Delayed ejaculation

One of the common signs of delayed ejaculation is when a man takes more than 30 minutes of penetrative sex to reach an orgasm and ejaculate. However, there are different stimulants for different people: while some men are only able to ejaculate with manual or oral stimulation, some may not be able to orgasm at all, which is also known as anorgasmia.

Read more: Sex education and sexual health

The scenarios or situations can also differ from person to person, as some men experience delayed ejaculation from a young age and may have to live with it, while others may develop it later in life. Some others may just have the problem in specific sexual situations, while some men may experience delayed ejaculation only with certain sexual partners.

If delayed orgasm is a regular occurrence for a person during sexual activity, there may even be an underlying health condition at play, which should be seen as a sign to visit a doctor without wasting any time.

Several physiological, as well as psychological conditions, are said to be behind delayed ejaculation in a person. Researchers have often called delayed ejaculation the least understood of the sexual dysfunctions among men, besides being one of the least common conditions. Here's a look at what can cause delayed ejaculation:

Physiological causes

• The nerve pathways that help release semen or facilitate ejaculation may be damaged. Such nerve damage is usually experienced due to a spinal cord injury.
• According to a study done in 2005, chronic conditions such as diabetes and multiple sclerosis can also be the reason for delayed ejaculation.
• Other medical conditions such as infections of the prostate and urinary tract infections could also be behind the occurrence of delayed ejaculation.
• Advancing age is also said to be behind the emergence of delayed ejaculation among some men, although the argument has been divided thanks to conflicting outcomes of studies. A 2006 study says the condition may be because of low penile sensitivity which occurs as a result of ageing. But a 2014 study didn't find enough evidence to suggest low penile sensitivity was a primary cause of delayed ejaculation.
• Heart disease is also known to be a factor behind delayed ejaculation, as it can affect blood pressure to the pelvic region.
• Stroke or neuropathy.
• Low hormone levels, such as low thyroid (hypothyroidism) or low testosterone.
• Birth defects.

Psychological causes

• High frequency of masturbation or using unusual or unique styles to masturbate that may be very different from stimulation occurring from penetrative sex. Some men are also used to masturbating to a particular fantasy or imagery which cannot be replicated during a normal sexual experience.
• Anxiety, depression and other mental health conditions are also known factors behind delayed ejaculation, as they can reduce sexual desire in men.
• Traumatic past experiences involving sex or physical abuse can also cause sexual dysfunctions such as delayed ejaculation.

Other possible factors behind delayed ejaculation are:

• Prolonged drug use or alcohol consumption (read more: alcoholism) are also known to be behind the symptoms of delayed ejaculation.
• Prolonged use of antidepressants, blood pressure medications and certain diuretics can also cause delayed ejaculation in some people.

If you have observed any of the above-mentioned symptoms of delayed ejaculation during sexual activity for about six months, it is time to visit a doctor.

The doctor is likely to ask you questions around your general health and lifestyle, the symptoms you have been noticing, and perform a physical examination to assess your condition.

Underlying medical conditions will be taken into account, such as a prior history of infections or chronic illnesses, which would allow the doctor to make the correct diagnosis.

Depending on the underlying cause of delayed ejaculation in a patient, the right treatment method is chosen.

A general physician is usually able to assess if there is a medication that has caused this condition, especially if delayed ejaculation has been a relatively recent development.

In the past, doctors have prescribed medications—including drugs used to treat Parkinson's disease—to people with delayed ejaculation. Anti-anxiety medications have also been used in the treatment of the symptoms of delayed ejaculation.

If there are other factors behind the development of delayed ejaculation such as alcohol or drug abuse, therapy or suitable corrective measures can also be an option.

In some cases, especially when unusual sexual practices that may be behind delayed ejaculation, sex therapy and counselling—which can involve either only the patient or include their partner—may help.

Delayed ejaculation is a condition that can cause a great deal of stress among patients as well as their partners due to unsatisfactory experiences during sexual intercourse. There are several factors behind the onset of delayed ejaculation, which include physiological as well as psychological reasons.

Delayed ejaculation is a treatable medical condition and if a person experiences the symptoms for more than six months, they should visit a doctor who would be able to diagnose the problem and advise the right course of treatment.