Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
Delayed ejaculation (DE) is a medical condition in which a man has difficulty reaching anorgasm.The “Diagnostic and Statistical Manual of Mental Disorders” defines DE as a significant delay, infrequency, or absence of ejaculation at least 75% of the time during partnered sexual activity for six months.
DE should not be confused witherectile dysfunction(the inability to achieve an erection) or decreased libido (low sex drive), although both can sometimes contribute. DE can be treated with medications or other medical interventions.
This article discusses delayed ejaculation, what causes it, and how it can be treated.
Delayed ejaculation is believed to affect 1% to 4% of the male population, according to a 2016 review of studies published inTranslational Andrology and Urology.
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What Are the Symptoms of Delayed Ejaculation?
Delayed ejaculation is usually self-evident, especially to those affected. In some cases, the man may feel as if he on the verge of climax but is unable to reach the point of ejaculation. At other times, there may be an erection but no sense of an approaching orgasm.
The condition can range in severity, and symptoms can include:
What Causes Delayed Ejaculation?
Delayed ejaculation may have pathologic, neurological, hormonal, pharmaceutical, or psychological causes. In some cases, there may be overlapping causes that only add to the dysfunction.
Some of the causes your healthcare provider may consider include:
Psychological problems can both cause and contribute to DE. Depression,anxiety, or emotional trauma can alone cause dysfunction. Religious or social taboos may interfere with your ability to enjoy sex and reach orgasm. Work stress, financial stress, or stress within the relationship are common narratives among couples experiencing DE.
Stress has a cause-and-effect relationship with DE. Not only can stress contribute to DE, but the inability to achieve orgasm can build upon these negative emotions, making orgasm all the more impossible.
Diagnosing DE is not always straightforward and simple, and there are several different definitions in use.In some of the more severe cases, it may require multiple healthcare providers or specialists to pinpoint the cause.
With that being said, a physical exam and review of your medical history may be all that is needed to render a diagnosis. If the cause is not readily apparent, the healthcare provider may order tests to help narrow the causes. These may include:
If the cause is believed to be psychological (and no other reasonable explanation can be found), the healthcare provider may refer you to a psychologist or sex therapist trained in treating sexual dysfunction.
If a disease, medical condition, or surgical complication is believed to be the cause, various lab tests, imaging studies, and diagnostic procedures may be performed to support or rule out the suspicion.
How to Treat Delayed Ejaculation
Testosterone injections or patches may sometimes be used if hypogonadism is diagnosed. (The use of testosterone in men without hypogonadism is unlikely to help.)
Erectile dysfunction (ED) drugslike Viagra (sildenafil) or Cialis (tadalafil) may be prescribed if ED is a contributing factor. With that said, ED drugs do nothing to promote orgasm outside of enhancing confidence and performance.
Medical interventions may be explored if chronic conditions are not being managed, including high blood pressure, diabetes, and thyroid disease.
If there is anejaculation (the inability to ejaculate) with the sense of orgasm, your healthcare provider may also consider ruling out retrograde ejaculation with post-ejaculatory urinalysis. They may also suggest trying medication to tighten the bladder neck, such as pseudoephedrine.
Additionally, a psychologist or psychiatrist may help you overcome any emotional barriers that are standing in the way of an orgasm. This may involve one-on-one counseling or counseling with your partner.
Coping With Delayed Ejaculation
Delayed ejaculation is a frustrating condition for both you and your partner. Overcoming DE can take time and require commitment from both of you as a team. Central to this is open and honest communication, not only about what you are experiencing but also what is working or not working in bed.
By working together as a team, you are more likely to improve not only your sex life but your relationship as well.
Summary
Delayed ejaculation is type of male sexual dysfunction that causes difficulty reaching orgasm. It can have a number of causes, including medical conditions like heart disease and diabetes, hormonal problems, and medication side effects.
Delayed ejaculation treatment depends on the underlying cause. Certain medications can help, and therapy may also be useful.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Di Sante S, Mollaioli D, Gravina GL, et al.Epidemiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):541–548. doi:10.21037/tau.2016.05.10Abdel-Hamid IA, Ali OI.Delayed ejaculation: Pathophysiology, diagnosis, and treatment.World J Mens Health. 2018;36(1):22-40. doi:10.5534/wjmh.17051Chen J.The pathophysiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):549-62. doi:10.21037/tau.2016.05.03Morgentaler A, Polzer P, Althof S, et al.Delayed ejaculation and associated complaints: Relationship to ejaculation times and serum testosterone levels.J Sex Med.2017;14(9):1116-1124. doi:10.1016/j.jsxm.2017.06.013Perelman MA.Reexamining the definitions of PE and DE.J Sex Marital Ther. 2017;43(7):633-644. doi:10.1080/0092623X.2016.1230161Additional ReadingChen J.The pathophysiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):549-62. doi:10.21037/tau.2016.05.03
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Di Sante S, Mollaioli D, Gravina GL, et al.Epidemiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):541–548. doi:10.21037/tau.2016.05.10Abdel-Hamid IA, Ali OI.Delayed ejaculation: Pathophysiology, diagnosis, and treatment.World J Mens Health. 2018;36(1):22-40. doi:10.5534/wjmh.17051Chen J.The pathophysiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):549-62. doi:10.21037/tau.2016.05.03Morgentaler A, Polzer P, Althof S, et al.Delayed ejaculation and associated complaints: Relationship to ejaculation times and serum testosterone levels.J Sex Med.2017;14(9):1116-1124. doi:10.1016/j.jsxm.2017.06.013Perelman MA.Reexamining the definitions of PE and DE.J Sex Marital Ther. 2017;43(7):633-644. doi:10.1080/0092623X.2016.1230161Additional ReadingChen J.The pathophysiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):549-62. doi:10.21037/tau.2016.05.03
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Di Sante S, Mollaioli D, Gravina GL, et al.Epidemiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):541–548. doi:10.21037/tau.2016.05.10Abdel-Hamid IA, Ali OI.Delayed ejaculation: Pathophysiology, diagnosis, and treatment.World J Mens Health. 2018;36(1):22-40. doi:10.5534/wjmh.17051Chen J.The pathophysiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):549-62. doi:10.21037/tau.2016.05.03Morgentaler A, Polzer P, Althof S, et al.Delayed ejaculation and associated complaints: Relationship to ejaculation times and serum testosterone levels.J Sex Med.2017;14(9):1116-1124. doi:10.1016/j.jsxm.2017.06.013Perelman MA.Reexamining the definitions of PE and DE.J Sex Marital Ther. 2017;43(7):633-644. doi:10.1080/0092623X.2016.1230161
Di Sante S, Mollaioli D, Gravina GL, et al.Epidemiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):541–548. doi:10.21037/tau.2016.05.10
Abdel-Hamid IA, Ali OI.Delayed ejaculation: Pathophysiology, diagnosis, and treatment.World J Mens Health. 2018;36(1):22-40. doi:10.5534/wjmh.17051
Chen J.The pathophysiology of delayed ejaculation.Transl Androl Urol. 2016;5(4):549-62. doi:10.21037/tau.2016.05.03
Morgentaler A, Polzer P, Althof S, et al.Delayed ejaculation and associated complaints: Relationship to ejaculation times and serum testosterone levels.J Sex Med.2017;14(9):1116-1124. doi:10.1016/j.jsxm.2017.06.013
Perelman MA.Reexamining the definitions of PE and DE.J Sex Marital Ther. 2017;43(7):633-644. doi:10.1080/0092623X.2016.1230161
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