What is delayed ejaculation?
Delayed ejaculation — sometimes called impaired ejaculation — is a condition in which it takes an extended period of sexual stimulation for a man to reach sexual climax and release semen from the penis (ejaculate). Some men with delayed ejaculation are unable to ejaculate at all. Delayed ejaculation can be temporary or a lifelong problem.
It’s normal for men to have delayed ejaculation from time to time. Delayed ejaculation is only a problem if it’s ongoing or causes stress for you or your partner.
How common is delayed ejaculation?
Delayed ejaculation can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
What are the symptoms of delayed ejaculation?
Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate.
Often, a man might have difficulty reaching orgasm during sexual intercourse or other sexual activities with a partner. Some men can ejaculate only when masturbating. Or, they may not be able to ejaculate at all (anejaculation).
Delayed orgasm is divided into the following types based on symptoms:
- Lifelong vs. acquired. With lifelong delayed ejaculation, the problem is present from the time a male reaches sexual maturity. Acquired delayed ejaculation occurs after a period of normal sexual functioning.
- Generalized vs. situational. Generalized delayed ejaculation isn’t limited to certain sex partners or certain kinds of stimulation. Situational delayed ejaculation occurs only under certain circumstances.
These categories help in diagnosing an underlying cause, and determining what might be the most effective treatment.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- Delayed ejaculation is an issue for you or your partner
- You have another known health problem that may be linked to delayed ejaculation, or you take medications that could be causing the problem
- You have other symptoms along with delayed ejaculation that may or may not seem related
What causes delayed ejaculation?
Delayed ejaculation can result from certain chronic health conditions, surgeries and medications. Or it may be caused by substance abuse or a mental health concern, such as depression, anxiety or stress. In many cases, delayed ejaculation is due to a combination of physical and psychological concerns.
Physical causes of delayed ejaculation include:
- Certain birth defects affecting the male reproductive system
- Injury to the pelvic nerves that control orgasm
- Certain infections, such as a urinary tract infection
- Prostate surgery, such as transurethral resection of the prostate (TURP) or prostate removal
- Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord
- Hormone-related conditions, such as low thyroid hormone (hypothyroidism) or low testosterone (hypogonadism)
- Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis
Psychological causes of delayed ejaculation include:
- Depression, anxiety or other mental health conditions
- Relationship problems due to stress, poor communication or other concerns
- Anxiety about performance
- Poor body image
- Cultural or religious taboos
- Differences between the reality of sex with a partner and sexual fantasies
Medications and other substances that can cause delayed ejaculation include:
- Some antidepressants
- Certain high blood pressure medications
- Certain diuretics
- Some antipsychotic medications
- Some anti-seizure medications
- Alcohol — particularly drinking too much (alcohol abuse or alcoholism)
For some men, a minor physical problem that causes a delay in ejaculation may cause anxiety about ejaculating during a sexual encounter. The resulting anxiety may worsen delayed ejaculation.
What increases my risk for delayed ejaculation?
There are many risk factors for delayed ejaculation, such as:
- Older age — as men age, it’s normal for ejaculation to take longer
- Psychological conditions, such as depression or anxiety
- Medical conditions, such as diabetes or multiple sclerosis
- Certain medical treatments, such as prostate surgery
- Medications, particularly certain antidepressants, high blood pressure medications or diuretics
- Relationship problems, such as poor communication with your partner
- Alcohol abuse, especially if you’re a long-term heavy drinker
Diagnosis & Treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is delayed ejaculation diagnosed?
But, there’s no specific time that indicates a diagnosis of delayed ejaculation. Instead, a man is probably experiencing delayed ejaculation if the delay is causing him distress or frustration, or if he has to stop sexual activity due to fatigue, physical irritation, loss of erection or a request from his partner.
A physical exam and medical history may be all that’s needed to recommend treatment for delayed ejaculation. However, if delayed ejaculation appears to be caused by an underlying problem that might need treatment, you may need further tests or you may need to see a specialist.
Tests for underlying problems can include:
- Physical exam. This may include careful examination of your penis and testicles. The doctor will use light touch to make sure you have normal sensation in your genitals.
- Blood tests. A sample of your blood may be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health problems.
- Urine tests (urinalysis). Urine tests are used to look for signs of diabetes, infection and other underlying health conditions.
How is delayed ejaculation treated?
Delayed ejaculation treatment depends on the underlying cause, but may include taking a medication or making changes to medications you currently take, undergoing psychological counseling, or addressing alcohol abuse or illegal drug use.
Medications: If you’re taking medication that may be causing delayed ejaculation, reducing the dose of a medication or switching medications may fix the problem. Sometimes, adding a medication may help. There aren’t any drugs that have been specifically approved for the treatment of delayed ejaculation. Medications used to treat delayed ejaculation are used primarily to treat other conditions.
Medications sometimes used to treat delayed ejaculation include:
- Amantadine (Parkinson’s)
- Buspirone (antianxiety)
- Cyproheptadine (allergy)
Psychological counseling (psychotherapy): Psychotherapy can help by addressing underlying mental health problems leading to delayed ejaculation, such as depression or anxiety. It’s also used to address psychological issues that directly affect your ability to ejaculate.
Counseling may involve seeing a psychologist or mental health counselor on your own, or along with your partner. Depending on the underlying cause, you may benefit most from seeing a sex therapist — a mental health counselor who specializes in talk therapy for sexual problems. The type of counseling that’s best for you will depend on your particular concerns.
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage delayed ejaculation?
If it’s an ongoing concern, delayed ejaculation can cause mental and emotional stress for a man and his partner. If you have delayed ejaculation only on occasion, try not to assume that you have a permanent problem or to expect it to happen again during your next sexual encounter. Remember, occasional delayed ejaculation due to stress or other temporary factors may improve when the underlying cause gets better.
In addition, if you experience occasional or persistent delayed ejaculation, it’s important to reassure your sexual partner. Your partner may think your inability to reach climax is a sign of diminished sexual interest.
Communicate openly and honestly with your partner about your condition. Treatment is often more successful if couples work together as a team. You may even want to see a counselor with your partner. This can help you address concerns you both may have about delayed ejaculation.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Delayed ejaculation. http://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/basics/definition/con-20034981. Accessed 2 Mar, 2017.
Delayed Ejaculation. http://www.healthline.com/health/delayed-ejaculation#1. Accessed 2 Mar, 2017.
Delayed ejaculation. https://medlineplus.gov/ency/article/001954.htm. Accessed 2 Mar, 2017.
Review Date: March 2, 2017 | Last Modified: September 13, 2019