What is delayed ejaculation?
Ejaculation is associated with orgasm but they are two separate physiological processes. While it’s possible to reach orgasm and not ejaculate, you can’t ejaculate if you don’t reach orgasm1 .
Delayed ejaculation is the term commonly used for conditions that result in men experiencing difficulties with reaching orgasm and ejaculating.
We don’t really know how many men have delayed ejaculation, but it’s probably somewhere between 1 in 5 and 1 in 502.
Delayed ejaculation is more likely to occur if you have particular health conditions or take specific types of medicines.
Symptoms of delayed ejaculation
Delayed ejaculation is diagnosed if you take a long time to reach orgasm or do not reach orgasm at all, even though you want to and are trying, and you are upset or having relationship problems because of it.
Causes of delayed ejaculation
Orgasm and ejaculation are both controlled by the nervous system, so psychological and physical things that affect the necessary nerve activity can both contribute to delayed ejaculation3.
Examples of psychological reasons for delayed ejaculation include:
- Performance anxiety
- Religious conflict
- Fears of pregnancy, intimacy, or abandonment.
Physical causes of delayed ejaculation can include:
- Abnormalities in reproductive system development
- Nerve damage from diabetes or surgery
- Hormone problems.
The way some men masturbate can affect their ability to reach orgasm and ejaculation with their sexual partners4.
Antidepressants and medications to help control blood pressure are among the drugs that may delay ejaculation3.
The more medical problems you have, the more likely you are to have delayed ejaculation. Stress and being tired also increase your chance of delayed ejaculation5.
Diagnosis of delayed ejaculation
The reasons for delayed ejaculation vary from person to person and can be quite complicated. Your doctor may need to perform a physical examination, ask some questions and run some tests to work out the best way to treat your delayed ejaculation.
Treatment of delayed ejaculation
There are a variety of medications that can be used to treat delayed ejaculation, but vibratory stimulation of the penis and counselling are usually effective.
If the cause of your delayed ejaculation is psychological, then speaking to someone like a sexual health therapist can help.
Health effects of delayed ejaculation
Delayed ejaculation can make you depressed or anxious and can have negative effects on your relationship with your partner1.
Delayed ejaculation can be successfully treated but, because it’s such a complex problem, it’s difficult to know how long it might take and exactly how successful your treatment will be.
What to do about delayed ejaculation
If you sometimes take a long time to reach orgasm and ejaculate but it doesn’t bother you or your partner, then you probably don’t need to worry too much about it. But it might still be worth mentioning to your doctor, so they can keep a full record of your health and wellbeing.
If problems with orgasm or ejaculation are bothering you, it’s best to see your doctor sooner rather than later.
Questions to ask your doctor about delayed ejaculation
- Could my delayed ejaculation be caused by any medications I’m taking?
- Do you think it’s worthwhile for me to talk to a sexual health specialist about my delayed ejaculation?
- Do you have any more questions for me to help you better understand what might be causing my delayed ejaculation?
 Jenkins & Mulhall, 2015. Delayed orgasm and anorgasmia. Fertility and Sterility
 Butcher & Serefoglu, 2017. Treatment of Delayed Ejaculation. In: The Textbook of Clinical Sexual Medicine, W.W. IsHak (ed)
 Abdel-Hamid & Ali, 2018. Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment. The World Journal of Men’s Health
 Perelman, 2016. Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model. Translational Andrology and Urology
 McCabe & Connaughton, 2014. Psychosocial Factors Associated with Male Sexual Difficulties. The Journal of Sex Research
Ejaculation problems fact sheet
Clinical summary guide
Ejaculatory Disorders Clinical Summary Guide