A host of factors cause or contribute to ISD. Some may stem from a relationship in which one partner is not intimately close to the other. Communication problems, inadequate affection, inadequately expressed affection, and personal conflicts can cause or contribute to the disorder.
ISD is associated with depression and stress. Physical illness and the side effects of medicine can lead to ISD. Hormone deficiencies have been implicated. These occur most frequently in women post menopause but they can also appear in men as they age. Other factors that contribute are insomnia, lack of sleep, and biophysical problems such as premature ejaculation, retrograde ejaculation and erectile dysfunction. One or combinations of all these factors may lie at the foundation of ISD.