Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or they may not be able to ejaculate at all (anejaculation). In the most common form of delayed ejaculation, a man can't reach orgasm during sexual intercourse — but can ejaculate with oral or manual stimulation of the penis. Some men can ejaculate only when masturbating.
Delayed orgasm is divided into the following types based on symptoms:
- Lifelong vs. acquired. With lifelong delayed ejaculation, the problem is present from the time a male reaches sexual maturity. Acquired delayed ejaculation occurs after a period of normal sexual functioning.
- Generalized vs. situational. Generalized delayed ejaculation isn't limited to certain sex partners or certain kinds of stimulation. Situational delayed ejaculation occurs only under certain circumstances.
These categories help in diagnosing an underlying cause, and determining what might be the most effective treatment.
When to see a doctor
Your family doctor is a good place to start when you have delayed ejaculation. See your doctor if:
- Delayed ejaculation is an issue for you or your partner
- You have another known health problem that may be linked to delayed ejaculation, or you take medications that could be causing the problem
- You have other symptoms along with delayed ejaculation that may or may not seem related
Delayed ejaculation can result from certain chronic health conditions, surgeries and medications. Or it may be caused by substance abuse or a mental health concern, such as depression, anxiety or stress. In many cases, delayed ejaculation is due to a combination of physical and psychological concerns.
Physical causes of delayed ejaculation include:
- Certain birth defects affecting the male reproductive system
- Injury to the pelvic nerves that control orgasm
- Certain infections
- Prostate surgery, such as transurethral resection of the prostate (TURP) or prostate removal
- Heart disease
- Prostate infection or urinary tract infection
- Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord
- Hormone-related conditions, such as low thyroid hormone (hypothyroidism) or low testosterone
Psychological causes of delayed ejaculation include:
- Depression, anxiety or other mental health conditions
- Relationship problems due to stress, poor communication or other concerns
- Anxiety about performance
- Cultural or religious taboos
- Differences between the reality of sex with a partner and sexual fantasies
Medications and other substances that can cause delayed ejaculation include:
- Most types of antidepressants
- Certain high blood pressure medications
- Certain diuretics
- Some antipsychotic medications
- Alcohol — particularly drinking too much (alcohol abuse or alcoholism)
For some men, a minor physical problem that causes a delay in ejaculation may cause anxiety about ejaculating during a sexual encounter. The resulting anxiety can worsen delayed ejaculation.
A number of things can increase your risk of having delayed ejaculation, including:
- Older age — as men age, it's normal for ejaculation to take longer
- Psychological conditions, such as depression or anxiety
- Medical conditions, such as diabetes or multiple sclerosis
- Certain medical treatments, such as prostate surgery
- Medications, particularly certain antidepressants, high blood pressure medications or diuretics
- Relationship problems, for example, problems communicating openly with your partner
- Drinking alcohol or using illegal drugs, especially if you're a long-term drug user or heavy drinker
Complications of delayed ejaculation can include:
- Diminished sexual pleasure for a man or his partner
- Stress or anxiety about sexual performance
- Marital or relationship problems due to an unsatisfactory sex life
- Inability to get your partner pregnant (male infertility)
Because it can happen for a number of physical and psychological reasons, no one strategy can prevent delayed ejaculation. But taking these steps may help:
- Spend more time with your partner to increase intimacy.
- Limit or avoid the use of alcohol.
- Don't use illegal drugs, such as marijuana.
- Stop using tobacco.
- Exercise regularly.
- Take steps to reduce or better manage stress.
- Get enough sleep.
- Get help for anxiety or depression.
- Make sure you're getting the treatment you need for any chronic health problems.