A common bedroom issue often discussed is premature ejaculation, but what about just the opposite – delayed ejaculation.  Delayed ejaculation is when a man struggles or is unable to ejaculate, ejecting semen from the penis resulting in an orgasm. It is estimated somewhere around 5% of men in the United States alone have this problem.

What is delayed ejaculation?

A man’s ejaculation is brought about by an involuntary response or reflex when a man is sexually aroused.  Prior to ejaculation, a man’s penis becomes stiff and hard by becoming erect which is coordinated by the nervous and vascular systems. Ejaculation builds in anticipation as semen along with other secretions pass from the prostate gland and seminal vesicles into the urethra.  Then the seminal fluid is expelled from the urethra as a result of muscle contractions that are associated with the sensations experienced when a man has an orgasm.

Generally, the average man will ejaculate in about 4 minutes during intercourse.  Men with delayed ejaculation however will either require prolonged intercourse (up to 45 minutes or longer) or will be unable to ejaculate during sexual intercourse or through manual stimulation.

It is normal from time to time for a man to have delayed ejaculation.  It becomes a problem when it is ongoing or is causing stress for the man and his partner.

Causes and risk factors

There can be several reasons for causes of delayed ejaculation, many often related to psychological or physical reasons

Psychological reasons can include:

·         No attraction toward their partner

·         Anger toward their partner

·         Habit of excessive masturbation

·         Fear of pregnancy

·         Traumatic event involving sex – having illicit sex, being discovered masturbating, etc.

Physical reasons can include:

·         Neurological conditions such as a stroke, spinal cord injury or disease resulting in nerve damage

·         Blockage of the ducts that semen passes through

·         Alcohol or drug use

·         Medications such as antidepressants

·         Testosterone deficiency

·         Nerve damage during surgery in the pelvis

Treatment for delayed ejaculation

Treatment for delayed ejaculation depends on the underlying cause. It is advised to start with a urologist to determine if the cause is due to a psychological or a physical reason. 

If it is determined that the problem is due to taking a medication, reducing the dose or switching medications may solve the problem.  Sometimes, adding a medication may help. 

If the cause involves a psychological reason, then a man should be sent to a therapist who specializes in ejaculation problems.  This type of therapy is known as sex therapy and should involve both partners.  The therapist’s job will be to help the couple learn how to communicate and guide each other in providing the right stimulation.  Usually the outlook or prognosis of using a sex therapist is about a 70-80% success rate.

What will help increase the likelihood of successful treatment and a better outcome is if:

·         The man has not had the problem for a long time

·         He still has feelings of sexual desire, love and attraction for his partner

·         He is motivated to get treated

·         He does not have a serious psychological problems

Preventing delayed ejaculation

Prevention is always the best cure for anything and that includes delayed ejaculation.  The longer a man delays seeking help, the greater the chance of creating marital stress, sexual dissatisfaction, inhibiting sexual desire, and avoiding any form of sexual contact.

When a man has a healthy attitude about his sexuality this goes a long ways towards the process of treating this issue.  Just like a man can’t force himself to fall asleep, he also has to realize he cannot force himself to ejaculate.  In the throes of passion, a man should focus on the pleasure at hand not worrying about how long it may take to have an orgasm.  When the sexual atmosphere is more relaxed and without pressure to perform, is when a man can learn to let go and be completely in the moment.