What is Delayed Ejaculation?

Medication side effects

One of the most common causes of delayed ejaculation is a side effect from a medication. These medications include:

1. Antidepressants, such as paroxetine (Paxil), fluvoxamine (Luvox), sertraline (Zoloft), and fluoxetine (Prozac). Alternatives that are less likely to cause problems are mirtazapine (Remeron) and bupropion (Wellbutrin).
2. Blood pressure medications, such as beta blockers and diuretics like hydrochlorothiazide.
3. Antipsychotics, such as haloperidol (Haldol) and risperidone (Risperdal).
4. Mood stabilizers, including valproic acid, carbamazepine (Tegretol), and phenytoin (Dilantin)

Psychiatric, behavioral, and interpersonal issues

Numerous mental health issues can cause sexual disruptions, including delayed ejaculation. Both depression and anxiety are two major ones can that interfere with levels of sexual arousal and slow things down. Excessive alcohol drinking and drug use can lead to sexual dysfunction, including delayed ejaculation. Trauma and unhealthy social or familial attitudes around sex can also cause problems.

Lack of communication between partners about their respective wants and needs in sex can interfere with intercourse. Another unique cause of delayed ejaculation is frequent or aggressive masturbation techniques that may desensitize the person, making it difficult to ejaculate during intercourse.

Medical causes

Numerous medical conditions can cause delayed ejaculation. This include neurological conditions such as multiple sclerosis, spinal cord injuries, or neuropathy that can affect nerve signals required for ejaculation. One of the most widespread causes of neuropathy is chronic, unmanaged diabetes, which damages nerves throughout the body. Hormone imbalances such as hypothyroidism or low testosterone can delay ejaculation as well. Delayed ejaculation can also present as an unfortunate side effect after prostate surgery.

Making the Diagnosis

People with Delayed Ejaculation have issues in all or almost all of their sexual encounters. The problems include either a significant delay in ejaculation or the inability to ejaculate at all. This happens in spite of sufficient arousal and desire to ejaculate. There is no definitive cut-off for what constitutes a “delay”. It’s essentially whatever amount of time is “too long” for either or both partners. Penetrative intercourse that lasts too long can can become exhausting, uncomfortable, and even painful. This leads people to give up, leaving people unsatisfied and frustrated. Many men begin avoiding sex, and their partners can often take it personally, feeling like they are less sexually attractive.

When making the diagnosis, doctors will note whether the issue has lasted the person’s whole life or is a new occurrence. They will also determine if delayed ejaculation is happening all the time or just under specific circumstances. Doctors also look at several other factors when encountering this disorder.

1. Individual factors, such as psychiatric problems, life stressors, or personal trauma history.
2. Partner factors, such as any changes or issues with the partner’s sexual functioning.
3. Relationship factors, such as communication issues or sexual incompatibilities.
4. Cultural and religious factors, such as differing outlooks on sexuality.
5. Medical factors, such as medications or conditions that could contribute to the problem.

Changing medications

The methods for treating people with delayed ejaculation depend on what doctors determine the causes to be. Given that one of the most common causes of delayed ejaculation is a medication side effect, that is a good place to start looking. You can refer to the list above under “Causes and Risk Factors” to find out if you might be taking a medication that is causing the issue. If you think this might be the cause, the best remedy is to talk to your doctor about changing to another medication.

Therapy options

Unfortunately, many causes of delayed ejaculation are not a simple as switching medications. Furthermore, there is no medication that can directly treat delayed ejaculation, either. In these cases, the best option is therapy focused on sex. Sex therapy is a special form of counseling that focuses on addressing sexual issues like delayed ejaculation. A sex therapist is a licensed therapist or counselor who has received additional training and certification in the field of sexual health and relationships. Sex therapists will work with individuals or couples to help them improve their sexual functioning, including addressing issues like delayed ejaculation.

Communication is key

Effective communication with your partner is crucial. Discuss concerns, desires, and boundaries openly and honestly. Talking openly about sex will help couples know what works and what doesn’t for each other. This mutual understanding can reduce anxiety and improve the overall sexual experience.

Avoid excessive masturbation

Pay attention to masturbation habits. If someone has developed a distinct pattern of self-stimulation that differs from partnered sex, they should consider adjusting their approach to align more closely with the sensations experienced during intercourse.

Stay in the moment

Relaxation techniques like mindfulness can help people stay present during sexual activity. Focusing on sensations and emotions in the moment rather than performance can reduce delayed ejaculation. This can help people whose problems are related to anxiety. Other stress reduction techniques such as deep breathing, meditation, yoga, or exercise can also help.