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Ejaculation disorders (ejaculatory dysfunction) are not a frequent disease, but as a cause of fertility disorders they are extremely serious. Classification according to the „Guidelines on Disorders of Ejaculation – EAU“:

Anejaculation

Anejaculation is a complete loss of ejaculation. It is caused by failure of emission of semen from the prostate and seminal ducts into the urethra. True anejaculation is usually associated with a normal orgasmic sensation. Occasionally, for example in incomplete spinal cord injuries, the orgasmic sensation may be altered or reduced. True anejaculation is always connected with central or peripheral nervous system dysfunctions or influence of drugs.

Anorgasmia

Anorgasmia is the inability to reach orgasm. It may be caused by anejaculation. Some patients report sporadic nocturnal emissions or ejaculation during great emotional excitement unrelated to sexual activity. The causes of anorgasmia are usually psychological.

Delayed ejaculation

Delayed ejaculation is the condition in which abnormal stimulation of the erect penis is necessary to achieve orgasm with ejaculation. It is considered a moderate form of anorgasmia, both symptoms may appear in the same patient. The causes may be psychological or organic, such as:

• incomplete spinal cord lesion
• iatrogenic damage of cavernous nerves
• use of antidepressants, antihypertensives or antipsychotics.

Retrograde ejaculation

Retrograde ejaculation is a complete loss of antegrade ejaculation, because the ejaculate passes backwards through the bladder neck into the bladder. Patients experience a normal or decreased orgasmic sensation, except in paraplegia. Retrograde ejaculation is usually complete. Partial antegrade ejaculation may be confused with the secretion of bulbo-urethral glands.

Asthenic (weak) ejaculation

Asthenic ejaculation, also defined as partial ejaculatory incompetence or  „éjaculation baveuse“, is characterized as a normal emission phase and an altered propulsive phase of ejaculation. The orgasmic sensation is reduced and the typical rhythmic contractions associated with ejaculation are missing, while these are present in asthenic ejaculation due to urethral obstruction.

Premature ejaculation

Premature ejaculation is fast and incontrollable triggering of the ejaculatory reflex, inability to control ejaculation for a "sufficient" length of time before emission. No universally accepted definition of "sufficient" length of time exists. We talk about premature ejaculation when a man is unable to prolong coitus for more than one minute. Relative premature ejaculation is considered when the coitus lasts longer but the time is not sufficient to satisfy the partner. Coitus lasting shorter than three minutes is called coitus brevis. If ejaculation occurs before or during emission, the phenomenon is called ejaculatio ante or intra portas. Premature ejaculation may be psychogenic or organic, congenital or acquired, partner-related or associated with erectile dysfunction. When intravaginal ejaculation occurs, fertility is not influenced.

Painful ejaculation

Painful ejaculation is usually an acquired condition. Painful sensations in the rectum, outer opening or meatus of the urethra can be caused by ejaculatory duct obstruction, prostatitis, urethritis, autonomous nerve dysfunction of psychological problems.