Although many men don’t wish to talk about it, delayed ejaculation (DE) is a common medical condition. Also called impaired ejaculation, this condition occurs when it takes a prolonged period of sexual stimulation before ejaculation. In some cases, ejaculation cannot be achieved at all. Most men experience DE from time to time, while for others this may be a lifelong problem.
While this condition does not pose any serious medical risks, it can be a source of stress and may create problems with your sex life and/or relationships. However, treatments are available. Talk to your doctor if DE is creating significant problems in your personal life.
There are many potential causes of DE, including psychological hang-ups, chronic health conditions, and reactions to medications.
Psychological causes for DE can occur due to a traumatic experience regarding sex. Cultural or religious taboos can give sex a negative connotation. Anxiety and depression can both suppress sexual desire, which may result in DE as well.
Relationship stress, poor communication, and anger can make DE worse. Disappointment in sexual realities with a partner compared to sexual fantasies can also result in DE. Often, men with this problem can ejaculate during masturbation, but not during stimulation with a partner.
Certain chemicals can affect the nerves involved in ejaculation. This can affect ejaculation with and without a partner. Medications such as antidepressants (Prozac), antipsychotics (Mellaril), high blood pressure medications (guanethidine), diuretics, and alcohol can all cause DE.
Surgeries or trauma may also cause temporary DE. Physical causes of DE may include:
- damage to nerves in the spine or pelvis
- certain prostate surgeries that cause nerve damage
- heart disease that affects blood pressure to the pelvic region
- infections, especially prostate or urinary infections
- neuropathy (nerve damage) or stroke
- low thyroid hormone and low testosterone levels
- birth defects that impair the ejaculation process
A temporary ejaculation problem can give a man a lot of anxiety. This anxiety can cause the problem to recur, even when the underlying physical cause has been resolved.
Delayed ejaculation occurs when a man requires more than 30 minutes of sexual stimulation to orgasm and ejaculate. Ejaculation is when semen is discharged from the penis. Some men can only ejaculate with manual or oral stimulation. Some men cannot ejaculate at all.
A lifelong problem with DE is very different from an acquired problem later in life. Some men have a generalized problem in which DE occurs in all sexual situations. For other men, it may only occur with certain partners or in certain circumstances.
If you feel that this condition is a significant problem, you should see your doctor. In some cases, DE may be a sign of a worsening health problem, such as heart disease or diabetes.
A physical examination and explanation of your symptoms are necessary to make an initial determination. If a chronic health problem is suspected, more testing may need to be done. This includes blood and urine tests for infections, hormonal imbalances, etc.
Testing the reactions of the penis to a vibrator may reveal if the problem is psychological or physical.
Treatment will depend on the suspected underlying cause.
For lifelong problems or for a man who has never ejaculated, you may need to see an urologist to see if you have a structural birth defect. If medication may be the cause of sexual dysfunction, talk to your physician about not taking that medication.
Some drugs have been used to attempt to help with DE, but no drug has been specifically approved for this use. According to the Mayo Clinic, a drug to treat Parkinson’s disease (amantadine), an antianxiety drug (buspirone), and an allergy drug (cyproheptadine) have been tried (Mayo Clinic, 2012).
Treating illicit drug use and alcoholism can also help DE problems.
Psychological counseling can help treat the depression, anxiety, and fears that trigger DE. Sex therapy may also be useful in addressing the underlying cause of sexual dysfunction. This type of therapy may be completed alone or with your partner.
The long-term outlook for DE will depend on treating the underlying cause. According to the National Library of Medicine (NLM), therapy has a 70 to 80 percent success rate in treating psychological issues and stresses (NLM, 2011).
If a medication is causing your problem, changing that medication can lead to a full recovery.
Nerve damage may result in difficulties regaining sexual function. A sex therapist can help with these issues as well.
DE can cause conflict in a relationship. Treatment or counseling can help resolve these issues.
Other complications may include:
- decreased sexual pleasure
- anxiety about sex
- inability to conceive (male infertility)