What is delayed ejaculation?

Delayed ejaculation is the inability to ejaculate at will, so that ejaculation takes much longer than desired or does not happen at all. Some men find that they can only reach orgasm (come) and ejaculate after long periods of stimulation, even though they have the normal desire and a normal erection. This may happen only with sexual intercourse with a partner or may occur at all times, including with masturbation. This may or may not cause relationship problems or embarrassment.

You may have delayed ejaculation if:

• you cannot ejaculate when you want to and experience an unwanted delay of 30 to 60 minutes
• you cannot ejaculate at least half the times you have sex

Delayed ejaculation can be a temporary or a lifelong problem. It is normal for some men to experience it from time to time. It is only a problem if it is worrying you or your partner.

What causes delayed ejaculation?

Many different types of medicines can cause delayed ejaculation, including antidepressants, some strong pain killers and some medicines for high blood pressure and heart disease. Alcohol and some recreational drugs can also cause delayed ejaculation for many men.

There can be physical reasons for delayed ejaculation, such as surgery or trauma to the pelvis or genitals, problems with nerves or the spinal cord, some hormonal conditions, chronic illnesses like diabetes or multiple sclerosis.

There are also underlying psychological causes, such as anxiety, depression and relationship issues.

Stress and tiredness can also increase the chances of experiencing delayed ejaculation.

Intermittent delayed ejaculation may be due to ageing, as ejaculation tends to take longer as men get older.

When should I see my doctor?

You should talk to your doctor if you are experiencing delayed ejaculation because they can provide reassurance, assess to identify the cause and offer management options. It can also help to talk to your partner and include your partner when you talk to a health professional.

It is important to remember that ejaculation problems are common and are nothing to be embarrassed or shy about.

How is delayed ejaculation diagnosed?

Your doctor will ask questions about your sexual history and details about the delayed ejaculation. Your doctor may perform a physical examination, or order blood or urine tests, to identify or rule out any underlying causes.

How is delayed ejaculation treated?

If medicines are causing delayed ejaculation you should discuss with your doctor whether or not there are any alternatives, and discuss the benefits and potential side effects of all treatment options.

If there are psychological causes, then the best approach is to talk to your partner and consider seeking counselling and therapy.

For men who want to father a baby but can’t ejaculate, vibrator stimulation and electrical stimulation of the penis can be used to promote reflex ejaculation

Your doctor will be able to provide specific advice and treatment options and, if necessary, refer you to a specialist.