Delayed Ejaculation (DE)

What is Delayed Ejaculation?

Delayed ejaculation (DE) is a common condition. Men who are affected by it require unusually long periods of time for sexual stimulation before they can reach orgasm and ejaculate. By most definitions, this means more than thirty minutes. Sometimes a man is simply unable to ejaculate at all or can only do so in certain situations. The majority of men will experience DE now and again throughout their life. However, it occasionally becomes a chronic issue.

In rare situations, DE may be an indication of an underlying condition such as diabetes or heart disease. Most of the time, though, it is rarely cause for medical concern, and neither does it pose any major health risk. Just the same, it can create high stress levels in a man’s sexual relationships. Numerous possible catalysts can cause DE, including reactions to medication, chronic health conditions, physical trauma, and psychological issues.

What are the Symptoms of Delayed Ejaculation?

The main indication of DE is when a man has difficulty or is unable to ejaculate. Men may also have to stop a sexual encounter due to feeling physical irritation, fatigue, or loss of erection. Rather than experiencing symptoms from the condition directly, men will usually develop various complications that arise in response to it.

Symptoms include

  • Feelings of failure, inadequacy, anger, frustration, embarrassment, or negativity
  • Avoiding intimacy and sexual contact
  • Sexual anxiety
  • Low libido
  • Stress
  • General anxiety
  • Infertility

Delayed Ejaculation Causes

Delayed Ejaculation (DE) is usually caused by certain medications, chronic health conditions or surgeries. DE can also be caused by mental health issues (such as anxiety or depression) or substance abuse. Many times, DE is caused by a combination of psychological and physical factors.

Psychological causes of DE include poor body image, depression or anxiety, differences between sexual fantasies and the reality of sex with a partner, relationship problems, anxiety about performance, and cultural or religious taboos.

Physical causes of DE include neurological diseases (like spinal cord damage or diabetic neuropathy), certain infections (like urinary tract infections), certain birth defects harmful to the male reproductive system, and injury to the pelvic nerves controlling orgasms. DE can also be caused by hormone-related conditions (like hypothyroidism or hypogonadism), prostate surgery (such as prostate removal or transurethral resection of the prostate), and retrograde ejaculation (a condition that causes the semen to go back up into the bladder instead of through the penis).

Medications that can cause DE include anti-seizure medications, certain diuretics, some antidepressants, some antipsychotic medications, and some high blood pressure medications. Alcoholism can also cause DE. Any type of anxiety related to male performance in the bedroom can cause DE.

How is Delayed Ejaculation Treated?

The key to treating delayed ejaculation lies in determining the cause. Men who have never ejaculated or have had lifelong issues can speak with a urologist to find out if they have a structural defect that may have been present from birth.

Treatment includes

If the condition is in reaction to medications, adjustments can be made to the dosage. Treating alcoholism and drug abuse, psychological counseling for anxiety and depression, and sex therapy are also beneficial in correcting recurring DE.

Delayed Ejaculation Prevention

Men can prevent DE by having a healthier attitude about sexuality and their own bodies. Try focusing on the pleasure of the moment, rather than about how well you will perform or whether you will ejaculate. Thinking about this only causes more of a delay. You and your partner can try creating a relaxing atmosphere, perhaps setting the mood by lighting candles or playing soft, soothing music.

Any fears either of you have (such as disease or pregnancy) may be worth discussing when you’re not in the bedroom. You can’t force yourself to have a sexual response, so it’s best that you try to relax and enjoy the moment as much as you can.

Last Reviewed:
September 20, 2016
Last Updated:
December 12, 2017