What Causes Delayed Ejaculation (DE) And How Is It Treated?

Delayed ejaculation (DE) is a condition where an individual fails to ejaculate within an acceptable time after being sexually stimulated. DE has been reported in 1 to 4% sexually active men, making it a more uncommon sexual dysfunction compared to others.

 

However, just because you failed to ejaculate after 30 minutes of having sex doesn’t necessarily mean you have DE or another type of sexual dysfunction. The DSM-V outlines certain criteria before being diagnosed with delayed ejaculation as follows:

 

• Substantial delay in ejaculating; infrequent (75%) or complete and total lack of ejaculation over the past six months.
• Significant psychological distress from the failure to ejaculate as you desire.

 

Individuals that meet the aforementioned conditions – therefore, with textbook delayed ejaculation symptoms – can experience psychological symptoms like low self-esteem, depression, anxiety, relationship problems, and lack of sexual satisfaction.

 

What are the different types of delayed ejaculation (DE)?

 

Delayed ejaculation can be a chronic or acquired condition, and it can also happen in every sexual encounter. Just as much, DE doesn’t have to be chronic – it can also be  situational, or affecting individuals on different occasions.

On the other hand, delayed ejaculation that is acquired typically arises later in life. 75% of men with delayed ejaculation fall under this category.

 

 

What are the causes of delayed ejaculation (DE)?

 

Delayed ejaculation happens due to a variety of reasons ranging from psychological, 

A person may have problems climaxing and ejaculating when they want to for many reasons. These reasons could be physical, psychological, or both. Let’s take a look at some of them.

 

Physical causes

 

Congenital abnormalities, pre-existing medical conditions, surgery, or medicines affecting the nerves or nervous system may cause DE.

Here are some health conditions that may become underlying causes of DE include:

 

• Injuries to the spinal column
• Diabetic neuropathy (diabetes-induced nerve damage)
• Multiple sclerosis (MS)
• A swelling of the aorta known as abdominal aortic aneurysm (AAA)
• Injuries to the urethra

 

Meanwhile, procedures, surgeries, or medical treatments that can lead to ED include:

 

• Adult circumcision
• Radiation therapy on the pelvic region
• Pelvic trauma
• Surgery on the prostate

 

The aging process can also exacerbate symptoms of delayed ejaculation. For instance, diminishing penis sensitivity brought on by aging may make it harder for a man to orgasm and ejaculate. Furthermore, age-related diseases like heart disease, diabetes, or treatment related to such disease (including cancer) can make ejaculating more difficult.

Additionally, hormonal imbalances brought on by hormonal disorders can cause delayed ejaculation, such as:

 

• Hypogonadism (low testosterone). Low testosterone happens when the male reproductive system don’t produce enough hormones – or is unable to produce any at all.
• Hypothyroidism. Hypothyroidism happens when the thyroid produces an insufficient amount of thyroid hormones, leading to a hormonal imbalance.
• Hyperprolactinemia. This is a condition where the body produces an oversupply of prolactin, the hormone responsible for the development of breasts.

 

Certain medications and substances can result in delayed ejaculation, such as:

 

• Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants
• Analgesics or pain relief medications
• Diuretics 
• Antipsychotics and anti-anxiety medications
• Muscle relaxants
• Anti-hypertensives
• Alcohol
• Anti-epileptic medicines`

 

Psychological causes

 

DE may also arise due to psychological factors. For instance, some men may experience delayed ejaculation when they aren’t sexually stimulated enough.

Other factors arising from psychological causes include:

 

• Fears surrounding intimacy and having sex
• Fears about impregnating a partner or having reproductive health problems
• Fear of rejection
• Having sex with a partner you aren’t sexually attracted to
• Unresolved relationship problems
• Sexual performance anxiety
• Feelings of guilt about having sex
• Sexual attraction to oneself that causes a person to prefer masturbation than having sex with others
• Low libido

 

Mental health concerns such as anxiety and depression may also result in symptoms of delayed ejaculation.

 

How is delayed ejaculation treated?

 

There is no one-size-fits-all way to diagnose and treat delayed ejaculation; your healthcare provider will put you through a routine physical examination while taking into consideration your medical history, sexual habits, and listing your symptoms before diagnosing you with delayed ejaculation.

From there, they will prescribe a treatment plan based on the factors that might be the cause of your delayed ejaculation

The following treatment options for delayed ejaculation may include:

 

Psychological treatment

 

If your healthcare provider determines that your orgasm and ejaculation issues are due to psychological issues, they might refer you to a mental health professional or psychotherapist for the appropriate treatment. The latter may include treatment for depression, anxiety, or irrational fears that cause your DE.

For instance, this might include marriage counseling or sex therapy if the root of your delayed ejaculation is related to relationship problems.

 

 

Medicines

 

There aren’t any FDA-approved medicines yet for treating delayed ejaculation. Therefore, any medicines prescribed or used to treat DE is considered an off-label use of said medication. While some of these may help improve a person’s ability to ejaculate, the reality is that research is needed to determine their viability as DE drugs. Moreover, such medicines may cause unpleasant side effects, such as dizziness, insomnia, gastrointestinal discomfort, and many more.

Off-label medicines used to treat delayed ejaculation may include the following:

 

• Cabergoline, a drug used to reduce prolactin levels in the body
• Bupropion, an antidepressant
• Amantadine, a drug used to treat Parkinson’s disease
• Cyproheptadine, an antihistamine that affects brain chemicals 
• Bethanechol, a drug used to relieve urination difficulties caused by trauma or surgery

 

The final word on delayed ejaculation

 

Sex, which should be pleasurable and fun, may end up becoming a chore you don’t look forward to if you have problems ejaculating. Delayed ejaculation can also wreak havoc on your relationship and cause untold amounts of anxiety, stress, and depression in your sex life. However, regardless of the cause, know that there are a variety of treatments that can help you overcome delayed ejaculation. Consult a healthcare professional and find out your options today.