What Is Delayed Ejaculation and How to Overcome It

What is Delayed Ejaculation?

Delayed ejaculation  is a rare and widely uncommon form of male sexual dysfunction. Delayed ejaculation occurs when there is  either a delay in ejaculation or when ejaculation is unable to occur.  A man can be diagnosed with delayed ejaculation if he also experiences challenges with orgasm. The condition is highly published in clinical literature. According to the DSM-5, the official gold standard Diagnostic and Statistical Manual of Mental Disorders, to meet the criteria to be diagnosed with delayed ejaculation, an individual must either experience an infrequency or absence of ejaculation for a period of at least six months of partnered sexual activity. 

Furthermore, the individual must not have desired a delay and the delay must have caused significant impotent or distress for the individual.  An individual can experience these problems even if their erection is normal . Men who receive an accurate diagnosis of delayed ejaculation are typically not able to ejaculate more than half of all the times they have sex. 

What Causes Delayed Ejaculation?

Delayed ejaculation has several different causes which can either be physical or psychologically based. Some psychological causes include stress and relationship issues.  Relationship concerns can make it difficult for men to ejaculate. Our relationships can take up a lot of mental energy, provoking stress when we feel unable to thrive or successfully manage problems with our partner. 

Relationship distress can be caused by conflict, infidelity, communication problems, unmet needs and general unhappiness in a relationship. It is important that if you start to experience issues that resemble delayed ejaculation to investigate if there are  any major life changes or stressors that have recently occurred prior to the start of your ejaculation concerns. Depression is also a relevant concern that can cause this condition.

Some other psychological factors that may be associated with delayed ejaculation include having an  aversive childhood or experiencing childhood abuse, repressed anger, and body image issues. 

As with most sexual dysfunctions and disorders, the cause may be more physiological. This particular sexual challenge can also be caused by chronic health conditions such as diabetes and multiple sclerosis or the essential medications that may be used to treat these conditions. For example, SSRIs and antipsychotics which are used to treat mental health challenges can cause issues with ejaculation. Blood pressure medication, anxiety medication and painkillers can also lead to delayed ejaculation in some men. Age is also a natural cause for the condition. 

How it Affects Men

Delayed ejaculation can cause serious threats to someone's self esteem. Experiencing challenges with orgasm can make someone feel like they are unworthy or not good enough when it comes to sexually satisfying their partner. Delayed ejaculation can also negatively impact one’s confidence, making them feel like they will continue to have these ejaculation issues for the rest of their lives. 

Furthermore, this rare condition can also  cause stress and anxiety related to sexual performance. To further complicate matters, the new or additional stress and anxiety caused by delayed ejaculation can further exacerbate challenges related to the condition. In other words, someone who feels more stress about not being able to ejaculate is more likely to experience more problems related to ejaculation and orgasm. Men who have this condition may also experience pain if they engage in sexual activity and fail to orgasm.

How it impacts relationships

Due to the stress and anxiety caused by delayed ejaculation,  some men may even find it difficult to feel excited about sex. Instead, their excitement may be replaced by feelings of inadequacy and insecurity that make it difficult to remain present during sexual activity, which might increase the likelihood that they will experience difficulty orgasming during sex. 

Performance anxiety may also begin to dominate the relationship of a man who is diagnosed with delayed ejaculation, however, this is not a guarantee. The person who is diagnosed may fear that they cannot sexually satisfy their partner. In some cases, partners of men who have delayed ejaculation may not feel sexually satisfied in their relationship and  struggle to communicate their feelings to their partner. Partners of men who have delayed ejaculation may also feel frustrated and fear that they themselves are unable to satisfy their partners. 

Sometimes men who have delayed ejaculation may feel that they would want to  avoid sex  all together due to their associated feelings of  frustration and anger . An avoidance of sex can lead to a partner worrying that they are undesirable.

Another relevant concern that may be experienced by partners is fear or frustration that they may be unable to have children with their partner. Long term delayed ejaculation may lead to issues with infertility or  challenges related to conceiving children. 

How to Overcome Delayed Ejaculation

It’s important to remember that delayed ejaculation is a treatable condition. Receiving an official diagnosis or even suspecting that you may have the condition does not mean that you cannot or will not have a satisfying sex life.  Satisfying sex is possible and happens everyday for men around the world who are diagnosed with this condition. 

The most highly recognized and accepted treatment for delayed ejaculation involves receiving some form of  sex therapy . Sex therapy is a form of therapy that combines traditional talk therapy and behavioral changes that can improve your sex life. You can see a sex therapist on your own or with a partner. Both forms of treatment are acceptable. Throughout the therapy process, you will likely be assigned sexual activities to try at home that directly condition your body to more readily have an orgasm. 

If medication is the cause of delayed ejaculation, it is advised to speak with your doctor. In many cases, your doctor may be able to recommend a change to your medication or switch the medication all together to combat delayed ejaculation. 

If psychological challenges such as stress and anxiety are the cause of delayed ejaculation, it may be a good idea to incorporate more practices in your daily life that target these symptoms such as mediation,  yoga, breath work, and consistent exercise. In psychological cases, therapy treatment can also improve symptoms that both caused and currently exacerbate challenges related to delayed ejaculation. 

It can also be a good idea to prioritize strengthening communication with your partner. Delayed ejaculation can undoubtedly cause insecurity for both you and your partner. By having good communication, you both can specifically communicate about your particular sexual needs and desires and find new alternative ways to enjoy sex together.  You should approach these conversations with an open mind and strive to listen to one another nonjudgementally. 

Regardless of a diagnosis, a good and healthy partner for you will be supportive of you and willing to improve both of your well being together as a couple. You still deserve respect. Harsh criticism during such vulnerable discussions may bring attention to deep rooted issues that have existed before delayed ejaculation ever occurred. 

It’s also okay to take breaks during sex if and when necessary. This may also be a great practice to employ especially if either you or your partner start to feel stressed or worried during sex or if either one of you experience sexual performance anxiety. 

Be adventurous where you can. You can try new sex positions or incorporate sex toys to enhance your sexual experience together. This may be a good idea even if you don’t experience delayed ejaculation since couples who are willing to try new things sexually more often report higher levels of satisfaction together during sex compared to couples who don’t. 

References:

Abdel-Hamid, I. A., & Ali, O. I. (2018). Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment. The world journal of men's health, 36(1), 22–40.  https://doi.org/10.5534/wjmh.17051

NHS. (2023). Ejaculation Problems. NHS.  https://www.nhs.uk/conditions/ejaculation-problems/

MacGill, M. (2024). What you need to know about delayed ejaculation. MedicalNewsToday.  https://www.medicalnewstoday.com/articles/284679