Delayed Ejaculation

What is delayed ejaculation?

Delayed ejaculation is when you take a long time and need a lot of stimulation to reach sexual climax (orgasm) and release semen from your penis (ejaculate or cum). It’s a type of ejaculatory disorder. In some cases, you might not ejaculate at all. Delayed ejaculation can happen when you’re masturbating or having sexual intercourse with a partner.

Delayed ejaculation can be frustrating or unfulfilling, for you or a sexual partner. But it’s normal to have delayed ejaculation sometimes. There’s no “normal” time limit for how long it should take to orgasm or ejaculate. However, if it causes stress and it’s a long-lasting (chronic) issue, a healthcare provider can help.

Other names for delayed ejaculation include:

• Delayed orgasm
• Impaired ejaculation
• Male orgasmic disorder
• Slow ejaculation

How common is delayed ejaculation?

A 2023 study estimates that delayed ejaculation affects at least 5% to 10% of people assigned male at birth (AMAB).

What are the symptoms of delayed ejaculation?

The primary symptom of delayed ejaculation is that you have trouble ejaculating. Typically, people AMAB can ejaculate after only minutes of sexual stimulation. But if you have delayed ejaculation, it may take you 30 minutes or longer.

Other physical symptoms may include:

• Getting physically tired
• Pain during intercourse (dyspareunia)

Mental and emotional symptoms can also affect you or your sexual partner. These may include:

• Anxiety
• Feelings of inadequacy
• Feeling unattractive, undesirable or unskilled
• Stress

Your feelings matter a lot. If you or your partner is upset by the time it takes to ejaculate, talk to a healthcare provider.

What causes slow ejaculation?

There are physical and psychological (mental and emotional) causes for delayed ejaculation.

Physical causes of delayed ejaculation

Physical causes may include:

• Conditions that affect your nervous system, such as a stroke, spinal cord injury or multiple sclerosis (MS) — nerve damage may also occur as a complication of diabetes or surgery
• Underactive thyroid gland (hypothyroidism)
• A blockage in your penis, such as an ejaculatory duct obstruction
• Certain prescription medications, including antibiotics, antidepressants, blood pressure medications (antihypertensives) and alpha blockers such as tamsulosin (Flomax®)
• Drinking a lot of alcohol or using recreational (nonprescription) drugs
• Getting older, which may cause natural changes to your testosterone levels, reduced sensitivity in your penis and low sex drive (libido)

Psychological causes of delayed ejaculation

Psychological causes may include:

• Feeling guilty about sexual intercourse, possibly due to your upbringing or religious background
• Feeling angry or uncomfortable with your sexual partner
• Being afraid of something, such as sexually transmitted infections (STIs), pregnancy or childbirth (tokophobia) or hurting your partner emotionally or physically
• Sexual performance anxiety
• Sex addiction and pornography addiction

A healthcare provider may suggest that you don’t have a physical cause of delayed ejaculation if you’re able to easily orgasm by yourself but have difficulty with your partner. It’s also possible that you have a certain technique that feels good to you that your partner can’t duplicate, or that you’re not comfortable asking your partner to duplicate.

Do men have trouble ejaculating as they get older?

Many people AMAB have delayed ejaculation issues as they get older. You may need more time and stimulation to ejaculate. You may also notice that the force of your ejaculation and the volume of your semen decreases.

At what age do men stop ejaculating?

It depends. The hormone testosterone is essential for sperm production and enhances your sex drive. Testosterone production usually starts to decrease after you turn 30. Some people AMAB may have delayed ejaculation issues in their 40s. But others have no problems ejaculating in their 70s and older.

Who does delayed ejaculation affect?

Delayed ejaculation can affect anyone AMAB. It can affect some people for their entire lives. For others, it only happens once in a while, or it starts to occur more regularly as they get older.

How is delayed ejaculation diagnosed?

A healthcare provider will ask you questions about your medical history, sexual habits and ejaculation patterns. Questions may include:

• When did you first notice you had problems ejaculating?
• Does delayed ejaculation happen a lot, or only sometimes?
• Are you able to ejaculate when you masturbate?
• Are you able to ejaculate when you have sexual intercourse?
• If you can ejaculate, how long does it take?
• Do you have any other penile disorders, such as erectile dysfunction or a penile fracture?
• Do you have any new or changing sexual desires?
• What medications are you currently taking?
• How much alcohol do you drink?
• Do you use any nonprescription drugs?

These questions may feel awkward or intrusive, but they’re an important part of a provider’s diagnosis. It’s important to answer these questions honestly, even if you feel embarrassed.

A provider may perform a physical examination and order tests to help identify or rule out other conditions. These tests may include:

• Blood tests
• Urinalysis (pee test)
• Semen analysis, particularly if you’re trying to conceive a biological child

How do you fix delayed ejaculation?

A healthcare provider may offer several different delayed ejaculation treatments. There isn’t one clear way to treat the condition unless the cause involves certain medications, nonprescription drug use or alcohol use. In those cases, you may need to stop using or find an alternative medication, stop nonprescription drug use or cut down on alcohol.

A provider may also recommend that you speak with a therapist (psychotherapy) or sex therapist. If delayed ejaculation happens primarily with your partner, they may suggest counseling for both of you.

A sex therapist may suggest that you and/or your partner use erotic or masturbatory aids, including:

• Erotic material, like movies or literature
• Sex toys

Is there a medication for delayed ejaculation?

The U.S. Food and Drug Administration (FDA) hasn’t approved a drug treatment for delayed ejaculation. And the FDA doesn’t regulate herbal supplements, so be careful when trying any herbal remedies you might hear about. But some healthcare providers may prescribe medications on an “off-label” basis with some success. This means the medication doesn’t specifically treat delayed ejaculation but has approval for another condition and may help in your situation. These may include:

• Testosterone subcutaneous injection or testosterone subcutaneous pellets
• Cyproheptadine, an antihistamine
• Buspirone, a treatment for anxiety
• Amantadine, a treatment for Parkinson’s disease
• Oxytocin, a hormone that stimulates uterine contractions during childbirth and lactation after childbirth. Your body also produces it after you orgasm
• Cabergoline, a drug that promotes dopamine levels

These medications may or may not help. If a provider prescribes a medication, they’ll review the list of possible side effects with you.

If delayed ejaculation affects your ability to have a biological child, a provider may suggest procedures to retrieve sperm from your testicles that they can use for insemination. These procedures may include microsurgical testicular sperm extraction (microTESE) or testicular sperm aspiration (TESA).

Are there exercises that will help with delayed ejaculation?

Kegel exercises help strengthen the muscles in your pelvic floor. Strengthening your pelvic floor may give you greater control over when you ejaculate.

Can delayed ejaculation be prevented?

It depends. Some causes you can’t prevent, such as nerve damage or aging. But drinking alcohol in moderation can help reduce your chances of having delayed ejaculation.

It’s also important to have an open, honest relationship with your partner. Improving your communication may help prevent delayed ejaculation from developing or getting worse.

What can I expect if I have delayed ejaculation?

It depends on the cause of delayed ejaculation. Your body is unique, and how it responds to the cause may be different from others. to A healthcare provider will explain what you should expect.

Generally, physical causes of delayed ejaculation depend on their severity. Severe conditions, such as a spinal cord injury or stroke, may not improve, even with treatment. But if prescription medications, nonprescription drugs or alcohol cause delayed ejaculation, your outlook is good if you’re able to switch medications or reduce or quit your nonprescription drug or alcohol consumption. If you need help, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a hotline that’s available 24/7, 365 days a year. Call 1-800-662-HELP (4357).

Age-related delayed ejaculation may not improve, even with treatment.

Psychological causes may improve with therapy.

How do I take care of myself?​

Talk to a healthcare provider as soon as you have problems ejaculating. If you have difficulty ejaculating with a partner, talking to a therapist can help. You may want to go to therapy alone or with your partner, depending on both of your preferences.

When should I see a healthcare provider?

Talk to a healthcare provider when you first notice an inability to ejaculate, especially if it’s frustrating or troubling for you or your partner. They can help you determine the cause and prescribe the proper treatment.

What questions should I ask a healthcare provider?

You may want to ask your provider:

• What’s causing delayed ejaculation?
• Is it temporary or long-term?
• What delayed ejaculation treatment do you recommend?
• What tests will you order?
• Should I see a specialist, such as a therapist, urologist or an endocrinologist?

Can Viagra^® help with delayed ejaculation?

Sildenafil (Viagra^®) helps treat erectile dysfunction by increasing blood flow to your penis so you can maintain an erection for a longer period. Researchers haven’t studied its effects on delayed ejaculation.

A 2013 study shows that another erectile dysfunction drug, tadalafil (Cialis^®), may promote ejaculation.

How can I help my partner with delayed ejaculation?

If your partner has delayed ejaculation, be supportive. Ask them if there’s something specific you can do to help, or gently encourage them to see a healthcare provider for an exam. Be open to the idea of talking to a couple’s therapist. Talking to a couple’s therapist isn’t an admission of defeat or failure. It can help you better understand your partner and their needs and make your relationship stronger.

What happens after seven days of not ejaculating?

Not ejaculating for seven days won’t cause any problems. Your body will absorb any sperm you don’t release. Your testosterone levels may also increase.

What is anejaculation?

Anejaculation is when you can’t ejaculate when you orgasm. Causes may include nerve damage, cancer treatments, certain medications, stress or anxiety.

What is anorgasmia?

Anorgasmia is the inability to orgasm, even if you have lots of stimulation and it feels good. Certain conditions may cause anorgasmia. But it may also occur as a result of physical, mental or emotional factors.

What is retrograde ejaculation?

Retrograde ejaculation is when ejaculate travels backward into your bladder instead of out through your penis during orgasm. Certain medications or medical conditions, like diabetes, can cause it.