Delayed ejaculation (impaired ejaculation)

What is Delayed Ejaculation?
Delayed ejaculation (impaired ejaculation) is a condition where it takes an extended period of sexual stimulation to reach climax and release semen. Some men are unable to ejaculate at all.

It is considered a medical issue only if it is ongoing and causes distress for you or your partner. Occasional delay is normal.

Symptoms & Types

Men with this condition may need 30 minutes or more of stimulation to orgasm. In many cases, a man cannot reach orgasm during intercourse but can ejaculate with oral or manual stimulation.

Doctors classify the condition into categories:

• Lifelong vs. Acquired: "Lifelong" means the problem has existed since sexual maturity. "Acquired" means it started after a period of normal sexual function.
• Generalized vs. Situational: "Generalized" happens in all sexual situations. "Situational" happens only under certain circumstances (e.g., with a partner but not during masturbation).

Causes

The cause is often a mix of physical and psychological factors.

1. Medications (Common)

Many prescription drugs can block the nerve signals required for ejaculation:

• Antidepressants: Particularly SSRIs (Selective Serotonin Reuptake Inhibitors).
• Blood Pressure Meds: Certain diuretics and high blood pressure drugs.
• Antipsychotics: Medications used for mental health conditions.
• Painkillers: Long-term use of strong pain medications.

2. Physical Health

• Nerve Damage: From diabetes, stroke, or spinal cord injury.
• Hormones: Low testosterone or thyroid issues (hypothyroidism).
• Surgery: Procedures involving the prostate (like TURP).
• Age: Sensitivity naturally decreases with age.

3. Psychological Factors

• Performance Anxiety: Worrying about taking too long can actually make it take longer.
• Depression & Anxiety: Both the condition and the meds used to treat it can dampen libido.
• Relationship Issues: Poor communication or loss of attraction.

Complications

While not physically dangerous, the condition can lead to:

• Relationship Stress: Partners often feel inadequate, thinking they aren't "attractive enough" to cause an orgasm.
• Male Infertility: Difficulty conceiving if ejaculation cannot occur during intercourse.
• Sexual Avoidance: Stopping sexual activity due to frustration or fatigue.

Diagnosis

A physical exam and review of your medications are the first steps. Doctors may check:

• Sensation: Testing for normal feeling in the genitals.
• Blood Tests: Checking for diabetes or low testosterone.

Treatment

Treatment depends entirely on the root cause.

1. Medication Management

If an antidepressant is the cause, your doctor might reduce the dose or switch you to a different type (like Bupropion) that has fewer sexual side effects.

⚠️ WARNING
Never stop taking your mental health medication without consulting your doctor. Sudden withdrawal can be dangerous.

2. Psychological Counseling

• Sex Therapy: Addressing performance anxiety and differences between sexual fantasy and reality.
• Couples Counseling: Improving communication to reduce the partner's feeling of inadequacy.

3. Off-Label Medications

While no drug is specifically approved for this, doctors sometimes prescribe medications like Amantadine or Buspirone to help restore chemical balance and improve function.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.