Ejaculation, also called cum or come, is the discharge of semen containing sperm from the penis during an orgasm. It is the final stage of male sexual stimulation and is a requirement for natural conception.
The ejaculatory response is a synchronized autonomic and somatic response involving two interacting stages, emission and expulsion. Emission involves the autonomic activation of the prostate, seminal vesicles and epididymis.
Definition
A man’s ejaculation (also called orgasm) is the discharge of semen containing sperm. It is the final stage and natural objective of male sexual stimulation, and it is also necessary for conception. The ejaculatory process is controlled by nerve impulses that are initiated by the bulbocavernosus muscle in the penis. Once this muscle contracts, the semen is forced out of the urethra by strong spasmodic contractions that can’t be voluntarily interrupted.
The amount of sperm that is ejected during an orgasm varies from person to person. It can range from 0.1 to 10 milliliters of fluid. The amount of sperm ejected during an orgasm depends on the duration of sexual stimulation immediately preceding it, and it can vary from day to day. An unusually low volume of sperm is known as hypospermia, and an abnormally high volume of sperm is known as hyperspermia.
Some men are able to reach orgasm without ejaculating. This is sometimes referred to as a ‘dry orgasm.’ However, other men are unable to ejaculate even after ample sexual stimulation. This is a medical condition known as anorgasmia. Men who regularly experience this problem should see a doctor for diagnosis and treatment. In rare cases, a man may ejaculate in his sleep. This is known as a wet dream. This can be alarming, but it is entirely normal and usually caused by the excitement of a sexy dream.
Causes
When a man achieves orgasm during sexual penetration, muscles in the pelvis and penis contract several times. This causes a flow of semen from the epididymis (the small pouch at the base of the penis that stores or releases sperm) into the urethra, the tube through which urine and semen exit the body. This occurs because of a spinal reflex from the brain that triggers the bulbospongiosus and pubococcygeus muscles. The first phase of ejaculation, called emission, is a brief phase that releases sperm from the epididymis and the testes into the urethra. Emission is controlled by nerves from the autonomic nervous system (a part of the body’s “fight-or-flight” response).
The second phase of ejaculation is called expulsion. This involves muscle contractions that push the semen into the urethra, out of the penis and into the bladder. This is controlled by the same nerves that control orgasm. During this stage, the sperm is mixed with seminal fluid, which consists of water, salts, cellular debris and other nutrients. The number of sperm present in a person’s semen varies from one individual to another.
Some men may have difficulty reaching orgasm, and a few can’t reach it at all. These problems may be caused by psychological or physical factors. They may be a lifelong condition, or they may be the result of injury or surgery. For example, a nerve injury can interfere with arousal and cause delayed or absent ejaculation.
Treatment
In most cases, PE has a psychological cause and can be treated with therapy or medication. Medications, such as the phosphodiesterase-5 inhibitors (sildenafil) sold as Viagra, can help men have more control over when they ejaculate. Behavioral treatment, such as the “squeeze” technique, can also be useful in reducing or stopping premature ejaculation.
When you visit your doctor, be sure to discuss all of the symptoms and details of your PE. Your provider might do a physical exam and may order blood tests to check your hormone levels. In addition, your provider may want to know if you have any other sexual problems or if you are taking any medications.
Some of the treatments that your doctor might recommend include sex therapy or other forms of counseling to improve your sexual confidence and intimacy with your partner, which can lead to better sex performance. Counseling for couples can also help you deal with any emotional or relationship issues that may be causing or contributing to your PE.
If you have retrograde ejaculation, your doctor might ask you to urinate into a cup soon after you reach sexual climax to see if there is sperm present. If so, your doctor might prescribe medicines to treat prostate or urethra problems. He or she might also recommend that you stop drinking alcohol and taking recreational drugs.
Prevention
Premature ejaculation is more common than many people realize, but it can cause problems in intimate relationships. If you’re experiencing PE, it’s important to talk to your doctor as soon as possible. Your doctor can help you determine if your PE is due to a physical or psychological issue and what steps you can take to resolve it.
If your PE is caused by a mental or emotional problem, therapy may help. This can include relationship counseling, sex therapy or thought distraction techniques to reduce anxiety. Talking about your PE with your partner is also a good idea. If your PE is causing strain in your relationship, your doctor can refer you to a sex therapist or a marriage counselor.
There are some medications that can be used to treat PE, but the best treatment is usually behavioral therapy. For example, you might try stimulating yourself until you’re close to ejaculating, then stopping stimulation. You can also try distracting yourself by focusing on nonsexual thoughts, such as naming the players in your favorite sports team or counting to 10. This will help you learn to control your body’s sensations so you don’t ejaculate prematurely. This type of therapy can be combined with medication to get the best results. Eventually, you should be able to have sex without having to worry about your PE.
