Delayed ejaculation is a type of ejaculatory dysfunction, and probably the least understood. It is also the least common form of male sexual dysfunction, affecting around 1 to 4% of men, compared to 15 to 30 percent of men who report of premature ejaculation problems.

In short, delayed ejaculation is a man’s difficulty or inability to reach orgasm and ejaculate sperm. In general, if it takes more than 30 minutes of sexual penetration, despite a healthy erection, it is considered delayed ejaculation.

Delayed ejaculation can cause significant psychological distress in a man and his partner. This can cause relationship problems, concerns about general and sexual health, low libido or lack of sex drive, and sexual dissatisfaction for both parties. Men with delayed ejaculation are more likely to suffer from anxiety and depression. The psycho-social distress and relationship difficulties that result from delayed ejaculation are often worse for couples trying to start a family.

Delayed ejaculation is diagnosed when a man worries about a marked delay or insufficient ejaculation during most sexual encounters for six months or more and when other problems have been ruled out.

Causes of delayed ejaculation

Delayed ejaculation can have a psychological or biological reason or both. This can be a long-term condition, where a man has always had difficulty reaching an orgasm, but more commonly, delayed ejaculation occurs after a period of normal function.

The physical causes of delayed ejaculation include:

  • Side effects of drugs: There can be an adverse effect of antidepressants (especially SSRIs - selective serotonin reuptake inhibitors), anti-anxiety drugs, blood pressure drugs (anti-hypertensives), pain relievers and other drugs.
  • Alcohol or the use of certain recreational drugs (whether legal or illegal)
  • Nerve damage (neurological causes) - stroke, spinal cord injury, surgery, multiple sclerosis, and severe diabetes can all lead to abnormal ejaculatory function.
  • Increasing age can reduce penis sensitivity to sexual stimulation.

An acquired case is generally determined to have a psychological cause if it only occurs in specific situations. For example, delayed ejaculation is more likely to have a psychological basis if a man can ejaculate normally during masturbation, but experiences ejaculation issues during intercourse with a partner.

The psychological causes of delayed ejaculation include:

  • Early life history, including abuse, bonding difficulties, parental neglect, negative sex education
  • Unformulated anger
  • Religious belief, considering sex as taboo
  • Fear of, for example, sperm or female genitals, or mistreating partner
  • Fear of pregnancy
  • Problems with lost confidence or performance anxiety - for example, anxiety about body image that interrupts the process of sexual stimulation

Previous masturbation is a factor that is strongly linked to delayed ejaculation too. Here’s how:

  • Masturbating more often, typically more than three times not only affects sexual health but can delay orgasms
  • Having a style of masturbation that cannot be matched by sex - especially a high speed, high pressure or high intensity form
  • The partner’s hand, mouth or vagina is not able to easily reproduce the learned style
  • Sex partner differs from fantasy used during masturbation to achieve orgasm

Whether delayed ejaculation can be successfully treated depends on the cause of the problem and the type of treatment. However, it is important to be concerned about your sexual function and health. Speak with a doctor so that the right course can be taken.

Medically reviewed by Rishabh Verma, RP