Although knowledge of the neurophysiology and neuropharmacology of ejaculation has increased in the last decade, our understanding of the pathophysiology of the different types of ejaculatory dysfunction (EjD) remains limited. Epidemiological studies provide strong evidence of a relationship between lower urinary tract symptoms (LUTS) and EjD in aging men. Clinical trial results indicate that treatments for LUTS suggestive of benign prostatic hyperplasia (BPH) can be associated with EjD side effects. The present article provides an overview of current knowledge on the physiology of ejaculation, possible common pathophysiologic mechanisms for EjD and LUTS, with a focus on LUTS/BPH, and the effects of different BPH treatments on ejaculation.