Is Delayed Ejaculation (DE)?
Delayed ejaculation (DE) is a common medical condition. Also
called “impaired ejaculation,” this condition occurs when it takes a prolonged
period of sexual stimulation for a man to ejaculate. In some cases, ejaculation
cannot be achieved at all. Most men experience DE from time to time, but for
others this may be a lifelong problem.
While this condition does not pose any serious medical risks, it
can be a source of stress and may create problems in your sex life and personal
relationships. However, treatments are available.
Are the Symptoms of Delayed Ejaculation?
Delayed ejaculation occurs when a man needs more than 30 minutes
of sexual stimulation to reach orgasm and ejaculate. Ejaculation is when semen
is discharged from the penis. Some men can only ejaculate with manual or oral
stimulation. Some men cannot ejaculate at all.
A lifelong problem with DE is very different from a problem that
develops later in life. Some men have a generalized problem in which DE occurs
in all sexual situations. For other men, it may only occur with certain
partners or in certain circumstances. This is known as “situational delayed
In rare cases, DE may be a sign of a worsening health problem,
such as heart disease or diabetes.
Causes Delayed Ejaculation?
There are many potential causes of DE, including psychological concerns,
chronic health conditions, and reactions to medications.
Psychological causes for DE can occur due to a traumatic
experience. Cultural or religious taboos can give sex a negative connotation.
Anxiety and depression can both suppress sexual desire, which may result in DE
Relationship stress, poor communication, and anger can make DE
worse. Disappointment in sexual realities with a partner compared to sexual
fantasies can also result in DE. Often, men with this problem can ejaculate
during masturbation but not during stimulation with a partner.
Certain chemicals can affect the nerves involved in ejaculation.
This can affect ejaculation with and without a partner. These medications can
all cause DE:
- antidepressants, such as fluoxetine (Prozac)
- antipsychotics, such as thioridazine (Mellaril)
- medications for high blood pressure, such as
Surgeries or trauma may also cause DE. The physical causes of DE
- damage to the nerves in your spine or pelvis
- certain prostate surgeries that cause nerve
- heart disease that affects blood pressure to the
- infections, especially prostate or urinary
- neuropathy (nerve damage) or stroke
- low thyroid hormone
- low testosterone levels
- birth defects that impair the ejaculation
A temporary ejaculation problem can potentially cause anxiety and
depression. These conditions can cause the problem to recur, even when the
underlying physical cause has been resolved.
Is Delayed Ejaculation Diagnosed?
A physical examination and explanation of your symptoms are
necessary to make an initial determination. If a chronic health problem is
suspected, more testing may need to be done. This includes blood tests and
These tests will look for infections, hormonal imbalances, and
more. Testing the reaction of your penis to a vibrator may reveal if the
problem is psychological or physical.
Treatments Are Available for Delayed Ejaculation?
Treatment will depend on the underlying cause. If you’ve had
lifelong problems or you’ve never ejaculated, a urologist can determine if you
have a structural birth defect.
Your physician can determine if a medication is the cause. If so,
adjustments will be made to your medication regimen and your symptoms will be
Some medications have been used to help with DE, but no
medication has been specifically approved for this use. According to the Mayo
Clinic, there are a few medications used to treat DE. They include:
- cyproheptadine (Periactin), which is an allergy
- amantadine (Symmetrel), which is a drug used to
treat Parkinson’s disease
- buspirone (Buspar), which is an anti-anxiety
Treating illicit drug use and alcoholism, if applicable, can also
help DE problems. Finding inpatient or outpatient recovery programs is one
Psychological counseling can help treat depression, anxiety, and
fears that trigger or perpetuate DE. Sex therapy may also be useful in
addressing the underlying cause of sexual dysfunction. This type of therapy may
be completed alone or with your partner.
DE can generally be resolved by treating the mental or physical
causes. Identifying and seeking treatment for DE sometimes exposes another
underlying medical condition. Once this is treated, DE often resolves as well.
The same is true when the underlying cause is a medication. However, don’t stop
taking any medication without your doctor’s recommendation.
Are the Complications of Delayed Ejaculation?
DE can cause problems with self-esteem. According to the Boston
University School of Medicine, DE can cause feelings of inadequacy,
failure, and negativity. Men who experience the condition may avoid intimacy
with others due to frustrations and fear of failure.
Other complications may include:
- decreased sexual pleasure
- anxiety about sex
- inability to conceive, or male infertility
- low libido
- stress and anxiety
DE can also cause conflicts in your relationships, often stemming
from misunderstandings on the part of both partners. For example, your partner
might feel that you’re not attracted to them. You might feel frustrated or
embarrassed about wanting to achieve ejaculation but being physically or
mentally unable to do so. Treatment or counseling can help resolve these
issues. By facilitating open, honest communication, understanding can often be
Can I Expect in the Long Term?
There are many possible causes of DE. Regardless of the cause,
treatments are available. Don’t be embarrassed or afraid to speak up. The condition
is very common. By asking for help, you can get the psychological and physical
support needed to address the issue and enjoy a more fulfilling sex life.