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. Possible causes of delayed ejaculation include certain chronic health conditions, surgeries and medications. Treatment for delayed ejaculation depends on the underlying cause.
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.
SYMPTOMS
Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or they may not be able to ejaculate at all (anejaculation). In the most common form of delayed ejaculation, a man can't reach orgasm during sexual intercourse — but can ejaculate with oral or manual stimulation of the penis. Some men can ejaculate only when masturbating.
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.
CAUSES
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 systemInjury to the pelvic nerves that control orgasmCertain infectionsProstate surgery, such as transurethral resection of the prostate (TURP) or prostate removalHeart diseaseProstate infection or urinary tract infectionNeurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cordHormone-related conditions, such as low thyroid hormone (hypothyroidism) or low testosterone
Psychological causes of delayed ejaculation include:
Depression, anxiety or other mental health conditionsRelationship problems due to stress, poor communication or other concernsAnxiety about performanceCultural or religious taboosDifferences between the reality of sex with a partner and sexual fantasies
Medications and other substances that can cause delayed ejaculation include:
Most types of antidepressantsCertain high blood pressure medicationsCertain diureticsSome antipsychotic medicationsAlcohol — 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 can worsen delayed ejaculation.
COMPLICATIONS
Complications of delayed ejaculation can include:
Diminished sexual pleasure for a man or his partner,Stress or anxiety about sexual performance, Marital or relationship problems due to an unsatisfactory sex life, Inability to get your partner pregnant (male infertility)
DIAGNOSIS
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.
TREATMENT
To find the best treatment for you, the doctor will first need to determine whether your delayed ejaculation is due to an underlying medical condition, a psychological issue or another concern. 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
Medication may be a treatment option, particularly if you're taking an antidepressant that's causing the problem. Sometimes reducing the dose of a medication or switching medications may help. In some cases, adding a medication may do the trick. 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.
It 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.
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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.
SYMPTOMS
Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or they may not be able to ejaculate at all (anejaculation). In the most common form of delayed ejaculation, a man can't reach orgasm during sexual intercourse — but can ejaculate with oral or manual stimulation of the penis. Some men can ejaculate only when masturbating.
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.
CAUSES
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 systemInjury to the pelvic nerves that control orgasmCertain infectionsProstate surgery, such as transurethral resection of the prostate (TURP) or prostate removalHeart diseaseProstate infection or urinary tract infectionNeurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cordHormone-related conditions, such as low thyroid hormone (hypothyroidism) or low testosterone
Psychological causes of delayed ejaculation include:
Depression, anxiety or other mental health conditionsRelationship problems due to stress, poor communication or other concernsAnxiety about performanceCultural or religious taboosDifferences between the reality of sex with a partner and sexual fantasies
Medications and other substances that can cause delayed ejaculation include:
Most types of antidepressantsCertain high blood pressure medicationsCertain diureticsSome antipsychotic medicationsAlcohol — 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 can worsen delayed ejaculation.
COMPLICATIONS
Complications of delayed ejaculation can include:
Diminished sexual pleasure for a man or his partner,Stress or anxiety about sexual performance, Marital or relationship problems due to an unsatisfactory sex life, Inability to get your partner pregnant (male infertility)
DIAGNOSIS
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.
TREATMENT
To find the best treatment for you, the doctor will first need to determine whether your delayed ejaculation is due to an underlying medical condition, a psychological issue or another concern. 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
Medication may be a treatment option, particularly if you're taking an antidepressant that's causing the problem. Sometimes reducing the dose of a medication or switching medications may help. In some cases, adding a medication may do the trick. 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.
It 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.
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