Delayed ejaculation, also sometimes called impaired or retarded ejaculation, is a condition in which a man can get an erection, but he can’t ejaculate easily, so it takes an abnormally long time for him to climax and ejaculate (release semen from the penis). Sometimes, ejaculation does not happen at all.
It’s normal for delayed ejaculation to affect men from time to time. Also, sexual response often changes with age. The older a man gets, often, the more stimulation he may need to get an erection and ejaculate (‘come’), and the more time he needs between erections before he can have sex again.
Delayed ejaculation is a problem when it affects you all the time and it is causing you (and/or your partner) distress. See your doctor if you have been experiencing an unwanted delay of about 30-60 minutes or a frequent inability to ejaculate.
Symptoms of delayed ejaculation include:
- ejaculation that takes longer than desired; or
- an inability to ejaculate at all (anejaculation).
Some men who are not able to ejaculate are still able to have an orgasm.
Delayed ejaculation can be lifelong or it can develop after a period of normal sexual functioning.
For some men, delayed ejaculation is situational (for example, it may only occur during sex with a partner and is not a problem when masturbating). For other men, delayed ejaculation occurs in all situations.
What causes delayed ejaculation?
Delayed ejaculation may be caused by psychological or physical factors, or both.
Delayed ejaculation can sometimes be triggered by anxiety about ‘coming’ in your partner’s presence or relationship problems such as underlying resentment or problems with intimacy. Stress, anxiety or depression may also contribute to delayed ejaculation.
In some cases, an early sexual trauma may be a contributing factor.
Delayed ejaculation can be the result of:
- spinal cord injuries;
- multiple sclerosis (MS); and
- pelvic nerve damage following surgery or injury.
The use of some recreational drugs, particularly alcohol, can result in delayed ejaculation.
Medication side effects
Delayed ejaculation can be a side effect of certain medicines.
Medicines that have been found to cause delayed ejaculation in some men include:
- some types of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs);
- some medicines used to treat high blood pressure (for example, beta-blockers);
- certain muscle relaxants; and
- some antipsychotic medicines, such as those used to help treat schizophrenia.
Complications of delayed ejaculation can include:
- reduced satisfaction with your sex life;
- feelings of frustration, embarrassment or reduced confidence; and
- relationship issues that can further impact on your sex life.
Fertility can be a problem for men who have anejacuation (inability to ejaculate). If you would like to father a child you may need treatment to achieve this.
Remember that there are treatments available for delayed ejaculation. Understanding the problem and communicating with your partner are important in reducing stress and resolving any relationship problems.
When to see your doctor
If you are worried about delayed ejaculation or it is affecting your sex life, see your doctor.
Your doctor will ask about your symptoms, perform a physical examination and check which medicines you are taking regularly.
Your doctor can check whether you have any underlying health problems that could be causing your delayed ejaculation.
What treatments are available?
Treatment for delayed ejaculation will depend on the cause.
If you think that a medicine you are taking is the cause of delayed ejaculation, your doctor may be able to recommend a different treatment that avoids this unwanted side effect. Alternatively, a change in dose or adding another medicine may help.
Treatments for psychological causes of delayed ejaculation
If delayed ejaculation is thought to be due to a psychological cause, your doctor may recommend sex therapy, counselling or psychological therapy. Depending on your circumstances and the treatment recommended, you may see a therapist on your own or with your partner.
A sex therapist may teach you techniques to help minimise anxiety about ejaculating and teach you some tips to help with timing, as well as offering advice to you and your partner to help improve your sex life.
Communicating with your partner is important, so that they can understand the problem and you can try to work towards a solution together. Reassurance that the problem is not due to lack of desire is important for most couples.
If you are experiencing anejaculation (inability to ejaculate) and you and your partner would like to have a baby, there are treatments available. Vibrator stimulation and electrical stimulation of the penis are treatments that can be used to achieve reflex ejaculation. Talk to your doctor, who may refer you to a specialist for treatment if you want to father a child.
If you’re concerned about your sexual response, ask your doctor for further advice.