Delayed Ejaculation

Overview

Delayed ejaculation is a condition in which it takes an extended period of sexual stimulation for men to reach sexual climax and release semen from the penis (ejaculate). Some men with delayed ejaculation are unable to ejaculate at all. This can be a temporary or lifelong problem, and its causes can be either physical or psychological. Possible physical causes include certain chronic health conditions, surgeries, and medications, while psychological factors may include stress, anxiety, or relationship issues. Delayed ejaculation can lead to distress or frustration, and affects the quality of sexual experiences for both the man and his partner. It's important to consult a healthcare provider to determine the underlying cause and appropriate treatment.

Understanding the disease

Symptoms

Symptoms of delayed ejaculation include the need for 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or in some cases, not being able to ejaculate at all. If the delay is causing distress or frustration, or if you have to stop sexual activity due to fatigue, physical irritation, loss of erection, or a request from your partner, it is considered delayed ejaculation.

Risk Factors

The risk factors for developing delayed ejaculation include:

1. Older age
2. Psychological conditions, such as depression or anxiety
3. Medical conditions, such as diabetes or multiple sclerosis
4. Certain medical treatments, such as prostate surgery
5. Medications, particularly certain antidepressants, high blood pressure medications, or diuretics
6. Relationship problems, such as poor communication with your partner
7. Excessive alcohol use, especially if you're a long-term heavy drinker Remember that it's normal for men to have delayed ejaculation from time to time, and it's only a problem if it's ongoing or causes stress for you or your partner.

Development

The various types of delayed ejaculation can develop due to different factors.

1. Lifelong delayed ejaculation: This type of delayed ejaculation is present since the time of sexual maturity, and it is often caused by anatomical abnormalities, hormonal imbalances, or neurological problems.
2. Acquired delayed ejaculation: This type of delayed ejaculation occurs after a period of normal sexual functioning. It can be caused by various factors, such as medications, surgeries, chronic health conditions, psychological issues, or stress. Some common causes include: a. Medications: Antidepressants, high blood pressure medications, diuretics, antipsychotic medications, and anti-seizure medications can contribute to delayed ejaculation. b. Alcohol and substance abuse: Excessive alcohol consumption or substance abuse can lead to delayed ejaculation. c. Psychological factors: Stress, anxiety, depression, or relationship issues can cause or exacerbate delayed ejaculation. d. Surgical procedures: Surgeries, such as prostate surgery, can lead to delayed or absent ejaculation. e. Neurological or hormonal disorders: Conditions such as diabetic neuropathy, stroke, nerve damage to the spinal cord, hypothyroidism, or hypogonadism can cause delayed ejaculation. Remember that the specific cause of delayed ejaculation can vary from person to person, and it's essential to consult a healthcare professional to determine the underlying issue and develop an appropriate treatment plan.

Assessment and Diagnosis

Triage

You should see a doctor if delayed ejaculation is causing distress or frustration for you or your partner, or if you have to stop sexual activity due to fatigue, physical irritation, loss of erection, or a request from your partner. Additionally, if you are unable to ejaculate at all (anejaculation), it is advisable to consult a healthcare provider.

Diagnosis

Diagnosis of delayed ejaculation typically involves a physical exam, medical history review, and potentially further tests depending on the suspected underlying cause. A healthcare provider may perform a physical exam of the penis and testicles, checking for normal sensation. Blood tests and urine tests (urinalysis) may also be conducted to assess hormone levels, signs of cardiovascular disease, diabetes, or other health issues that could contribute to delayed ejaculation. If necessary, a specialist may be consulted for further evaluation and treatment.

Management and Treatment

Complications

Diminished sexual pleasure for you and your partner, stress or anxiety about sexual performance, marital or relationship problems due to an unsatisfactory sex life, and inability to get your partner pregnant (male infertility) are potential complications of delayed ejaculation. It's important to address any concerns related to delayed ejaculation and seek appropriate treatment if necessary.

Home Remedies

It is important to consult a healthcare professional for proper evaluation and treatment of delayed ejaculation, as it can have various underlying causes.

Treatment

Treatment for delayed ejaculation depends on the underlying cause. Possible treatments include:

1. Medications: If delayed ejaculation is caused by a medication, switching to a different medication or adjusting the dosage may help.
2. Behavioral therapy: For cases related to psychological factors, such as anxiety or depression, therapy and counseling can help manage and overcome the issues.
3. Hormone replacement: In cases where hormone-related conditions, such as low testosterone or thyroid hormone levels, are causing delayed ejaculation, hormone replacement therapy may be recommended.
4. Pelvic floor exercises: For cases caused by nerve damage or injury, pelvic floor exercises may improve the muscle function and help restore normal ejaculation.
5. Couples therapy: If relationship issues are contributing to the problem, couples therapy can help address communication and intimacy concerns. It's important to consult a healthcare professional for an accurate diagnosis and appropriate treatment recommendations.

Preparing for medical consultation

To prepare for an appointment for delayed ejaculation, you should:

1. Gather information: Note down any symptoms you've experienced, including those that may seem unrelated to delayed ejaculation. Also, make a list of key personal information, such as major stresses, recent life changes, illnesses, or changes in medications you're taking.
2. Get ready to discuss your sexual history: Reflect on your relationships and sexual experiences since becoming sexually active. Consider if you've experienced problems with delayed ejaculation before, and in what circumstances.
3. Prepare your medical history: Write down any other medical conditions you've been diagnosed with, including mental health conditions. Make a list of all medications, vitamins, herbal remedies, and supplements you're currently taking or have taken recently, including prescription drugs and those purchased without a prescription.
4. Create a list of questions: Write down any questions you have for your healthcare provider in advance. This will help you make the most of your time together.
5. Follow any pre-appointment restrictions: When you make your appointment, ask if there are any restrictions you need to follow in the time leading up to your visit. Remember to be open and honest with your healthcare provider about your concerns, as they are there to help you find the best treatment for your situation.