Delayed ejaculation

Specialty of Andrology

What is delayed ejaculation?

Delayed ejaculation (also referred to as impaired ejaculation) is the delay of releasing semen during sexual intercourse regardless of being sexually stimulated. Anejaculation is the name given to the condition in which the man is unable to ejaculate or ‘come’ at all. In some cases, a man can achieve orgasm with masturbation or foreplay but not during sexual intercourse.

The possible causes of delayed ejaculation may include certain chronic health conditions, some medications or psychological issues. It can be normal for men to have delayed ejaculation at times but it only becomes a problem if it’s ongoing and puts pressure and strain on a relationship, especially if the couple are trying for a baby.
 

What are the symptoms of delayed ejaculation?

Men with delayed ejaculation find it difficult to ejaculate and can only do so after 30 minutes or more of stimulation before reaching orgasm. Some men may not be able to ejaculate at all. There is not really a specific time that indicates a diagnosis of delayed ejaculation but signs of the condition may include stress, frustration and loss of an erection.
 

What are the causes of delayed ejaculation?

Delayed ejaculation may be caused by physical or psychological reasons. Physical problems may include neurological problems such as diabetic neuropathy, stroke, multiple sclerosis or damage to the spinal cord. Hormone-related issues such as low thyroid hormone level or low testosterone levels also cause delayed ejaculation.

The psychological causes of delayed ejaculation include depression, anxiety (about sexual performance) and poor body image. Medications such as some antidepressants, high blood pressure and anti-seizure medication, and excessive alcohol consumption can cause delayed ejaculation.
 

What are the risk factors?

A number of factors can increase the likeliness of delayed ejaculation, which includes:

  • ageing
  • relationship problems
  • excessive alcohol and drug consumption

Complications of delayed ejaculation may make sex less pleasurable for a couple and put a strain on the relationship. There may also be frustration if the couple is trying to conceive and start a family due to male infertility.
 

How is delayed ejaculation treated?

In cases where the man has been unable to ejaculate for a considerable period of time, it is recommended to see a psychologist who specialises in sexual therapy. The object of therapy is to gradually dispel the man’s anxiety about being able to climax in his partner without difficulty. There are some medications that are used to treat delayed ejaculation, which include:
 

  • Amantadine – a Parkinson’s medication
  • Buspirone– an anti-anxiety medicine
  • Cyproheptadine – used to treat allergies


There are not any drugs that are specifically approved for the treatment of delayed ejaculation. These medications are prescribed by a doctor on an experimental basis.

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