Ejaculatory incompetence (retarded ejaculation) refers to an inability to ejaculate during sexual intercourse in a man with an adequate erection and suitable stimulation.
To be considered a problem this should occur with some frequency (not rarely).
It may be complete (no ejaculation at all) or partial (minimal fluid produced).
Possible causes:
(1) psychogenic
(2) pituitary adenoma with hyperprolactinemia
(3) learned behavior
(4) drug-induced
It may be:
(1) associated with retrograde ejaculation.
(2) a cause of male infertility
Therapies may include:
(1) psychiatric counseling
(2) sexual therapy (may be better than psychiatric counseling since it may address technique issues)
(3) use of an alpha-adrenoceptor agonist such as Midodrine or bromocriptine (an ergot alkaloid)
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