Disease: Delayed ejaculation

    Overview

    Delayed ejaculation — sometimes called impaired ejaculation — is a condition in which it takes an extended period of sexual stimulation for men to reach sexual climax and release semen from the penis (ejaculate). Some men with delayed ejaculation are unable to ejaculate at all.

    Delayed ejaculation can be temporary or a lifelong problem. Possible causes of delayed ejaculation include certain chronic health conditions, surgeries and medications. Treatment for delayed ejaculation depends on the underlying cause.

    It's normal for men to have delayed ejaculation from time to time. Delayed ejaculation is only a problem if it's ongoing or causes stress for you or your partner.

    Source: http://www.mayoclinic.com

    Symptoms

    Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate. Other men might not be able to ejaculate at all (anejaculation).

    But, there's no specific time that indicates a diagnosis of delayed ejaculation. Instead, you are probably experiencing delayed ejaculation if the delay is causing distress or frustration, or if you have to stop sexual activity due to fatigue, physical irritation, loss of erection or a request from your partner.

    Often, men might have difficulty reaching orgasm during sexual intercourse or other sexual activities with a partner. Some men can ejaculate only when masturbating.

    Delayed ejaculation is divided into the following types based on symptoms:

    • Lifelong vs. acquired. With lifelong delayed ejaculation, the problem is present from the time of sexual maturity. Acquired delayed ejaculation occurs after a period of normal sexual functioning.
    • Generalized vs. situational. Generalized delayed ejaculation isn't limited to certain sex partners or certain kinds of stimulation. Situational delayed ejaculation occurs only under certain circumstances.

    These categories help in diagnosing an underlying cause and determining what might be the most effective treatment.

    When to see a doctor

    Your primary care doctor is a good place to start when you have delayed ejaculation. See your doctor if:

    • Delayed ejaculation is an issue for you or your partner
    • You have another known health problem that might be linked to delayed ejaculation, or you take medications that could be causing the problem
    • You have other symptoms along with delayed ejaculation that might or might not seem related

    Source: http://www.mayoclinic.com

    Causes

    Delayed ejaculation can result from medications, certain chronic health conditions and surgeries. Or it might be caused by substance misuse or a mental health concern, such as depression, anxiety or stress. In many cases, it is due to a combination of physical and psychological concerns.

    Psychological causes of delayed ejaculation include:

    • Depression, anxiety or other mental health conditions
    • Relationship problems due to stress, poor communication or other concerns
    • Anxiety about performance
    • Poor body image
    • Cultural or religious taboos
    • Differences between the reality of sex with a partner and sexual fantasies

    Medications and other substances that can cause delayed ejaculation include:

    • Some antidepressants
    • Certain high blood pressure medications
    • Certain diuretics
    • Some antipsychotic medications
    • Some anti-seizure medications
    • Alcohol — particularly drinking too much (excessive alcohol use or alcoholism)

    Physical causes of delayed ejaculation include:

    • Certain birth defects affecting the male reproductive system
    • Injury to the pelvic nerves that control orgasm
    • Certain infections, such as a urinary tract infection
    • Prostate surgery, such as transurethral resection of the prostate or prostate removal
    • Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord
    • Hormone-related conditions, such as low thyroid hormone level (hypothyroidism) or low testosterone level (hypogonadism)
    • Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis

    For some men, a minor physical problem that causes a delay in ejaculation might cause anxiety about ejaculating during a sexual encounter. The resulting anxiety might worsen delayed ejaculation.

    Source: http://www.mayoclinic.com

    Diagnosis

    A physical exam and medical history might be all that are needed to recommend treatment for delayed ejaculation. However, if delayed ejaculation appears to be caused by an underlying problem that might need treatment, you might need further tests or you might need to see a specialist.

    Tests for underlying problems can include:

    • Physical exam. This might include careful examination of your penis and testicles. The doctor will use light touch to make sure you have normal sensation in your genitals.
    • Blood tests. Your health care provider might take a blood sample and send it to a lab to check for signs of cardiovascular disease, diabetes, a low testosterone level and other health problems.
    • Urine tests (urinalysis). Urine tests are used to look for signs of diabetes, infection and other underlying health conditions.

    Source: http://www.mayoclinic.com

    Complications

    Complications of delayed ejaculation can include:

    • Diminished sexual pleasure for you and your partner
    • Stress or anxiety about sexual performance
    • Marital or relationship problems due to an unsatisfactory sex life
    • Inability to get your partner pregnant (male infertility)

    Source: http://www.mayoclinic.com

    Coping and support

    If it's an ongoing concern, delayed ejaculation can cause mental and emotional stress for you and your partner. If you have delayed ejaculation only on occasion, try not to assume that you have a permanent problem or to expect it to happen again during your next sexual encounter. Remember, occasional delayed ejaculation due to stress or other temporary factors might improve when the underlying cause gets better.

    In addition, if you experience occasional or persistent delayed ejaculation, it's important to reassure your sexual partner. Your partner might think your inability to reach climax is a sign of diminished sexual interest.

    Communicate openly and honestly with your partner about your condition. Treatment is often more successful if couples work together as a team. You might even want to see a counselor with your partner. This can help you address concerns you both might have about delayed ejaculation.

    Source: http://www.mayoclinic.com

    Risk factors

    A number of things can increase your risk of having delayed ejaculation, including:

    • Older age — as men age, it's normal for ejaculation to take longer
    • Psychological conditions, such as depression or anxiety
    • Medical conditions, such as diabetes or multiple sclerosis
    • Certain medical treatments, such as prostate surgery
    • Medications, particularly certain antidepressants, high blood pressure medications or diuretics
    • Relationship problems, such as poor communication with your partner
    • Excessive alcohol use, especially if you're a long-term heavy drinker

    Source: http://www.mayoclinic.com

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