and Addressing Ejaculation Issues: Causes and Solutions

Ejaculatory dysfunction: Issues and Solutions

Hello doctor, I have been masturbating since the sixth grade until the second year of high school.
I remember that only the first time I ejaculated, and afterward, I only experienced fluid release during masturbation.
Is this related to having a long foreskin (a doctor previously told me I have phimosis)? I am also overweight; could this be related to a lack of exercise? If I want to improve this situation, what changes should I make? Thank you, doctor, for your hard work.

Yu, 10~19 year old female. Ask Date: 2019/12/07

Dr. Du Shixi reply Urology

Hello; If the foreskin covers the glans even when erect, there may be a possibility of discharge.
Factors such as obesity, lack of exercise, and weak pelvic muscles can contribute to this condition.
It is advisable to seek medical attention to confirm the situation.
As for what you can do on your own, engaging in exercise, particularly pelvic floor training, is recommended, but it should be increased gradually to avoid overexertion.
Wishing you good health.

Reply Date: 2019/12/07

More Info

Ejaculation issues can be a complex topic, often influenced by a variety of physical, psychological, and lifestyle factors. Based on your description, it seems you have concerns regarding your ejaculation process, particularly the difference between your first experience and subsequent ones, as well as the potential impact of a medical condition like phimosis (the medical term for a condition where the foreskin cannot be easily retracted over the glans of the penis).

Understanding the Causes
1. Phimosis: If you have been diagnosed with phimosis, it could indeed affect your ejaculation. When the foreskin is too tight, it can lead to discomfort during sexual activity or masturbation, potentially impacting the ejaculation process. In some cases, phimosis can lead to a condition known as "retained ejaculation," where the semen does not exit the body as expected.

2. Obesity and Physical Fitness: Being overweight can contribute to various health issues, including hormonal imbalances that may affect sexual function. Lack of physical activity can also lead to decreased blood flow and overall health, which can impact sexual performance and ejaculation.

3. Psychological Factors: Anxiety, stress, and other psychological factors can significantly affect sexual performance. If you have concerns about your body image or sexual function, these feelings can create a cycle of anxiety that may further complicate the issue.

Solutions and Recommendations
1. Consult a Urologist: The first step in addressing your concerns should be to consult a urologist. They can provide a thorough examination and determine if your phimosis is contributing to your ejaculation issues. Depending on the severity, treatment options may include topical steroids to help retract the foreskin or, in more severe cases, a circumcision.

2. Weight Management: If you are overweight, consider adopting a healthier lifestyle that includes a balanced diet and regular exercise. Weight loss can improve overall health, increase testosterone levels, and enhance sexual function. Aim for at least 150 minutes of moderate aerobic activity each week, along with strength training exercises.

3. Pelvic Floor Exercises: Strengthening your pelvic floor muscles can improve sexual function and ejaculation control. Kegel exercises, which involve contracting and relaxing the muscles used to stop urination, can be beneficial.

4. Psychological Support: If anxiety or stress is a concern, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can help address any underlying psychological issues that may be affecting your sexual health.

5. Education and Communication: Educating yourself about sexual health and communicating openly with partners can alleviate anxiety and improve sexual experiences. Understanding that variations in ejaculation are common can also help reduce pressure.

6. Avoiding Substances: Limit alcohol and avoid recreational drugs, as these can negatively impact sexual performance.

Conclusion
Ejaculation issues can stem from a variety of causes, including physical conditions like phimosis, lifestyle factors such as obesity, and psychological influences. By consulting a healthcare professional, adopting a healthier lifestyle, and addressing any psychological concerns, you can work towards improving your sexual health and overall well-being. Remember, it’s essential to approach this topic with openness and seek the support you need.

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