Delayed Ejaculation

What is delayed ejaculation?

Delayed ejaculation, also called delayed orgasm, happens when you take a long time and need a lot of stimulation to reach sexual climax and ejaculate (the term for when semen is forcefully pushed out of your penis). In some cases, you might not ejaculate at all.

Delayed ejaculation, also called delayed orgasm, was previously called male orgasmic disorder. The inability to ejaculate is called anejaculation. Being unable to reach a climax (orgasm) is called anorgasmia.

There’s really no “normal” time limit for how long it should take to orgasm. However, if you have delayed ejaculation, the time it does take may cause stress for you and possibly for your partner.

Who does delayed ejaculation affect?

Delayed ejaculation can affect anyone. It affects some individuals their entire lifetime. For others, it happens once in a while or begins to be a problem as they get older.

Factors that can make delayed ejaculation more likely include:

• Having diabetes, mostly type 1 diabetes, multiple sclerosis, a stroke or spinal cord injury.
• Getting older.
• Having had surgery on your bladder or prostate.
• Taking certain medications, including some drugs that treat depression, psychosis, high blood pressure and pain.
• Mental health or relationship issues.

Delayed ejaculation can happen when you’re masturbating or when you’re having sex with a partner. It could be something that has just started or something that has happened throughout your lifetime. If it only happens in certain situations, like when you’re with someone, delayed ejaculation could have a psychological cause.

How common is delayed ejaculation?

There are estimates that 1% to 4% of men in the U.S. have delayed ejaculation.

What are the symptoms of delayed ejaculation?

Usually, men are able to ejaculate after only minutes of sexual stimulation. One symptom of delayed ejaculation is that it takes you 30 minutes or more to climax.

Another issue is that you might get physically tired. You might actually even start to feel some pain. Both of these things might also be true for your partner, if there’s a partner involved. Your partner could feel hurt thinking they aren’t attractive enough or skillful enough to stimulate you to orgasm.

What’s important, really, is how you feel. If you’re frustrated or upset by the time that it takes you to ejaculate, or if you don’t ejaculate, then it’s a problem that needs to be addressed.

What causes delayed ejaculation?

There are physical and psychological causes for delayed ejaculation.

Physical causes may include:

• Nervous system conditions, such as stroke, spinal cord injury and multiple sclerosis. Nerve damage can also happen as a complication of diabetes and surgery.
• Hypothyroidism.
• Some type of blockage in your penis.
• Using certain prescription medications, like antidepressants, or using street drugs.
• Drinking alcohol to excess.
• Aging.

Psychological or emotional causes may include:

• Feeling guilty about sex, possibly due to your upbringing.
• Feeling angry at or uncomfortable with your partner.
• Being afraid of something, such as disease, pregnancy or hurting your partner.
• Having sexual performance anxiety.
• Being addicted to pornography.

If you’re able to have an orgasm easily by yourself, but have difficulty with your partner, your healthcare provider might suggest that the cause isn’t physical. It’s also possible that you have a certain technique that you use that your partner can’t duplicate or that you’re not comfortable asking your partner to duplicate.

How is delayed ejaculation diagnosed?

Your healthcare provider will ask you questions about your medical history, sexual habits and ejaculation patterns. They will rule out other conditions, possibly doing laboratory testing on hormones (testosterone), urine (pee) or semen.

Finally, your feelings about how and when you ejaculate are an important part of the diagnosis. Your healthcare provider may also want to ask your partner some questions.

How is delayed ejaculation treated?

Your healthcare provider may offer you a number of different kinds of treatments. There really isn’t one clear way to treat the condition, though, except if it’s caused by certain drugs or alcohol use. You can stop using the drugs and cut down on the drinking.

If delayed ejaculation is a side effect of prescription drugs, you can work with your healthcare provider to switch to another medicine that may not have the same effect on you.

Your healthcare provider might refer you to other medical professionals like a sex therapist and/or a more traditional type of counselor. If delayed ejaculation happens primarily with your partner, your healthcare provider might suggest counseling for both you and your partner.

If you see a sex therapist, they might suggest using erotic materials or devices to help you ejaculate both by yourself and with a partner.

Medications

There isn’t an approved drug treatment for delayed ejaculation, and that includes supplements. However, some healthcare providers prescribe medicines on an “off-label” basis with a small degree of success. Some of these medicines are:

• Testosterone, a hormone.
• Cyproheptadine (Periactin®), an antihistamine.
• Buspirone (BuSpar®), a treatment for anxiety.
• Amantadine (Symmetrel®), a treatment for Parkinson’s disease.
• Oxytocin (Pitocin®), a hormone used in childbirth to strengthen uterine muscle to contract and produced by the body during orgasm.
• Cabergoline, a drug that promotes dopamine levels.

Keep in mind, though, that these drugs aren’t designed to treat delayed ejaculation specifically. They may or may not help.

If delayed ejaculation is interfering with having a child, your healthcare provider might suggest ways to retrieve sperm that can be used for insemination.

Complications/side effects of treating delayed ejaculation

Any medicine you take can cause side effects. Prescription drugs come with a list of side effects to watch out for.

Are there exercises that will help with delayed ejaculation?

You’ve probably heard of Kegel exercises, also called pelvic floor exercises. You can find the muscles to exercise by starting to pee and then stopping and then starting again. Once you’ve found these muscles, you can do these types of exercises anywhere and in any position. It might help you to have a stronger pelvic floor and more control over these muscles.

How can I prevent delayed ejaculation?

You can’t really prevent delayed ejaculation caused by nerve damage or aging. You can, however, prevent problems caused by drinking excessively or abusing drugs.

If you think relationship issues with your partner are a factor in delayed ejaculation, try having an honest conversation with them. Improving your relationship may help prevent delayed ejaculation from developing or from getting worse.

What is the prognosis (outlook) for delayed ejaculation?

The outlook for delayed ejaculation caused by a substance that you can quit taking is good, but the outlook for delayed ejaculation caused by other things is not as good.

When should I see my healthcare provider about delayed ejaculation?

If you’ve had lifelong problems with delayed ejaculation, or if you have newer episodes that have lasted six months or more, call your healthcare provider. If you have delayed ejaculation alone or with someone and the condition is causing trouble for you or your partner, call your healthcare provider. The first place to start is to look for medical issues that could be causing the condition, which your healthcare provider can do.

Can Viagra® help with delayed ejaculation?

Sildenafil (Viagra) helps people with erectile dysfunction (ED) last longer in sexual situations. It hasn’t been tested in treating delayed ejaculation. However, at least one new study indicated that another ED drug, tadalafil (Cialis®), may promote ejaculation.

How can I help my partner with delayed ejaculation?

If you’re the one talking to your healthcare provider about delayed ejaculation, please make sure your partner is involved in at least some of the conversations. Your healthcare provider might suggest your partner also have an examination to make sure there is nothing physical going on with them. This is true especially if you’re afraid of hurting your partner during sex.

If you’re the partner of someone with delayed ejaculation, try asking if there is something specific you can do to help. Be open to the idea of going for couples counseling or sex therapy. But try to let go of the thought that either one of you is doing something “wrong.”

A note from Cleveland Clinic

Delayed ejaculation or not ejaculating at all is a condition that is still being studied. There aren’t a lot of absolute guidelines about how much time is too much time to ejaculate, how delayed ejaculation should be treated or what causes it. But it’s a problem when it’s a problem for you and for your partner. Many people might think not ejaculating for a relatively long period of time in a sexual situation would be a good thing. However, in many cases, longer sexual activity isn’t resulting in more pleasure. It’s actually causing stress and even physical problems for all partners involved. It’s important to have honest conversations with your healthcare provider and your partner about all of your concerns.