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Of the male sexual dysfunction resulting from diabetes mellitus, significant focus is afforded to erectile dysfunction. Nevertheless, ejaculatory dysfunction constitutes important sexual sequelae in diabetic men, with up to 35%\u201350% of men with diabetes mellitus suffering from ejaculatory dysfunction. Despite this, aspects of its pathophysiology and treatment are less well understood than erectile dysfunction. The main disorders of ejaculation include premature ejaculation, delayed ejaculation, anejaculation and retrograde ejaculation.<\/jats:p><jats:p>Although ejaculatory dysfunction in diabetes mellitus can have complex multifactorial aetiology, understanding its pathophysiological mechanisms has facilitated the development of therapies in the management of ejaculatory dysfunction. Most of our understanding of its pathophysiology is derived from diabetic animal models; however, observational studies in humans have also provided useful information in elucidating important associative factors potentially contributing to ejaculatory dysfunction in diabetic men. These have provided the potential for more tailored treatment regimens in patients depending on the ejaculatory disorder, other co\u2010existing sequelae of diabetes mellitus, specific metabolic factors as well as the need for fertility treatment.<\/jats:p><jats:p>However, evidence for treatment of ejaculatory dysfunction, especially delayed ejaculation and retrograde ejaculation, is based on low\u2010level evidence comprising small sample\u2010size series and retrospective or cross\u2010sectional studies. Whilst promising findings from large randomised controlled trials have provided strong evidence for the licensed treatment of premature ejaculation, similar robust studies are needed to accurately elucidate factors predicting ejaculatory dysfunction in diabetes mellitus, as well as for the development of pharmacotherapies for delayed ejaculation and retrograde ejaculation. Similarly, more contemporary robust data are required for fertility outcomes in these patients, including methods of sperm retrieval and assisted reproductive techniques in retrograde ejaculation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13262","type":"journal-article","created":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T16:24:11Z","timestamp":1659889451000},"page":"379-398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Understanding and treating ejaculatory dysfunction in men with diabetes mellitus"],"prefix":"10.1111","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5390-8915","authenticated-orcid":false,"given":"Ankit","family":"Desai","sequence":"first","affiliation":[{"name":"Department of Andrology Imperial Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runzhi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Andrology Imperial Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Cayetano","sequence":"additional","affiliation":[{"name":"Department of Andrology Imperial Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Channa N.","family":"Jayasena","sequence":"additional","affiliation":[{"name":"Department of Reproductive Endocrinology Imperial Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suks","family":"Minhas","sequence":"additional","affiliation":[{"name":"Department of Andrology Imperial Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v12.i7.954"},{"key":"e_1_2_8_3_1","unstructured":"WHO.Diabetes[Online]. 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