Disorders of orgasm and ejaculation in men

David Rowland, Chris G. McMahon*, Carmita Abdo, Juza Chen, Emmanuele Jannini, Marcel D. Waldinger, Tai Young Ahn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction. Ejaculatory/orgasmic disorders are common male sexual dysfunctions, and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia. Aim. To provide recommendations and guidelines concerning current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. Methods. An international consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 25 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge of disorders of orgasm and ejaculation represent the opinion of seven experts from seven countries developed in a process over a 2-year period. Main Outcome Measure. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Results. Premature ejaculation management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin re-uptake inhibitor [SSRI] and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. Behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Retrograde ejaculation is managed by education, patient reassurance, pharmacotherapy, or bladder neck reconstruction. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic atiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Conclusions. Additional research is required to further the understanding of the disorders of ejaculation and orgasm. Rowland D, McMahon CG, Abdo C, Chen J, Jannini E, Waldinger MD, and Ahn TY. Disorders of Orgasm and Ejaculation in Men.

Original languageEnglish
Pages (from-to)1668-1686
Number of pages19
JournalJournal of Sexual Medicine
Volume7
Issue number4 PART 2
DOIs
StatePublished - Apr 2010

Funding

FundersFunder number
Janssen-Cilag
Eli Lilly and Company
Pfizer
Bayer Schering

    Keywords

    • Anejaculation
    • Behavioral Therapy
    • Ejaculation
    • Inhibited Ejaculation
    • Premature Ejaculation
    • Psychotherapy
    • Retrograde Ejaculation
    • Selective Serotonon Re-Uptake Inhibitors
    • Topical Anesthetics

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