Delayed Ejaculation: Longer lasting is not always better

By Dr. Raymond Zakhari

Overview

Delayed ejaculation — formerly known as retarded ejaculation — is a condition in which it seems like an extended period of sexual stimulation is required orgasm (climax) and ejaculate. Treating delayed ejaculation depends on the underlying cause (chronic health conditions, surgeries and medications).

Delayed ejaculation is only a problem if it is distressing to you or your partner. It is most common for delayed ejaculation to be a temporary problem.

Symptoms

Men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate. There is no specific time that indicates a diagnosis of delayed ejaculation. The delay must cause distress or frustration, or if you have to stop sexual activity due to fatigue, physical irritation, loss of erection or a request from your partner.

The type of delayed ejaculation is often classified based on symptoms:

  • Lifelong vs. acquired.Lifelong delayed ejaculation means the problem began from the time or very early on in adolescence. Acquired delayed ejaculation occurs after a period of normal sexual functioning.
  • Generalized vs. situational.Generalized delayed ejaculation isn’t limited to a specific sex partner(s) or act. Situational delayed ejaculation occurs only under specific circumstances.

These categories help in identifying an underlying cause and determining what might be the most effective treatment.

When to seek help

Your primary care provider is a good place to start when you have delayed ejaculation. If:

  • Delayed ejaculation is an issue for you or your partner
  • You have another known health problem that might be linked to delayed ejaculation, or you take medications that could be causing the problem
  • You have other symptoms along with delayed ejaculation that might or might not seem related

What causes delayed ejaculation?

Certain medications, chronic health conditions and surgeries can cause delayed ejaculation. Delayed ejaculation can also be caused by drug and alcohol misuse, abuse, or addiction. Often underlying mental health disorders such as depression, anxiety can cause delayed ejaculation. Often delayed ejaculation can also cause depression and anxiety which creates a self-perpetuating problem.

Mental health related factors 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
    • Pornography use
    • Masturbation pattern

Medications and substances that can cause delayed ejaculation include:

  • Psychiatric Medications
  • Blood pressure medications
  • Seizure medications
  • Alcohol and opioid use

Medical causes of delayed ejaculation include:

  • Certain birth defects affecting the male reproductive system
  • Pelvic nerve injury
  • Infections
  • Urologic surgery
  • Neurological diseases
  • Endocrine (Hormone-related conditions)

It is common for men to feel anxious or depressed regarding any sexual dysfunction such as delayed ejaculation. For some men, a minor physical problem that causes a delay in ejaculation might cause anxiety about ejaculating during a sexual encounter. The resulting anxiety might worsen delayed ejaculation.

General Risk factors for delayed ejaculation:

A number of other things can increase a man’s risk of having delayed ejaculation, including:

  • Older age — as men age, it’s normal for ejaculation to take longer
  • Temporary Psychological conditions, such as depression or anxiety (even related to life events, new job, loss of job, birth of child, meddling in-laws)
  • Acute and chronic medical conditions and surgical recovery phases
  • Relationship problems, such as poor communication with your partner, or recovering from or engaging in infidelity

What happens if you do nothing?

Complications of delayed ejaculation can include:

  • Possible less sexual pleasure for you and your 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)

The most common and effective treatment involve talk therapy and behavioral interventions homework which are done in the privacy of your own home.