What’s Delayed Ejaculation?

22 April, 2020
Delayed ejaculation is a sexual dysfunction characterized by a man’s inability to ejaculate. It can happen with a partner or during manual stimulation. This disorder affects approximately 1.5 of every 1,000 men.

Delayed ejaculation is the difficulty to ejaculate despite a full erection, sufficient arousal, and adequate sexual stimulation. Although it can occur during masturbation, it’s much more common during intercourse.

This disorder can lead to an unsatisfying sex life and cause relationship conflicts. Therefore, it’s important for it to be evaluated by a healthcare professional as soon as possible. Below, we’ll analyze the causes that lead to this dysfunction, as well as the diagnosis and proper treatment.

The causes of delayed ejaculation

A worried man in bed.
There are many causes of delayed ejaculation, among which psychological or physical factors predominate.

Delayed ejaculation can be caused by psychological or physical problems or certain drugs. In most cases, it’s due to a combination of the first two.

Psychological causes

Sexual pleasure is closely related to a person’s mental health. Therefore, a person’s sexual life can be affected if they’re stressed or worried or are suffering from other psychological discomforts. Below, we’ll analyze the most common psychological causes of delayed ejaculation:

  • Firstly, anxiety disorders, stress, and depression
  • Body image distortion
  • Low self-esteem
  • Traumatic sexual experiences
  • Problems with the sexual partner – lack of attraction or a fear of not meeting expectations
  • Finally, masturbation habits. Masturbation supported by pornographic content that’s difficult to reproduce as a couple can cause dissatisfaction.

Learn more here: Five Tips to Enjoy a Fulfilling and Safe Sex Life

Physical causes

Some of the physical causes of delayed ejaculation are:

  • Firstly, neurological causes. Nerve damage caused by strokes, spinal cord injuries, or different neuropathies.
  • Birth defects that affect the male reproductive system.
  • Hormonal causes. Low thyroid hormone or testosterone levels.
  • Finally, urinary tract infection.

Pharmacological causes

The following drugs may delay the ejaculatory response:

  • Antidepressants. Especially SSRIs (selective serotonin reuptake inhibitors).
  • Also, anxiolytics.
  • Likewise, antihypertensive drugs.
  • Anticonvulsants.
  • Finally, drugs. Alcohol, amphetamines, etc.

Delayed ejaculation diagnosis

  • Clinical history. Analyzing the patient’s clinical history can clarify the causes of this disorder without the need for a physical examination. If the cause is pharmacological, the dysfunction should disappear after the patient stops the treatment.
  • Blood tests to check for previously undetected signs of heart disease, diabetes, or low testosterone levels.
  • Urinalysis to detect possible infections related to the urinary tract that may be causing delayed ejaculation.
  • Physical examination. A thorough examination of the male genitalia, which may include palpation and sensitivity test.

Read more here: 6 Reasons Why You Are Not Fully Enjoying Sex

Treatment of delayed ejaculation

A woman in therapy.
When a psychological problem affects ejaculation, seeing a therapist will help the couple.

Treatment will depend on the underlying cause. If it’s due to the use of a certain type of drug, the patient should stop, decrease, or replace the treatment with another. But if the cause is physical, it’ll be corrected with the use of drugs. If the cause is psychological, adequate psychological treatment is necessary.

Drug treatment

Currently, there are no specific drugs to treat delayed ejaculation. Generally, doctors resort to drugs created to treat other diseases. Some examples are:

  • Amantadine. A drug originally developed to treat Parkinson’s.
  • Buspirone. An anxiolytic.
  • Finally, cyproheptadine. An antihistamine used in the treatment of allergies.

Psychological therapy

Depending on whether the root cause is related to relationship problems or psychological problems, proper psychological treatment is necessary.

In cases where there’s low sex drive or relationship problems, sex therapy may be indicated with a mental health professional that will guide the treatment towards improving communication and emotional intimacy.

Finally, if the underlying cause is a psychological problem, such as depression, anxiety, a body image disorder, or low self-esteem, the professional will indicate the treatment they deem appropriate to address these problems so that the patient can enjoy a healthy and satisfactory sex life.

  • Quesada Vázquez, A. J. (2002). Trastornos del funcionamiento sexual en pacientes diabéticos. Revista Cubana de Medicina General Integral (Vol. 18). 1999, Editorial Ciencias Médicas. Retrieved from http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21252002000400005
  • García Gutierrez, E., Aldana Vilas, L., Lima Mompó, G., Espinosa Riverón, M. del R., Castillo Castillo, C., & Felinciano Álvarez, V. (2005). Disfunción sexual masculina y estrés. Revista Cubana de Medicina Militar (Vol. 34). Centro Nacional de Información de Medicina Militar. Retrieved from http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572005000100005