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    Common orgasm issues for men

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      Reviewed by our clinical team

      Couple laying in bed

      Struggling to have an orgasm, or having one too quickly, is a problem that lots of men and women face, so if you’re having difficulty there’s no need to feel embarrassed. The important thing is to work out what the issue is and get help or advice from a healthcare professional or sex therapist if needed.

      For men, the most common orgasm issues are:

      If you’ve experienced any of these and you’re concerned about how it’s affecting your sex life, read on for some advice.

      Erectile dysfunction is a common orgasm issue for men

      The orgasm issue that most men will be familiar with is erectile dysfunction (ED for short). It's the same as the older term 'impotence'. This is where you’re unable to achieve or maintain an erection sufficient for sex, in other words ‘not staying hard enough for long enough’.

      Causes of ED

      Not being able to 'get it up' sometimes is completely normal, and you usually know why this has happened: too much alcohol, recreational drugs, being tired, stressed or simply not in the mood. But if it's happening most of the time you are trying to have sex, this would be called erectile dysfunction.

      Erection problems that are not going away or are bothering you most of the time could be a sign of an underlying physical condition, like high blood pressure, heart or circulation problems, diabetes or being overweight. Some medications can also cause or contribute to ED.

      It can also be a sign of a psychological issue like depression. Issues around gender identity or sexuality can also cause problems. Not being attracted to your partner or having problems in your relationship might be another factor. Trying for a baby can also cause stress just like worrying about causing an unwanted pregnancy.

      Treatments for ED

      If the cause of your erectile difficulties is an underlying physical condition that can be treated, you may find that this improves your erections. If the cause is something psychological, you may find that having some counselling or therapy helps.

      Otherwise, two popular treatments for erectile dysfunction to consider are:

      • ED tablets like Viagra 
      • Vacuum pumps

      ED tablets are taken about one hour before you plan to have sex. They work by increasing blood flow to the penis, normally for around four to six hours. If you become sexually aroused during this time, you should be able to get an erection sufficient for sex.

      The most popular ED tablet is Viagra (Sildenafil), but others include Tadalafil (Cialis), Avanafil (Spedra) and Vardenafil (Levitra). Each type has its own benefits – Tadalafil, for instance, can be effective for up to 36 hours.

      ED tablets are generally safe to take, however there are some men who shouldn’t use them e.g. those taking nitrates (an ingredient in certain heart medications and  creams to treat anal fissures) or living with severe kidney or liver disease. For this reason, you should only ever obtain ED tablets from your GP or through a trusted prescription service like Online Doctor. If you want to get ED tablets without a prescription, you can visit your local LloydsPharmacy and buy Viagra Connect over the counter after a short chat with the pharmacist.

      Vacuum pumps are physical devices that can be really effective at bringing on an erection. They’re a good option for men who can’t take ED tablets.

      A vacuum pump is a plastic cylinder with a pump attached. To use it, you place it over your penis and then use the pump to remove air from the cylinder. This creates a vacuum, which causes the penis to fill with blood and become erect. Once you have an erection, you should place a constriction ring around the base of your penis to keep it hard while you have sex.

      In some cases, vacuum pumps will be free for men on the NHS. Most of the time, however, you’ll have to buy your own penis pump

      Premature ejaculation is a common orgasm issue for men

      Premature ejaculation, or PE, is another issue that affects a lot of men. This is where the man orgasms and ejaculates too quickly. Find out more about how to last longer in bed

      Causes of PE

      PE that occurs every now and then is normal and nothing to worry about – usually it’s just a sign that you’re really enjoying yourself!

      If you’re regularly having trouble with PE, however, it can be a good idea to speak to your GP. PE that's happening most of the time can be a sign of an underlying physical condition like inflammation of the  prostate or an overactive thyroid or a psychological issue like performance anxiety.

      For some men, PE may have been a problem from a young age, possibly due to early sexual experiences and behaviours. A possible genetic link is also being discussed.

      Thinking about treatment?


      Treatments for PE

      There are a few different treatment options for PE. As with ED, treating an underlying physical condition, or getting counselling or therapy can be helpful. Other options include:

      Antidepressants in the SSRI family can also help with PE, but you would need to discuss this with your GP.

      Priligy is a prescription treatment for men who experience premature ejaculation. It’s a selective serotonin reuptake inhibitor (SSRI) that works by causing a delayed reaction in the areas of the brain that control ejaculation. You should take Priligy one to three hours before you have sex – this should allow you to last three times longer before ejaculating.

      It's not safe for everyone to take Priligy, which is why it’s important to get it on prescription from your GP, or through a trusted service like Online Doctor.

      Numbing creams like EMLA can be applied directly to the penis to create a mild anaesthetic effect. This makes your penis less sensitive during sex, which means you should last longer. You’ll need to apply a small amount of cream to your frenulum (banjo string) about 15 to 30 minutes before you plan to have sex, making sure you wipe away any excess before you start.

      EMLA is a good option for men who can't take Priligy or who don't want to take tablets. If you’re going to use condoms, opt for polyurethane types as EMLA cream is oil-based and can split latex.

      Special types of condom can be a good treatment option for men with PE. Some brands will offer varieties that are extra thick or contain a mild numbing liquid. Both of these will help reduce sensitivity, and should delay ejaculation.

      “Squeeze” and “stop-go” techniques are another option for men with PE. These are techniques that can be used to “train” your body to last longer. Both involve masturbating to the point of ejaculation and then stopping – in the squeeze technique, the head of the penis is squeezed for 10 to 20 seconds. To learn more, read this guide by one of our doctors.

      Sensitivity after an orgasm is a common issue for men

      You might notice that right after ejaculating, your penis feels very sensitive and perhaps even painful. This may make it difficult – or even impossible – to continue having sex with your partner, which may cause anxiety or lead to problems in a relationship.

      The thing to remember is: sensitivity after an orgasm is completely normal, and probably something experienced by all men. If it’s causing problems with your partner, try to be open and communicative, and consider mixing things up in the bedroom – either to focus on their pleasure in the first instance, or to delay ejaculation.

      If ejaculation itself is painful, or if you notice any blood in your semen or unusual discharge, it’s worth getting medical advice and an STI test.

      Delayed ejaculation is a common orgasm issue for men

      For some men, getting an erection isn’t a problem, but ejaculating is. You might find that when you’re having sex with your partner, you struggle to orgasm and fail to ejaculate even if you’re stimulated – this is known as delayed ejaculation.

      As with ED and PE, the causes of delayed ejaculation can be physical or psychological, so it’s always a good idea to speak to your GP if this a recurring problem. Normally, the treatment will be sex therapy.

      Very rarely men can't release any semen even though they have climaxed. This can be a cause for male infertility.

      Get help from Online Doctor

      At Online Doctor we offer effective treatment for ED and PE that saves you having to speak to a doctor or pharmacist face to face. Visit our secure online ED clinic or PE clinic today to browse our products and make a discreet order.

      VideoGP by LloydsPharmacy

      References

      https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
      https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20047821
      https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/VEDs.pdf
      https://www.nhs.uk/conditions/ejaculation-problems/
      https://www.irishtimes.com/life-and-style/health-family/my-boyfriend-loses-interest-in-sex-after-he-orgasms-1.3501903
      https://www.nhs.uk/conditions/blood-in-semen/
      https://sexualadviceassociation.co.uk/ejaculation-problems/

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