Overview
Delayed ejaculation is a condition in which it takes a long period of sexual arousal to reach climax and release semen from the penis, called ejaculate. Some people with delayed ejaculation can't ejaculate at all.
Delayed ejaculation can be a brief or lifelong problem. Possible causes of delayed ejaculation include certain ongoing health conditions, surgeries and medicines. Treatment for delayed ejaculation depends on the cause.
Delayed ejaculation can happen from time to time. Delayed ejaculation is a problem only if it's ongoing and causes stress or worry for you and your partner.
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Symptoms
There's no set time that means a diagnosis of delayed ejaculation. Some people with delayed ejaculation need many minutes of sexual stimulation to have an orgasm and ejaculate. Others might not be able to ejaculate at all, called anejaculation.
In delayed ejaculation, the delay causes upset. Also delayed ejaculation might mean stopping sex due to tiredness, physical irritation, loss of erection or because the partner wants to stop.
Often, there's trouble reaching orgasm during sexual intercourse or other sexual activities with a partner. Some people can ejaculate only when masturbating. But others may not be able to ejaculate by masturbating.
Delayed ejaculation is divided into the following types based on symptoms:
- Lifelong versus acquired. With lifelong delayed ejaculation, the problem is present from the time of sexual maturity. Acquired delayed ejaculation happens after a period of typical sexual functioning.
- Generalized versus situational. Generalized delayed ejaculation isn't limited to certain sex partners or certain kinds of arousal. Situational delayed ejaculation happens only under certain conditions.
When to see a doctor
Your main healthcare professional is a good place to start when you have delayed ejaculation. See your healthcare professional if:
- Delayed ejaculation is an issue for you or your partner.
- You have another health problem that might be linked to delayed ejaculation. Or you take medicines that could cause delayed ejaculation.
- You have other symptoms along with delayed ejaculation that might or might not seem linked.
Causes
Some medicines, certain ongoing health conditions and surgeries can cause delayed ejaculation. Other causes include substance misuse or a mental health concern, such as depression, anxiety or stress. Often, it's due to a mix of physical and psychological concerns.
Psychological causes of delayed ejaculation include:
- Depression, anxiety or other mental health conditions.
- Relationship problems due to stress, not communicating well 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.
Medicines and other substances that can cause delayed ejaculation include:
- Some antidepressants or antipsychotics.
- Certain high blood pressure medicines.
- Certain water pills, called diuretics.
- Some antipsychotic medicines.
- Some antiseizure medicines.
- Too much alcohol.
Physical causes of delayed ejaculation include:
- Certain birth defects that affect the 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, called hypothyroidism, or low testosterone level, called hypogonadism.
- A condition in which the semen goes backward into the bladder rather than out of the penis, called retrograde ejaculation.
Risk factors
The following can increase the risk of having delayed ejaculation:
- Older age. With aging, ejaculation takes longer.
- Psychological conditions, such as depression or anxiety.
- Medical conditions, such as diabetes or multiple sclerosis.
- Certain medical treatments, such as prostate surgery.
- Medicines, such as certain antidepressants, high blood pressure medicines or water pills, called diuretics.
- Relationship problems, such as not being able to talk to your partner.
- Excessive alcohol use, especially long-term heavy drinking.
Complications
Complications of delayed ejaculation can include:
- Less sexual pleasure for you and your partner.
- Stress or anxiety about having sex.
- Marital or relationship problems due to a poor sex life.
- Not being able to get your partner pregnant, called infertility.