Understanding Orgasmic Disorders in People with Penises

In previous pieces, I’ve explored orgasmic disorders affecting vulva owners — but orgasm disorders in men and people with penises are just as common and often overlooked. Folks with penises are not exempt from having issues with achieving a satisfying orgasm, and particularly, ejaculating how and when they want. Read on as we explore the main orgasmic disorders that affect the penis owners amongst us. Understanding orgasm disorders in men and people born with penises is an important step in reducing shame, seeking help, and reclaiming sexual confidence.

Premature Ejaculation

Among the most common orgasm disorders in men and folks with penises, premature ejaculation is often misunderstood but can be managed with the right tools.

What Is Premature Ejaculation?

Premature ejaculation is when you ejaculate faster than you would like to, most of the times when you have sex. It is perfectly normal to climax sooner than expected some of the time, but premature ejaculation is when this occurs most of the time. It is the most common orgasmic disorder to affect those with a penis, affecting between 1 in 3 men aged 18-59 years. Some people affected by the disorder ejaculate during the early stages of foreplay, while others may reach climax on penetration or very soon after. For some, this is a lifelong condition that affects them from their first sexual experience, but for others it develops later after having no issues previously. The hallmarks of the disorder are:

• that ejaculation occurs within 1 -3 minutes of sexual activity commencing
• the person has an inability to delay ejaculation all or nearly all the time, and 
• they experience distress surrounding the issue, resulting in them avoiding sexual activity.

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Common Causes of Premature Ejaculation

Premature ejaculation has a range of causes, including genetic origins related to communication between nerves, psychological factors, and other health problems such as issues with hormone levels. The reason behind why a person is ejaculating early will help to determine what action to take in regards to treatment. Lifelong premature ejaculation is not curable but it can be treated, whereas people who have acquired the condition can expect a successful outcome when the underlying issue is addressed. Issues with getting or maintaining an erection is also found in a third to a quarter of cases of premature ejaculation, affecting a wider spectrum of intimate activities. 

Treatment Options

Treatment for premature ejaculation can include start-stop techniques, squeeze techniques, and masturbation before sexual activity. Becoming mindful about what is going on in your body when you are aroused and engaging in sex is an important factor in treating this issue.

Delayed Ejaculation

Delayed ejaculation is another form of orgasm disorder in men and folks with penises that can cause frustration and emotional distress, particularly when left untreated.

What Is Delayed Ejaculation?

Also known as “impaired ejaculation”, delayed ejaculation is when it takes an extended period for someone with a penis to ejaculate. Some people with delayed ejaculation cannot orgasm at all, whilst in other cases it takes more than 30 minutes of stimulation to reach climax. Like premature ejaculation, it can happen to people periodically throughout their lives, however when delayed ejaculation becomes frequent, or someone cannot reach climax at all, then it requires treatment.

Delayed ejaculation does not pose a serious physical health risk, but it can result in stress, anxiety and relationship issues if not addressed. As with premature ejaculation, delayed ejaculation can be lifelong (where the person has always had difficulty ejaculating or never ejaculated at all) or develop with someone who has never had issues before. 

For some, delayed ejaculation occurs in all sexual situations, whereas for others it only occurs in certain situations and with certain partners. As with other orgasmic disorders, the cause and the circumstances surrounding the issue help provide direction in how to treat it.

Causes and Contributing Factors

The causes of delayed ejaculation range from side effect from certain medications (particularly antidepressants and antipsychotics), psychological issues and chronic health conditions. Traumatic events and cultural taboos can also play a role in why a person cannot reach climax. Delayed ejaculation, like premature ejaculation, can also be exacerbated by stress, poor communication with intimate partners and unrealistic expectations of sexual experiences. 

Treatment and Support

Although there are medications that can be used to treat delayed ejaculation, for those who acquire the disorder later in life, treatment of the underlying causes (whether that be psychological or due to relational stress or other health concerns) is key to resolving the issue.

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Retrograde Ejaculation

Although less known, retrograde ejaculation is still classified under orgasm disorders in men/folks born with a penis and may have fertility implications.

What Is Retrograde Ejaculation?

What is going on when you can get an erection, reach orgasm, but little to no semen emerges from your penis? This could be a sign of retrograde ejaculation. Also know as a “dry orgasm”, it differs from the other disorders discussed here as it is a result of structural issues. Muscles at the opening of the bladder do not tighten properly, resulting in sperm that was travelling through the vas deferens ending up in the bladder. 

Symptoms and Diagnosis

The symptoms of retrograde ejaculation are:

• Orgasms resulting in very little to no ejaculate coming from the penis
• Cloudy urine after orgasm, due to sperm entering the bladder and
• Infertility, that is being unable to get someone pregnant

Is It Harmful?

Retrograde ejaculation is not an issue in and of itself, although it is recommended you see a doctor to ensure that the absence of ejaculate is not a symptom of underlying health issues (such as medication side effects, nerve damage caused by medical conditions or lack of muscle tone resulting from pelvic surgery). Although the absence of a clear sign of orgasm can worry some people, it is not intrinsically harmful. 

However, if you are wanting to produce children that is a different story! You will require treatment of some kind. The main treatment is the prescription of medication that will help the muscle at the bladder opening close more tightly. If you want to have children and medication is not helping you successfully ejaculate, assisted reproductive technology (ART) can be used to retrieve sperm.

When to Seek Help

All the issues described here can lead to further difficulties if left untreated. Although essentially not life-threatening, they can result in stress, anxiety, and frustration with sexual intimacy. Getting support from a GP, a sex therapist, and communicating openly with your partner are all critical steps in addressing orgasm disorders in men and folks with a penis and restoring a fulfilling sex life. Because everyone deserves to have a fulfilling and satisfying sex life.

Rem Sequence is an Australian adult content creator, blogger, and internationally published alt model. She has a background in psychology, philosophy and political science and worked in health and sex education, youth work and trauma counselling for almost two decades. Now, she works full time in the adult industry, as well as indulging her passion for arts, writing and music in numerous side projects.