Delayed Ejaculation
What is Delayed Ejaculation?
The opposite of premature ejaculation is delayed ejaculation. Most men ejaculate after a few minutes of thrusting during sexual intercourse. However, some men experience delayed ejaculation where it may take them 30 minutes or longer to ejaculate. Delayed ejaculation can lead to relationship problems, diminished self-confidence, poor sexual pleasure, or concerns about sexual performance. From a female’s perspective, if she has achieved climax well before her man, her vaginal lubrication can run out and sex can be uncomfortable for people. Some men with delayed ejaculation may not be able to achieve ejaculation through vaginal penetration, thus relying on alternative means in which to climax. Other men will reach the point of orgasm but are unable to finish, leaving them uncomfortable and unsatisfied.
Delayed ejaculation can be categorized as lifelong (occurring since sexual maturity) or acquired (occurring after a period of normal sexual functioning). This is important to identify as it will help in determining which treatment options are most effective.
What causes Delayed Ejaculation?
Delayed ejaculation can be caused by chronic medical problems, certain medications or surgery. It may also have psychological causes. In some instances, it is a combination of both physical and psychological causes.
Physical Causes
Physical causes include nervous system pathology, such as strokes and mul. stroke), injury to the back or spine, endocrine disease (i.e. diabetes), prostate disease or surgery and heart surgery. Certain types of medication may also cause delayed ejaculation. These medications can include antidepressants, antipsychotics and antihypertensives. Delayed ejaculation may also occur with excessive alcohol use or recreational drug use.
Psychological Causes
Psychological causes of delayed ejaculation include relationship problems, anxiety, depression and other mental health problems, fatigue, performance anxiety, conditioning caused by a history of unusual masturbating and cultural or religious issues.
Other Factors
Other risk factors for delayed ejaculation include older age and erectile dysfunction.
What are the Treatment Options for Delayed Ejaculation?
The physicians at Tower Men’s Health will gather a thorough assessment of your history including:
- Medical History
- Sleep History
- Exercise and Diet
- Blood work/Hormones
For those men whose delayed ejaculation is associated with a hormone imbalance, your physician will assess your testosterone and prolactin levels to see if there’s an imbalance. Testosterone therapy can improve both sex drive and increase blood flow to the penis, creating more engorgement and making the nerves more sensitive. Men with high prolactin levels can have a non-cancerous tumor in the pituitary gland that produces prolactin and inhibits ejaculation. Medical and surgical treatment options are available that will reduce prolactin levels will help a man climax easier.
For those men whose delayed ejaculation is associated with a nerve injury, sometimes they respond to medical vibrators placed at the tip of the penis to re-train the nerves to become more sensitive and engage more rapidly. It is not uncommon for some couples to incorporate vibrators into their sexual activity to help stimulate the man to climax during intercourse.
If a man has erectile dysfunction and delayed ejaculation, he may respond to oral impotence drugs like sildenafil or tadalafil to increase penile engorgement and sensitivity, which usually addresses delayed ejaculation as well.
Antidepressant medications can lead to delayed or loss of ejaculation. There are a few antidepressant medications available that are not as harmful to ejaculation but still effective in treating depression. Psychological treatments for delayed ejaculation explore the reasons why a man may not be able to achieve climax. Sexual therapists are a great resource to explore these issues and come up with a good treatment plan to address delayed ejaculation.
Delayed ejaculation is a frustrating clinical condition for the man and his partner – the specialized physicians at Tower Men’s Health can help you navigate through the various treatment options.
Have a question or want to schedule an appointment?
Board-certified, fellowship-trained urologists staff Tower Men’s Health. We will pair you with one of our many experienced physicians to help address any concerns you may have and help you on your journey towards improved quality of life. Feel free to reach out to the physicians at Tower Men’s Health at 310-854-9898.