Delayed Ejaculation

Delayed ejaculation, also known as impaired ejaculation, is an experience when it takes an extended period of sexual stimulation for a guy to reach sexual climax and release semen from the penis or ejaculate.

Some men with delayed ejaculation report that they are completely unable to ejaculate but do experience orgasmic sensation.

It is not uncommon for a man to experience delayed ejaculation at some point in their life, the ‘concern’ is if the condition is ongoing and more importantly if it is affecting your sex life in ways that are unfulfilling you and/or your partner.

How long is too long?

This is a common question, and it is like asking “how long is a piece of string” – we tend to benchmark that a person who takes more than 30-minutes of constant sexual stimulation to ejaculate may be living with delayed or impaired ejaculation.

But it is important to note - there's no specific time that indicates a diagnosis of delayed ejaculation. Instead, you are probably experiencing delayed ejaculation if the delay is causing distress or frustration, or if you must stop sexual activity due to fatigue, physical irritation, loss of erection or even a request from your partner.

Clinical we tend to explore delayed or impaired ejaculation within the following types based on symptoms:

Lifelong vs. acquired. With lifelong delayed ejaculation, the problem is present from the time of 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.

SOURCE: The above comparatives are sourced from The Mayo Clinic, 2020

By exploring these categories, it helps in diagnosing an underlying cause and hence determining what might be the most effective treatment path.

So, what really causes it?

Once again this is a pretty broad question, as each man has his own life experience where this condition presents itself. The good thing is generallty it is a symptom of another challenge so once we can identify what the source of the challentge is we are able to better find solution.

For some guys it can be a result from medications, certain chronic health conditions and surgeries. For others it might be caused by substance misuse or a mental health concern, such as depression, anxiety or stress.

We tend to find for many cases, it is due to a combination of physical and psychological concerns; for example, a illness or injury might result in a delay in ejaculation – then anxiety and fear kick in resulting in the mind over matter where our brain creates a problem; but some guidelines on what can be the source of the problem are…

Psychological causes may 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

Medications and other substances that can cause delayed ejaculation are:

Some antidepressants
Certain high blood pressure medications
Certain diuretics
Some antipsychotic medications
Some anti-seizure medications
Alcohol — particularly drinking too much (excessive alcohol use or alcoholism)

Physical causes of delayed ejaculation include:

Certain birth defects affecting the male reproductive system
Injury to the pelvic nerves that control orgasm
Certain infections, such as a urinary tract infection
Prostate surgery, such as transurethral resection of the prostate or prostate removal
Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord
Hormone-related conditions, such as low thyroid hormone level (hypothyroidism) or low testosterone level (hypogonadism)
Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis