Ejaculatory Disorders

Payam Sazegar, MD, CCFP Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Premature ejaculation (PE): inability to control ejaculatory reflex resulting in ejaculation sooner than desired; most common type of sexual dysfunction affecting all age groups:

    • ▪ De...

DIAGNOSIS

  • Ejaculation occurs before individual wishes (PE).

  • Ejaculation does not occur following normal stimulation (including masturbation).

HISTORY

  • Detailed sexual history, including:

    • ▪ Time frame of th...

TREATMENT

GENERAL MEASURES

  • Identifying any medical cause (even if not reversible) helps patient accept condition.

  • Improve partner communication.

  • Psychological counseling for patient and partner

  • Reduce per...

ONGOING CARE

PATIENT EDUCATION

See “General Measures.” 

PROGNOSIS

Often improves with therapy and counseling 

COMPLICATIONS

Psychological impact on some males: signs of severe inadequacy, self-doubt, addit...

REFERENCES

Althof  SE, McMahon  CG. Contemporary management of disorders of male orgasm and ejaculation. Urology.  2016;93:9–21. [View Abstract on OvidInsights]
Melnik  T, Althof  S, Atallah  AN...

ADDITIONAL READING

  • Gur S, Sikka SC. The characterization, current medications, and promising therapeutics targets for premature ejaculation. Andrology.  2015;3(3):424–442.

  • Sahin S, Bicer M, Yeni...

CODES

ICD10

  • F52.4 Premature ejaculation

  • N53.11 Retarded ejaculation

  • N53.14 Retrograde ejaculation

  • N53.13 Anejaculatory orgasm

  • F52.8 Oth sexual dysfnct not due to a sub or known physiol cond

  • N53.12 Painful e...

CLINICAL PEARLS

  • If erectile dysfunction is contributing to ejaculatory difficulty, management of erectile dysfunction should precede attempted management of ejaculatory disorders.

  • Medications should al...

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