Delayed Ejaculation: Causes, Symptoms, & Treatment

Delayed Ejaculation: Causes, Symptoms, & Treatment
Steve Hinson, PhD - Life Sciences Published : Feb 04, 2024 Last Updated : Feb 07, 2024

What is Delayed Ejaculation?

Delayed ejaculation, or impaired ejaculation, is a common sexual problem. It occurs when a man takes a prolonged period of sexual stimulation to ejaculate. Sometimes, a man can't even ejaculate, despite having enough sexual stimulation and arousal. 

It appears occasionally in some men and some struggle with it for life. Such sexual issue usually does not pose any serious medical risks in men. But the condition can lead to frustration, stress, and difficulties in sexual relationships. However, there is nothing to worry about; treatments available for DE then can help improve the sex life of a man. 

Symptoms of Delayed Ejaculation

When a man needs more than 30 minutes of sexual stimulation to reach orgasm and ejaculate, it is a symptom of Delayed ejaculation. Ejaculation is the discharge of semen from the penis. To proceed with an ejaculation, some men only respond to manual or oral stimulation, while some cannot ejaculate at all. 

Facing a lifelong issue of DE is very different if compared with DE, which develops later in life. It becomes a generalized problem for someone dealing with it from the day first. 

In some men, Delayed ejaculation occurs in all sexual situations. 

While others have different situations, it may occur with certain partners or in certain situations. Such impaired ejaculation is generally known as “situational delayed ejaculation.”

In some men, Delayed ejaculation can be a sign of worsening health issues such as diabetes or heart disease. 

What causes Delayed ejaculation?

Many potential causes can lead to the condition, like Delayed ejaculation(DE). It may include psychological concerns, chronic health problems and the use of certain medications. 

The Psychological cause of DE can be a traumatic experience that may affect a man mentally and emotionally. Some religious and cultural taboos may have negative connotations about sex. And these circumstances may contribute to anxiety and depression, which may suppress sexual desire and result in DE. 

Poor communication among partners, relationship stress and anger can worsen DE. Feeling let down by sex, fantasies, or expectations can lead to DE. Often, in such cases, men can ejaculate during masturbation but not during stimulation with their partner. 

Moreover, certain medications may also affect the nerves involved in ejaculation. The effects due to such chemicals may affect your ejaculation with or without a partner. Here are some medications that may have a potential risk for DE-

  • Antipsychotic drugs such as thioridazine(Mellaril)
  • Diuretics
  • Antidepressants such as Fluoxetine(Prozac)
  • High blood pressure medications such as Propranolol(Inderal)
  • Alcohol

Undergoing surgeries or trauma may also cause the problem of Delayed ejaculation. Some of the physical causes that cause DE include-

  • Nerve damage due to prostate surgeries
  • Infections, especially prostate or urinary infections
  • Low thyroid hormone
  • Having congenital disabilities that impair the ejaculation process
  • Damage to the nerves in your spine or pelvis
  • Heart conditions that affect blood pressure in your pelvic region
  • Neuropathy or stroke
  • Low testosterone levels

Anxiety and depression, like psychological conditions, can cause temporary DE problems. This condition may cause a recurrence of DE, even if you have resolved the underlying physical for DE. 

How is Delayed ejaculation diagnosed?

You may need to explain the symptoms that you are facing, and the doctor may do a physical examination. These are some initial steps for diagnosing the condition. If chronic health problems are the underlying cause of your DE, then more testing may need. They may conduct blood tests or urine tests for it. These tests will look for infections, hormonal imbalances and other causes. They will also determine whether its cause is physical, psychological, or a combination. 

Depending on the causes, the doctor may suggest the best treatment available. Below are some tips that you prepare before you book an appointment with a doctor. 

Tips before you book an appointment

Prepare yourself for an appointment. These are something things you may keep in mind before consulting with a doctor-

  • Write down the symptoms you are dealing with. 
  • Add your personal information in it, for example, if you have other problems like stress, recent life challenges, illness, or taking any medications.
  • Make a list of all medications that you are taking, including vitamins, herbal remedies and supplements.
  • You can take your partner along if possible. Your partner may help in providing the information according to their vision. It will help diagnose and treat the problem by underlying its symptoms and causes. 
  • Also, write down questions that you want to ask your doctor. 

Complications due to Delayed ejaculation

DE may lead to psychological problems and may lower your self-esteem. A man can have feelings of negativity, failure, sexual anxiety, and inadequacy. Such a condition may make a person avoid intimacy due to fear of failure and frustration. 

Complications that DE may cause include-

  • Anxiety about sex
  • Low libido
  • Decrease sexual pleasure
  • Unable to conceive or male infertility
  • Stress and anxiety

There can be relationship conflicts or failure of relationships due to DE. Poor communication among couples may cause misunderstanding and negative influence due to such sexual issues.

For example, your partner might feel that you are not attracted to them or do not feel the way they feel for you. It may make you frustrated and embarrassed about wanting your part in sexual intimacy. 

Counselling, talk therapy and treatment may help resolve these issues. Honest communication and coming forward to discuss the issue might help better understand the partner. It may bring a different view of the problem and make things easier to deal with. 

 Treatments for Delayed Ejaculation

Treatment usually depends on the underlying cause of DE. If you're dealing with a lifelong issue with ejaculation, then you must talk to a urologist. In such conditions, congenital disabilities like circumstances may lead to such conditions. 

Your doctor may determine medication depending on the causes. So go for the test recommended to you and take the treatments as an expert advises. 

Some medications that may help in treating DE include-

These medications are not approved for treating DE, but this drug may help treat the root causes of DE. 

If low testosterone contributes to DE, then low testosterone supplements may help fix this sexual issue.

Taking illicit drugs and alcoholism may also contribute to DE. The best way to figure out these issues is to stop their use with the help of therapy or on your own. 

You must seek counselling if dealing with DE due to psychological conditions. Take sex therapy alone or with a partner to address the underlying cause and have a better sex life. 

What can I expect in the long-term DE?

As you have read, there can be many possible causes for Delayed Ejaculation(DE). Depending on the cause, treatments are available, and you should not be afraid or embarrassed to speak with an expert about it. It is among the common sexual problems that many men are dealing with. 

Ask for help, get psychological and physical support, and improve your sex life.