Informational article. If you are looking for an andrology consultation in Gdańsk, go directly to the consultation page — the link is provided below.
Ejaculation problems include premature ejaculation, delayed ejaculation, absent ejaculation, painful ejaculation and retrograde ejaculation. Their causes may be psychological, hormonal, neurological, urological, medication-related or mixed, so persistent symptoms should be discussed with an andrologist or urologist.
This article explains the most common types of ejaculation disorders, when the problem requires diagnostics, which tests may be needed and what treatment may involve. At Wyspa Medycyny Przyjaznej in Gdańsk, patients can begin with an andrology consultation.
Author: Wyspa Medycyny Przyjaznej Editorial Team · Medical consultation: Jakub Krukowski, MD, PhD, urologist · Publication: to be completed · Updated: 7 July 2026
Ejaculating too quickly, no ejaculation or pain during ejaculation?
You do not have to solve this alone. A consultation can help determine whether the cause is stress, medication, prostatitis, a hormonal disorder, a neurological problem, diabetes, erectile dysfunction or another condition.
Book an andrology consultation →Key information at a glance
| Problem | How may it present? | What should you do? |
|---|---|---|
| premature ejaculation | ejaculation occurs sooner than the patient wants, with a sense of poor control | consultation and assessment of duration, stress, erections and the relationship |
| delayed ejaculation | difficulty reaching ejaculation despite sexual arousal | assessment of medication, hormones, stress, neurological factors and chronic diseases |
| absent ejaculation | orgasm without semen or absence of orgasm/ejaculation | diagnostics for retrograde ejaculation, medication effects, neurological disease and previous procedures |
| retrograde ejaculation | little or no semen is released externally, sometimes with cloudy urine after orgasm | urological assessment, particularly when trying to conceive |
| painful ejaculation | pain in the penis, perineum, testicles, lower abdomen or prostate area during ejaculation | urological diagnostics to exclude inflammation, infection or a prostate problem |
What do ejaculation problems mean?
Ejaculation is a complex process dependent on the nervous system, blood vessels, hormones, prostate, seminal vesicles, pelvic floor muscles, psychological state and sexual relationship. Ejaculation disorders therefore rarely have one simple cause.
The problem may begin suddenly or may have been present since the start of sexual activity. It may occur in every sexual situation or only in a specific context, for example during intercourse with a partner but not during masturbation. These details are diagnostically important and help the doctor plan further management.
“Ejaculation disorders are nothing to be ashamed of. The doctor needs specific information: when the problem began, whether it occurs in every situation, which medications the patient takes and whether there are urological or hormonal symptoms.”
— expert comment, subject to approval by a WMP doctor
Premature ejaculation — when is it a medical problem?
Premature ejaculation is not defined only by a “short duration”. Three elements are important: ejaculation occurs earlier than the patient wants, it is difficult to control and it causes stress, frustration or relationship problems. In some men, the problem has been present since the beginning of sexual activity; in others, it develops later.
Possible causes include hypersensitivity, performance anxiety, stress, erectile dysfunction, prostatitis, hormonal disorders, sexual experiences, relationship factors or several factors acting together. Treatment should therefore be preceded by a detailed history and assessment of whether other problems, such as erectile dysfunction, are also present.
Delayed ejaculation and absent ejaculation — what causes them?
Delayed ejaculation means difficulty reaching ejaculation despite sexual arousal. In some men, ejaculation occurs during masturbation but not during intercourse. In others, it does not occur at all or orgasm requires very prolonged stimulation.
Possible causes include medications, particularly some antidepressants, hormonal disorders, low testosterone, neurological conditions, diabetes, pelvic surgery, stress, psychological tension, specific patterns of sexual stimulation and relationship problems.
If the problem began after starting a new medication, do not stop taking it on your own. Discuss the situation with the prescribing doctor and an andrologist or urologist.
Retrograde ejaculation — orgasm without semen or cloudy urine after intercourse
Retrograde ejaculation occurs when semen flows backwards into the bladder instead of leaving through the urethra. The patient may notice a very small amount of semen, no semen during orgasm or cloudy urine after intercourse.
Retrograde ejaculation is usually not dangerous to health, but it may be important when trying to conceive. Possible causes include certain medications, diabetes, procedures involving the prostate or bladder neck, nerve damage or neurological disease. Diagnostics may include a medical history, urological examination and assessment of urine after ejaculation.
Painful ejaculation — when should the prostate and urinary tract be checked?
Pain during ejaculation may be felt in the penis, testicles, perineum, anus, lower abdomen or prostate area. It may occur occasionally, but recurrent pain requires diagnostics.
Possible causes include prostatitis, a genitourinary infection, chronic pelvic pain syndrome, stones, previous urological procedures, pelvic floor muscle tension or neurological disease. More urgent medical assessment is needed if the pain is accompanied by fever, burning during urination, blood in the urine or semen, severe testicular pain or urinary retention.
When should you see an andrologist or urologist?
A single episode of ejaculation occurring too quickly or being delayed can happen to anyone. Consultation is advisable when the problem recurs, causes stress, affects the relationship, interferes with attempts to conceive or is accompanied by other symptoms.
Book an appointment if:
- premature ejaculation occurs regularly and there is a sense of poor control,
- difficulty ejaculating has persisted for several weeks or months,
- little or no semen is released after orgasm,
- ejaculation is painful,
- blood appears in the semen or urine,
- there are symptoms of infection: burning, frequent urination, fever or perineal pain,
- the problem began after starting a new medication, undergoing surgery, sustaining an injury or developing an illness,
- the couple is trying to conceive and there is a problem with ejaculation or semen volume,
- erectile dysfunction, low libido or symptoms of low testosterone are also present.
How are ejaculation disorders diagnosed?
Diagnostics begin with a conversation. The doctor asks how long the problem has been present, in which situations it occurs, about erection quality, libido, orgasm, medications, chronic diseases, previous urological procedures, attempts to conceive, stress, the relationship and previous treatment.
Depending on the symptoms, the doctor may consider:
- a urological examination,
- prostate assessment when pain or urinary symptoms are present,
- hormonal tests, such as testosterone, prolactin and TSH, depending on the situation,
- urinalysis or urine culture if infection is suspected,
- semen analysis when fertility is a concern,
- assessment of urine after ejaculation if retrograde ejaculation is suspected,
- ultrasound of the genitourinary system when indicated,
- a sexology or psychotherapy consultation when psychological or relationship factors are significant.
Not every patient needs every test. The scope of diagnostics depends on the type of problem and accompanying symptoms.
Ejaculation problems — possible causes
| Cause group | Examples | When might it be suspected? |
|---|---|---|
| psychological and relationship-related | stress, anxiety, performance pressure, relationship conflict, sexual experiences | when the problem depends on the situation or partner |
| urological | prostatitis, infection, pelvic pain, effects of procedures | pain, burning, frequent urination or blood in the semen |
| hormonal | low testosterone, prolactin disorders, thyroid disorders | reduced libido, fatigue, erectile dysfunction or reduced wellbeing |
| neurological and metabolic | diabetes, nerve damage, neurological disease | absent ejaculation, retrograde ejaculation or altered sensation |
| medication-related | some antidepressants, urological, neurological and antihypertensive medications | when the problem starts after a medication is introduced or changed |
Treatment of ejaculation problems — what does it depend on?
Treatment depends on the type of disorder and its cause. Premature ejaculation is managed differently from delayed ejaculation, while retrograde ejaculation and painful ejaculation require yet another approach. It is therefore not advisable to begin with random medication or supplements.
Possible elements of treatment include:
- education and behavioural techniques — particularly for premature ejaculation,
- treatment of erectile dysfunction if it coexists and worsens the problem,
- pharmacotherapy — selected by the doctor according to the type of disorder, indications and contraindications,
- treatment of infection or prostatitis if confirmed,
- hormonal diagnostics and treatment if testosterone, prolactin or thyroid abnormalities are present,
- medication adjustment, but only after consultation with the prescribing doctor,
- pelvic floor physiotherapy if excessive tension or pelvic pain is present,
- sex therapy or psychological therapy when stress, anxiety or relationship factors play an important role.
In retrograde ejaculation, treatment may not be necessary if the patient does not plan to have children and has no other symptoms. If the couple is trying to conceive, however, consultation with an andrologist or urologist is advisable.
What should you not do on your own?
Ejaculation problems often lead patients to buy products online or stop medications they suspect may be affecting their sexual function. This can be dangerous.
The following are not recommended:
- stopping antidepressants, urological, cardiac or hormonal medications without medical advice,
- using medication for premature ejaculation without consultation,
- combining erectile-dysfunction medication with heart medication without a doctor’s approval,
- buying medication from unreliable online sources,
- ignoring pain, blood in the semen, fever or symptoms of infection,
- assuming that the problem is “only psychological” without medical assessment.
How should you prepare for the consultation?
The visit is easier if the patient prepares specific information. The doctor is not judging the patient — detailed information is needed to distinguish between medical, psychological, medication-related and relationship causes.
Before the consultation, it is worth noting:
- how long the problem has been present,
- whether it occurs during every sexual activity or only in certain situations,
- whether it concerns intercourse, masturbation or both,
- whether erectile dysfunction, reduced libido or pain is present,
- whether there is blood in the semen, pain during urination or symptoms of infection,
- which medications and supplements are being taken,
- whether there have been urological procedures, spinal surgery, diabetes or neurological disease,
- whether the couple is trying to conceive.
Who should you see at Wyspa Medycyny Przyjaznej?
At Wyspa Medycyny Przyjaznej, a patient with premature ejaculation, delayed ejaculation, absent ejaculation, painful ejaculation or suspected retrograde ejaculation may begin with an andrology or urology consultation.
urologist — scope of andrology consultations to be confirmed before publication
More about the doctor
During the visit, the doctor will assess whether hormonal tests, urinalysis, prostate diagnostics, ultrasound, semen analysis, medication adjustment or cooperation with a sexologist or psychotherapist is needed.
Key information at a glance
- Ejaculation problems may involve ejaculation that is too rapid, delayed, painful, retrograde or absent.
- Causes may be psychological, urological, hormonal, neurological, metabolic, medication-related or mixed.
- Premature ejaculation is not only a short duration, but also poor control and distress for the patient or couple.
- No semen during orgasm may suggest retrograde ejaculation, particularly after prostate surgery, in diabetes or with certain medications.
- Painful ejaculation requires assessment for prostatitis, infection or pelvic pain.
- Treatment is selected according to the cause — it is not worth starting with random medication purchased online.
Frequently asked questions
Is premature ejaculation a medical condition?
It may be a sexual disorder if ejaculation regularly occurs earlier than the patient wants, is difficult to control and causes stress or relationship problems. A single episode does not necessarily indicate a disorder, but a recurrent problem is worth discussing with a doctor.
Why can I not ejaculate?
Delayed or absent ejaculation may result from medication, stress, hormonal disorders, diabetes, neurological disease, previous procedures, relationship problems or a specific pattern of stimulation. Persistent problems warrant diagnostics.
What does orgasm without semen mean?
Orgasm without semen may result from retrograde ejaculation, a low ejaculate volume, obstruction, medication, urological procedures or neurological disease. If the couple is trying to conceive or the symptom appeared suddenly, consultation with a urologist or andrologist is advisable.
Is painful ejaculation dangerous?
Not always, but recurrent pain should not be ignored. Painful ejaculation may be associated with prostatitis, a genitourinary infection, pelvic pain, stones or a neurological problem. More urgent assessment is required when pain is accompanied by fever, blood in the semen or urinary symptoms.
Can antidepressants affect ejaculation?
Yes. Some medications can delay ejaculation or affect libido and orgasm. They should not be stopped without medical advice. If the problem began after treatment was started, discuss it with the prescribing doctor and a urologist or andrologist.
Can ejaculation problems be treated?
In many cases, yes, but the method depends on the cause. Treatment may include education, behavioural techniques, medication, treatment of infection or hormonal disorders, medication adjustment, pelvic floor physiotherapy or sex therapy.
Which doctor should I see for an ejaculation problem?
It is best to begin with an andrologist or urologist, especially when there is pain, no semen, fertility problems, erectile dysfunction, urinary symptoms or a suspected hormonal or medication-related cause.
Is an ejaculation problem affecting sex, your relationship or attempts to conceive?
An andrology consultation helps identify the cause and select treatment for the specific type of disorder.
Book an andrology consultation →Summary
Ejaculation problems may take different forms: premature ejaculation, delayed ejaculation, absent ejaculation, retrograde ejaculation or painful ejaculation. Each may have different causes and require a different approach.
The key is to determine whether the problem is lifelong or acquired, whether it occurs in every situation and whether erectile dysfunction, pain, urinary symptoms, medication use, chronic diseases, low testosterone or fertility difficulties are also present. Only then can appropriate treatment be selected.
If the ejaculation problem persists, recurs or causes stress, book an andrology consultation in Gdańsk.
You may also be interested in
Sources and medical context:
- American Urological Association / SMSNA — Disorders of Ejaculation Guideline
- Shindel AW et al. — Disorders of Ejaculation: An AUA/SMSNA Guideline
- NHS — Ejaculation problems
- Mayo Clinic — Delayed ejaculation: symptoms and causes
- Cambridge University Hospitals NHS — Retrograde ejaculation
- Wyspa Medycyny Przyjaznej — andrology consultation
This article is informational and does not replace a medical consultation. Premature ejaculation, delayed ejaculation, absent ejaculation, painful ejaculation, blood in the semen, testicular pain, symptoms of infection, erectile dysfunction or fertility difficulties require individual medical assessment. The doctor decides on diagnostics, medication, therapy and further treatment during the consultation.