Delayed Ejaculation

What is delayed ejaculation?

Delayed ejaculation is a medical condition that is also called impaired ejaculation. It is a condition in which a man needs to take a longer period of sexual stimulation for men to reach sexual climax and release semen from penis/ejaculate. In some cases, some men cannot ejaculate at all, even with sexual stimulation either with or without partner. Delayed ejaculation could be a temporary or lifelong problem.

How to diagnose delayed ejaculation?

Some men need more than 30 minutes or more of sexual stimulation to reach orgasm and ejaculate. Some are even unable to ejaculate at all. But there is no specific time that indicates someone has delayed ejaculation. Instead, you can be labeled as delayed ejaculation if the delay is causing distress or frustration either to you or your partner. Some men are only able to ejaculate through masturbation.

Type of delayed ejaculation

Delayed ejaculation can be divided into two different categories:

  1. Lifelong vs acquired
    • Lifelong: Delayed ejaculation is present from the time of sexual maturity
    • Acquired: Happen after a period of normal sexual functioning
  2. Generalized vs situational
    • Generalized: Delayed ejaculation in all sexual stimulation and with all partners
    • Situational: Delayed ejaculation only happened under certain circumstances, for example, with a certain partner or only happens during sexual intercourse but not during masturbation

What causes delayed ejaculation?

There are many causes of delayed ejaculation. It can be related to psychological factors, certain medical conditions and reactions to medications.

  1. Psychological Factors:
    • Depression, anxiety or other mental health problem
    • Relationship problem
    • Performance anxiety
    • Poor body image
  2. Medical Conditions:
    • Hormone-related condition: low thyroid hormone level, low testosterone hormone level
    • Neurological-related condition: Diabetic neuropathy, stroke, nerve damage to the spinal cord
    • Retrograde ejaculation: semen goes backward instead of ejaculating out from penis
    • Birth defects that affect the male reproductive system
    • Certain infections: for example, urinary tract infection
    • Injury to the pelvic nerve that controls ejaculation/orgasm
    • Post prostate surgery
  3. Medications that can delay ejaculation:
    • Some antidepressant or antipsychotic medications
    • Some anti-hypertensive medications
    • Diuretics
    • Some anti-seizure medications
    • Excessive alcohol intake

What are the risk factors for delayed ejaculation?

Risk factors for delayed ejaculation are:

  1. Age: older age needs longer time to ejaculate
  2. Those who suffer from mental health problems such as depression, anxiety or so on
  3. Those with certain medical conditions like diabetes
  4. Those who undergo prostate surgery
  5. Those who take regular medications that can cause delayed ejaculation such as antidepressants, anti-hypertensive
  6. Excessive alcohol intake

Treatment for delayed ejaculation

If taking medications that might cause delayed ejaculation, reducing the dose or switch to other medications will help fix the problem.

There are still no drugs/medications that have been approved for delayed ejaculation treatment. Medications used to treat delayed ejaculation so far are also used to treat other medical conditions.

Medications that can be used to treat delayed ejaculation:

  • Amantadine🡪 use to treat Parkinson’s disease
  • Buspirone🡪 use to treat anxiety
  • Cyproheptadine🡪 use to treat allergy reaction

Another way to treat delayed ejaculation will be psychotherapy or counseling. Psychotherapy can help to treat underlying mental health problems and improve delayed ejaculation as well.

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