can affect the ability to father a child.

Causes of retrograde ejaculation

Retrograde ejaculation happens when the neck of the bladder does not close and semen passes into the bladder.

Usually when you ejaculate, semen is pushed out of your urethra. It is prevented from entering your bladder by the muscles around the neck of the bladder, which close tightly at the moment of orgasm.

However, damage to the surrounding muscles or nerves can stop the bladder neck closing, causing the semen to move into the bladder rather than up through the urethra.

Causes of retrograde ejaculation include prostate gland surgery, bladder surgery, diabetes, multiple sclerosis, and a class of medicines known as alpha blockers, which are often used to treat high blood pressure (hypertension).

Treating retrograde ejaculation

Most men do not need treatment for retrograde ejaculation because they are still able to enjoy a healthy sex life and the condition does not have adverse effects on their health.

But if treatment is required (usually because of wanting to father a child), there are options to try.

For example, pseudoephedrine (commonly used as a decongestant) has proved effective in treating retrograde ejaculation caused by diabetes or surgery.

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If retrograde ejaculation is caused by using a certain medicine, then normal ejaculation will usually return once medicine is stopped. Speak to your GP before stopping any prescribed medicine.

However, if the retrograde ejaculation has been caused by significant muscle or nerve damage, treatment may not be possible.

Men who want to have children can have sperm taken from their urine or testicles for use in intrauterine insemination or in-vitro fertilisation (IVF).

Involve your partner

If you’re having problems with your sex life and are seeking treatment, it is usually recommended you involve your partner as much as possible.

Communicating your concerns can often go a long way to helping to resolve them. And, in some cases, your partner may also have their own problems that are contributing towards problems with your sex life.

For example, some women are unable to reach climax during «normal» intercourse and require manual or oral stimulation.

Blood in your semen

Finding blood in your semen can be alarming. However, in most cases it’s not serious and will pass within a few days.

It can be caused by an infection of your urethra (urethritis) or prostate (prostatitis).

See your GP if you have blood in your semen. They can check if you need further tests or treatment.

Page last reviewed: 09 February 2023
Next review due: 09 February 2026


This article is about male ejaculation. For the female counterpart, see Female ejaculation. For other uses, see Ejaculation (disambiguation).

Ejaculation example

Look up ejaculate in Wiktionary, the free dictionary.

Ejaculation is the discharge of semen (the ejaculate; normally containing sperm) from the male reproductive tract as a result of an orgasm. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. Ejaculation can occur spontaneously during sleep, and is a normal part of human sexual development (a nocturnal emission or «wet dream»). In rare cases, ejaculation occurs because of prostatic disease. Anejaculation is the condition of being unable to ejaculate. Ejaculation is usually very pleasurable for men; dysejaculation is an ejaculation that is painful or uncomfortable. Retrograde ejaculation is the condition where semen travels backwards into the bladder rather than out of the urethra.



A usual precursor to ejaculation is the sexual arousal of the male, leading to the erection of the penis, though not every arousal nor erection leads to ejaculation, and ejaculation does not require erection. Penile sexual stimulation during masturbation or vaginal, anal, oral, or non-penetrative sexual activity may provide the necessary stimulus for a man to achieve orgasm and ejaculation. With regard to intravaginal ejaculation latency time, men typically reach orgasm 5–7 minutes after the start of penile-vaginal intercourse, taking into account their desires and those of their partners, but 10 minutes is also a common intravaginal ejaculation latency time. [1] [2] A prolonged stimulation either through foreplay (kissing, petting and direct stimulation of erogenous zones before penetration during intercourse) or stroking (during masturbation) leads to an adequate amount of arousal and production of pre-ejaculatory fluid («pre» or «precum»). While the presence of sperm in pre-ejaculatory fluid is thought to be rare, sperm from an earlier ejaculation, still present in the urethra, may be picked up by pre-ejaculatory fluid. [ citation needed ] In addition, infectious agents (including HIV) can often be present in pre-ejaculate. [3] Premature ejaculation is when ejaculation occurs before the desired time. If a man is unable to ejaculate in a timely manner after prolonged sexual stimulation, in spite of his desire to do so, it is called delayed ejaculation or anorgasmia. An orgasm that is not accompanied by ejaculation is known as a dry orgasm.

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Video of an ejaculation

When a man has achieved a sufficient stimulation and orgasm, ejaculation begins. At that point, under the control of the sympathetic nervous system, semen containing sperm is emitted from the penis. [4] The semen is ejected through the urethra with rhythmic contractions. [5] These rhythmic contractions are part of the male orgasm. They are generated by the bulbospongiosus and pubococcygeus muscles [6] under the control of a spinal reflex at the level of the spinal nerves S2–4 via the pudendal nerve. The typical male orgasm lasts several seconds. After the start of orgasm, pulses of semen begin to flow from the urethra, reach a peak discharge and then diminish in flow. The typical orgasm consists of 10 to 15 contractions, although the man is unlikely to be consciously aware of that many. Once the first contraction has taken place, ejaculation will continue to completion as an involuntary process. At this stage, ejaculation cannot be stopped. The rate of contractions gradually slows during the orgasm. Initial contractions occur at an average interval of 0.6 seconds with an increasing increment of 0.1 seconds per contraction. Contractions of most men proceed at regular rhythmic intervals for the duration of the orgasm. Many men also experience additional irregular contractions at the conclusion of the orgasm. [7] Ejaculation usually begins during the first or second contraction of orgasm. For most men, the first ejection of semen occurs during the second contraction, while the second is typically the largest expelling 40% or more of total semen discharge. After this peak, the magnitude of semen the penis emits diminishes as the contractions begin to lessen in intensity. The muscle contractions of the orgasm can continue after ejaculation with no additional semen discharge occurring. A small sample study of seven men showed an average of 7 spurts of semen followed by an average of 10 more contractions with no semen expelled. This study also found a high correlation between number of spurts of semen and total ejaculate volume, i.e., larger semen volumes resulted from additional pulses of semen rather than larger individual spurts. [8] Alfred Kinsey measured the distance of ejaculation, in «some hundreds» of men. In three-quarters of men tested, ejaculate «is propelled with so little force that the liquid is not carried more than a minute distance beyond the tip of the penis.» In contrast to those test subjects, Kinsey noted «In other males the semen may be propelled from a matter of some inches to a foot or two, or even as far as five or six and (rarely) eight feet». [9] Masters and Johnson report ejaculation distance to be no greater than 30–60 cm (12–24 in). [10] During the series of contractions that accompany ejaculation, semen is propelled from the urethra at 500 cm/s (200 in/s), close to 18 km/h (11 mph). [6]

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Refractory period

Most men experience a refractory period immediately following an orgasm, during which time they are unable to achieve another erection, and a longer period again before they are capable of achieving another ejaculation. During this time a male feels a deep and often pleasurable sense of relaxation, usually felt in the groin and thighs. The duration of the refractory period varies considerably, even for a given individual. Age affects the recovery time, with younger men typically recovering faster than older men, though not universally so. [10] Whereas some men may have refractory periods of 15 minutes or more, some men are able to experience sexual arousal immediately after ejaculation. A short recovery period may allow partners to continue sexual play relatively uninterrupted by ejaculation. Some men may experience their penis becoming hypersensitive to stimulation after ejaculation, which can make sexual stimulation unpleasant even while they may be sexually aroused. Some men are able to achieve multiple orgasms, with or without the typical sequence of ejaculation and refractory period. Some of those men report not noticing refractory periods, or are able to maintain erection by «sustaining sexual activity with a full erection until they passed their refractory time for orgasm when they proceeded to have a second or third orgasm». [11]


The force and amount of semen that will be ejected during an ejaculation will vary widely between men and may contain between 0.1 and 10 milliliters [12] (by way of comparison, note that a teaspoon is 5 ml and a tablespoon holds 15 ml). Adult semen volume is affected by the time that has passed since the previous ejaculation; larger semen volumes are seen with greater durations of abstinence. The duration of the stimulation leading up to the ejaculation can affect the volume. [13] Abnormally low semen volume is known as hypospermia and abnormally high semen volume is known as hyperspermia. One of the possible underlying causes of low volume or complete lack of semen is ejaculatory duct obstruction. It is normal for the amount of semen to diminish with age.


Main article: Semen quality

The number of sperm in an ejaculation also varies widely, depending on many factors, including the time since the last ejaculation, [14] age, stress levels, [15] and testosterone. Greater lengths of sexual stimulation immediately preceding ejaculation can result in higher concentrations of sperm. [13] An unusually low sperm count, not the same as low semen volume, is known as oligospermia, and the absence of any sperm from the semen is termed azoospermia.

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