Delayed ejaculation
Medically Reviewed by Dr Aifric Boylan
Last updated on 24.07.2024
Ejaculation is the act of semen and sperm exiting the penis during orgasm, a natural phenomenon culminating from sexual pleasure. Sometimes ejaculation can be quicker than desired (premature ejaculation), and sometimes it can go the opposite way (retrograde ejaculation). In today’s article, we discuss when ejaculation is delayed or not achieved at all.
Ejaculation is considered delayed if it takes over about 25-30 minutes. Generally, it is considered delayed if you desire it to be faster.
Orgasm and ejaculation are linked. You can only ejaculate if you orgasm; however, you can orgasm without ejaculating. This means that with delayed ejaculation, orgasms are also delayed.
Prevalence and symptoms
Most men with delayed ejaculation have it intermittently. However, a smaller subset of men who develop it have it long-term. The number of affected men is unknown, but is thought to be at least 2% of the population.
Delayed ejaculation often does not have other symptoms. However, it can be distressing and can lead to anxiety, stress, and mood changes. It can also affect intimate relationships, which can worsen the psychological component. The lack of orgasms also means sexual pleasure is not being achieved.
Delayed ejaculation is not bad for your physical health and is not associated with any life-threatening conditions.
Causes of delayed ejaculation
- Psychological factors. It can be complex to define a specific underlying cause for delayed ejaculation. It can involve performance anxiety, nervous excitement, fear of pregnancy, fear of sexually transmitted infections, non-sexual stressors such as health or financial issues, and religious or cultural taboos around sex.
- Medical conditions. Spinal or pelvic nerve damage, previous genital surgery, hormonal imbalances and prostatitis.
- Medications. Antidepressants, blood pressure medicines, opioids and antipsychotics.
- Other chemical substances. Alcohol, cocaine, MDMA and amphetamines.
Diagnosis and treatment
The diagnosis is made by consultation with your doctor, who may conduct a medical examination to look for an underlying condition. They may also suggest blood and urine tests.
Treatment of delayed ejaculation depends on the underlying cause. If there is an obvious cause, such as the recent commencement of an antidepressant, then changing medication or ceasing it with the assistance of your doctor is recommended if the delayed ejaculation is causing distress. If it is not distressing, then no treatment is necessary, particularly if the new medication is having other benefits.
- Medications. Sometimes medications such as sildenafil (Viagra) can be tried for delayed ejaculation, but this medication is primarily used for erectile dysfunction.
- Psychological treatment. As most delayed ejaculation is psychological, the primary treatment is psychotherapy to address the underlying triggers. This is best done with a psychologist, a therapist, or a counselor who is comfortable and skilled at talking about sexual issues.
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