Delayed Ejaculation
Normal ejaculation can vary from person to person and even from one sexual encounter to another. According to a study conducted by the National Institutes of Health (NIH), the average time it takes for a man to reach orgasm and ejaculate ranges from 5 to 7 minutes. During sexual intercourse, most men typically ejaculate within a timeframe of 5 to 10 minutes, with an average ejaculation time after penetration of about five and a half minutes.
But what if a man’s performance lasts longer than the average? This scenario introduces us to delayed ejaculation (DE), also known as “impaired ejaculation.” DE occurs when it necessitates an extended period of sexual stimulation for a man to achieve ejaculation, and in some cases, ejaculation may not occur at all. While occasional delays in ejaculation are common among men, for others, it can present as a persistent challenge throughout their sexual experiences, potentially impacting intimacy and satisfaction.
What causes delayed ejaculation?
Delayed ejaculation can stem from various factors, encompassing neurological, hormonal, and psychological aspects. Causes can include:
- Damage to pelvic nerves or spinal cord injuries below the lower thoracic level can disrupt the nerve connections necessary for ejaculation.
- Psychological influences such as stress, anxiety, depression, relationship strains, past traumas, or certain beliefs about sex can also play a role in delaying ejaculation.
- Physically, conditions like diabetes, neurological disorders, hormonal imbalances, prostate complications, or medication side effects may interfere with the ejaculation process.
- Substance abuse, including excessive alcohol consumption or drug use, as well as certain medications like antidepressants or antipsychotics, can also impact ejaculation.
- Age-related changes can contribute to delayed ejaculation as men may experience alterations in sexual function due to factors like decreased sensitivity or hormonal shifts.
- Additionally, individual masturbation habits developed over time may affect the ability to reach orgasm with a partner.
- Relationship issues such as communication barriers, unresolved conflicts, or intimacy issues can further complicate ejaculation.
Signs and symptoms of delayed ejaculation
Delayed ejaculation is when it takes you half an hour or more to reach climax. However, your feelings about the situation are crucial. If you’re frustrated or unhappy because it takes a long time to ejaculate, or if you can’t ejaculate at all, it’s important to address the issue and seek appropriate attention.
Treatment options for Delayed Ejaculation
Treatment options for delayed ejaculation vary depending on the underlying cause. Here are some approaches to consider:
- Psychological Therapy: Seeing a psychologist or sex therapist specializing in sexual therapy can help address anxiety and performance-related issues, gradually easing concerns about climaxing with a partner.
- Behavioral Exercises: These exercises aim to increase comfort and arousal during sexual activity, often involving sensate focus techniques to reduce anxiety and pressure.
- Medication: Off label medications such as cabergoline or bremelanotide can help with improving time to ejaculation.
- Medical Vibrators: For nerve injuries, medical vibrators placed on the penis can help retrain nerves to fire more rapidly, aiding in achieving climax.
- Hormone Therapy: Men with hormone imbalances may benefit from testosterone therapy to increase blood flow to the penis and enhance sensitivity. High prolactin levels, often caused by a pituitary tumor, can be treated with medication or surgery to reduce prolactin levels and improve ejaculation.
- Alternative Antidepressants: If antidepressants are causing delayed ejaculation, discussing alternative treatments with a psychiatrist or physician may be beneficial. Some antidepressants have less impact on ejaculation while still effectively treating depression.
- Couples Therapy: Involving a partner in therapy sessions can help address relationship dynamics and communication issues that may contribute to delayed ejaculation.
How can we prevent delayed ejaculation?
Preventing delayed ejaculation depends on its underlying causes:
- Nerve Damage or Aging: Delayed ejaculation caused by nerve damage or aging may be challenging to prevent. However, maintaining overall health through regular exercise, a balanced diet, and avoiding harmful habits like excessive alcohol consumption or drug abuse can support nerve health.
- Relationship Issues: If relationship issues contribute to delayed ejaculation, open communication with your partner is crucial. Honest conversations can help address underlying concerns and improve the relationship, potentially preventing or alleviating delayed ejaculation.
Diagnosis
Diagnosing delayed ejaculation typically involves:
- Your healthcare provider will inquire about your medical history, sexual habits, and ejaculation patterns. This helps to understand the context of the issue and rule out other potential conditions.
- A physical examination may be conducted to assess any physical factors contributing to delayed ejaculation.
- Depending on the suspected cause, laboratory tests may be performed on hormone levels, urine, or semen to rule out underlying medical conditions.
- Your feelings and perceptions about ejaculation, as well as any psychological factors contributing to the issue, are important aspects of the diagnosis. Your healthcare provider may also inquire about your partner’s perspective to gain a comprehensive understanding.
When to see a doctor?
- If delayed ejaculation consistently impacts sexual satisfaction or causes distress or makes sex difficult
- if delayed ejaculation coincides with the initiation of new medications, is associated with underlying medical conditions, or is accompanied by psychological concerns,
- If you have concerns regarding fertility
Resources and support
Speak to your doctor if you are worried about delayed ejaculation.
Rena Malik MD, a board-certified urologist specializing in sexual health and pelvic surgeon, offers compassionate and expert care to address a variety of urological concerns. Take the first step towards a solution by scheduling a consultation with Dr. Malik today.
