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Delayed Ejaculation: PE Isn’t the Only Ejaculatory Dysfunction

Overview:  An estimated one to four percent of men struggle with delayed ejaculation (DE). DE is the opposite of premature ejaculation and is defined as taking longer than 30 minutes to ejaculate during sex. Although research is limited on what causes DE, it is usually a treatable condition. Effective treatment options include psychotherapy, sex therapy, and prescription medications.

What is Delayed Ejaculation?

Definition: Delayed ejaculation is diagnosed when a man takes more than 30 minutes during sexual stimulation to ejaculate. 

Delayed ejaculation (DE) differs from premature ejaculation (PE) in that it is a sexual condition that causes men to take 30 minutes or longer to ejaculate. Men with this condition may experience discomfort and be unable to reach climax at all during sexual stimulation. DE is also commonly referred to as “impaired ejaculation.”

While occasional delays in ejaculation are normal, persistent issues related to delayed ejaculation may warrant a visit with your medical provider. Persistent DE affects approximately one to four percent of men living in the United States. The condition may arise suddenly and only last for a short period of time, or if untreated, it may persist and become a lifelong condition.

Symptoms of delayed ejaculation may include:

  • Difficulty reaching climax or ejaculating
  • Inability to ejaculate
  • Stress surrounding length of time it takes to ejaculate

Any persistent challenges related to ejaculation should be discussed with a medical provider.

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What Causes Delayed Ejaculation?

The exact cause of DE varies from person to person. Many times, the condition is caused by multiple factors, such as a combination of lifestyle factors and prescription medication use.

  • Alcohol or other substance use
  • Certain medications, such as antidepressants, antihypertensives, and antipsychotic drugs
  • Chronic health conditions
  • Hormone-related conditions
  • Infections, such as a urinary tract infection
  • Injury to the penis or nerve damage
  • Pelvic or penile surgeries
  • Aging and decreased sensation

Psychological problems are the most commonly cited causes of DE.  Potential psychological causes of delayed ejaculation include:

  • Chronic stress
  • Depression or other mood disorders, such as anxiety
  • History of abuse
  • Relationship issues

How is Delayed Ejaculation Diagnosed?

Only a medical provider can officially diagnose DE. The condition is challenging to diagnose, because the average length of time it takes for men to ejaculate varies greatly. Most providers recommend seeking medical counsel if you experience significant distress about the length of time it takes for you to ejaculate.

You should determine if your inability to ejaculate within a 30-minute timeframe has been persistent for six months or longer. You should also document any emotional challenges or distress related to the time it takes you to ejaculate. Your provider will likely discuss your medical and sexual history, then rule out any potential medical conditions prior to moving forward with treatment for DE.

DE can cause relationship stress and reduced sexual satisfaction if left untreated. Though it likely will not lead to any serious physical condition, it is still important to seek diagnosis if it causes you emotional distress.

What are the Treatment Options for Delayed Ejaculation? 

Your provider will likely recommend a combined treatment approach to effectively manage any factor contributing to DE. Combined treatment approaches may include counseling, sex therapy, behavioral modifications, or prescription medication. Your treatment team may consist of your medical provider, a sex therapist, and any other provider who can help to treat the root causes of your condition.

Common treatments for DE include:

  • Counseling. If your DE is rooted in anxiety, chronic stress, a mood disorder, or psychological trauma, you may benefit from counseling.
  • Prescription medication. There are currently no prescription drugs on the market that exist solely to treat DE. However, medications used to treat other disorders, such as anxiety and Parkinson’s disease, can be used to treat DE. These drugs include amantadine (Symmetrel), buspirone (Buspar), and cyproheptadine (Periactin).
  • Sex therapy. If your DE is rooted in relationship problems or anxiety surrounding sex, you may also benefit from sex therapy.

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What is the Easiest Way to Access Treatment for Delayed Ejaculation?

The first step in seeking treatment for any ejaculation disorder is to speak with your medical provider. Your provider can help to identify the root cause of your condition. They can also develop a treatment plan tailored to your specific needs.

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Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).