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.
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 . 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
- 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.
Causes of 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
- Prostate surgery, such as transurethral resection of the prostate (TURP) or prostate removal
- Heart disease
- Prostate infection or urinary tract infection
- 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
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
- 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:
- Most types of antidepressants
- Certain high blood pressure medications
- Certain diuretics
- Some antipsychotic 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 can worsen delayed ejaculation.
When to see a doctor
Your family doctor is a good place to start when you have delayed ejaculation. See your doctor if:
- 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.