Delayed Ejaculation

Delayed ejaculation (impaired ejaculation) is a condition characterized by prolonged period of sexual stimulation needed for men to reach sexual climax and ejaculate. Some of the men affected are not able do ejaculate at all. This condition can be either acute or chronic.

Causes include:

• Surgeries
• Injuries
• Medication
• Other chronic conditions

This condition tends to occur from time to time, and it is considered a problem only if it is persistent or causes stress to the affected men. Treatment depends on the underlying cause.

Delayed ejaculation is divided into the following types based on symptoms:

• Lifelong - present from the moment a male reaches sexual maturity.
• Acquired – occurs after a period of normal sexual functionng.
• Generalized - happens in all situations regardless of sex partner or kind of sexual stimulaton.
• Situational – happens only under some circumstances.

Normally, some men need more time to ejaculate, and some need less. But some may not be able to ejaculate at all. There is no specific predefined time frame in which a man should ejaculate.

Delayed ejaculation is diagnosed if the delay is causing them distress, physical irritation and discomfort.Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate and some can ejaculate only when masturbating. On the other hand, some may not be able to ejaculate at all (anejaculation).

The underlying cause for delayed ejaculation can be certain health conditions, medications(some antidepressants, antihypertensives, anti-seizure medications etc.)drug abuse, mental health conditions, and surgeries but in most cases it is caused by a combination of physical and psychological causes.

Physical causes include:

• Injuries of the pelvic nerves
• Birth defects
• Neurological conditions (stroke diabetic neuropathy, multiple sclerosis)
• Urinary and genital tract infections
• Hormone-related conditions ( low levels of thyroid hormones or testosterone)
• Prostate surgery
• Retrograde ejaculation

Psychological causes include:

• Depression
• Stress
• Anxiety
• Alcoholism

If you experience any of the above-mentioned symptoms of delayed ejaculation, talk to your primary care doctor who will refer you to the adequate specialist for a diagnosis. Please mention your personal information, all the symptoms that you are experiencing, all other chronic conditions, and all medications that you are taking and recent life changes. Doctor is most likely going to take your medical history and may suggest other diagnostic tests depending on the possible underlying cause.

These tests include:

• Careful examination of your penis and testicles
• Blood tests
• Urine tests
• Nerve tests

Treatment for delayed ejaculation depends on the underlying cause, but may include:

• Medication – there are no drug that are used specifically for treating delayed ejaculation. You may have to make changes to the medications you currently take. Medications that can sometimes be used in treating this condition include:
  • Amantidine
  • Buspirone
  • Cyproheptadine
• Psychotherapy – can prove helpful in dealing with mental problems leading to the condition. You may do it alone or with your partner.

Addressing alcohol or drug abuse.

Lifestyle modifications are necessary in order to cope with delayed ejaculation.

If you experience this condition it is very important to talk openly to your partner in order to avoid conflicts and doubts about your sexual interest.

Try not to assume that you have a permanent and non-treatable problem. You and you partner may also seek counseling about the issue.

Risk factors for developing delayed ejaculation include:

• Chronic medical conditions
  • Diabetes
  • Multiple sclerosis
• Older age
• Taking certain medications
  • Antidepressants
  • Diuretics
  • Antihypertensives
• Alcohol or drug abuse

Men with this condition are prone to developing various complications which include:

• Stress or anxiety about sexual performance
• Diminished sexual pleasure
• Relationship problems
• Male infertility