Delayed ejaculation — sometimes called impaired ejaculation — is a condition in which it takes an extended period of sexual stimulation for a man to reach sexual climax and release semen from the penis (ejaculate). Some men with delayed ejaculation are unable to ejaculate at all.
Delayed ejaculation can be temporary or a lifelong problem. Possible causes of delayed ejaculation include certain chronic health conditions, surgeries and medications. Treatment for delayed ejaculation depends on the underlying cause.
It's normal for men to have delayed ejaculation from time to time. Delayed ejaculation is only a problem if it's ongoing or causes stress for you or your partner.
Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or they may not be able to ejaculate at all (anejaculation). In the most common form of delayed ejaculation, a man can't reach orgasm during sexual intercourse — but can ejaculate with oral or manual stimulation of the penis. Some men can ejaculate only when masturbating.
Delayed orgasm is divided into the following types based on symptoms:
These categories help in diagnosing an underlying cause, and determining what might be the most effective treatment.
When to see a doctor
Delayed ejaculation can result from certain chronic health conditions, surgeries and medications. Or it may be caused by substance abuse or a mental health concern, such as depression, anxiety or stress. In many cases, delayed ejaculation is due to a combination of physical and psychological concerns.
Physical causes of delayed ejaculation include:
Psychological causes of delayed ejaculation include:
Medications and other substances that can cause delayed ejaculation include:
For some men, a minor physical problem that causes a delay in ejaculation may cause anxiety about ejaculating during a sexual encounter. The resulting anxiety can worsen delayed ejaculation.
A number of things can increase your risk of having delayed ejaculation, including:
Complications of delayed ejaculation can include:
Preparing for your appointment
If you've been having trouble achieving orgasm, talk with your primary care doctor. Your doctor may refer you to a specialist — such as a doctor who specializes in male genital problems (urologist), a doctor who specializes in the hormonal systems (endocrinologist), a doctor who diagnoses and treats mental health problems (psychiatrist), or another type of specialist.
Here's some information to help you get ready, as well as what to expect from your doctor.
What you can do
Questions to ask your doctor
What to expect from your doctor
Tests and diagnosis
A physical exam and medical history may be all that's needed to recommend treatment for delayed ejaculation. However, if delayed ejaculation appears to be caused by an underlying problem that might need treatment, you may need further tests or you may need to see a specialist.
Tests for underlying problems can include:
Treatments and drugs
To find the best treatment for you, the doctor will first need to determine whether your delayed ejaculation is due to an underlying medical condition, a psychological issue or another concern. Delayed ejaculation treatment depends on the underlying cause but may include taking a medication or making changes to medications you currently take, undergoing psychological counseling, or addressing alcohol abuse or illegal drug use.
Medications sometimes used to treat delayed ejaculation include:
Psychological counseling (psychotherapy)
It may involve seeing a psychologist or mental health counselor on your own, or along with your partner. Depending on the underlying cause, you may benefit most from seeing a sex therapist — a mental health counselor who specializes in talk therapy for sexual problems. The type of counseling that's best for you will depend on your particular concerns.
Coping and support
If it's an ongoing concern, delayed ejaculation can be a source of mental and emotional stress for a man and his partner. If you have delayed ejaculation only on occasion, try not to assume that you have a permanent problem or to expect it to happen again during your next sexual encounter. Remember, occasional delayed ejaculation due to stress or other temporary factors may improve when the underlying cause gets better.
In addition, if you experience occasional or persistent delayed ejaculation, remember your sexual partner. Your partner may think your inability to reach climax is a sign of diminished sexual interest. Your reassurance that this is not the case can help.
Communicate openly and honestly with your partner about your condition. Treatment is often more successful if couples work together as a team. You may even want to see a counselor with your partner. This can help you address concerns you both may have about delayed ejaculation.
The alternative medicine yohimbine is sometimes used to treat delayed ejaculation, though it hasn't been well-studied in clinical trials.
Because it can happen for a number of physical and psychological reasons, no one strategy can prevent delayed ejaculation. But taking these steps may help:
Last Updated: 2012-05-24
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