Delayed ejaculation (male orgasmic disorder) is classed as either:
- experiencing a significant delay before ejaculation
- being unable to ejaculate at all, even though the man wants to and his erection is normal
You may have delayed ejaculation if:
- you experience a repeated and unwanted delay before ejaculation lasting for 30 to 60 minutes
- you're unable to ejaculate at least half the times you have sex
Causes of delayed ejaculation
Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors.
Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation – for
example, early sexual trauma, strict upbringing, relationship problems, stress or depression.
Physical causes of delayed ejaculation include:
- diabetes (usually only type 1 diabetes)
- spinal cord injuries
- multiple sclerosis
- surgery to the bladder or prostate gland
- increasing age
Many medicines are known to cause delayed ejaculation, including:
- antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs)
- medicines to treat high blood pressure, such as beta-blockers
- muscle relaxantss uch as baclofen, which is widely used to treat motor neurone
disease and multiple sclerosis
- powerful painkillers, such as methadone (which is also widely used to treat people
addicted to heroin)
- relationship problems
- anxiety about sexual performance (particularly at the start of a new relationship,
or when a man has had previous problems with sexual performance)
Delayed ejaculation can suddenly start to happen after previously having no problems, or (less commonly)
the man may have always experienced it.
It can occur in all sexual situations, or only in certain situations. For example, you may be able to
ejaculate normally when masturbating, but not during sex. When ejaculation only occurs in certain
situations, there's usually a psychological cause.
Treating delayed ejaculation
Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in
your sex life. This can help to increase your feeling of enjoyment during sex, and help make ejaculation
During sex therapy, you'll have the opportunity to discuss any emotional or psychological issues related
to your sexuality and relationship, in a non-judgemental way.
Activities may also be recommended for you to try at home while you're having sex with your partner (you
should never be asked to take part in any sexual activities during a session with the therapist).
These may include:
- viewing erotic videos and magazines before having sex to increase the feeling of stimulation
- erotic fantasies and "sex games" to make your lovemaking more exciting
- using lubricating creams, or jellies, to make the physical act of sex more comfortable and relaxing
- using sexual aids, such as vibrators, to increase pleasure
There are a number of medicines that can be used if it's thought SSRIs are responsible for causing
delayed ejaculation. These include:
- amantadine – originally designed to treat viral infections
- buproprion – usually prescribed to help people quit smoking
- yohimbine – originally designed to treat erectile dysfunction
In the squeeze technique, your partner masturbates you, but stops before the point of ejaculation and
squeezes the head of your penis for between 10 to 20 seconds. They then let go and wait for another 30
seconds before resuming masturbation. This process is carried out several times before ejaculation is
allowed to occur.
These help block some of the chemical effects of SSRIs that may contribute towards delayed ejaculation.
Alcohol and drugs
Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.
If you need help with alcahol and drug misuse - contact a specialist - Download the Dokitari health app for free For android
or For iOS
Pseudoephedrine tablets may be tried, but these will need to be prescribed "off-label". This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).