What is Delayed Ejaculation? Causes & Treatments

We’re all likely aware of premature ejaculation — a common medical condition that’s reported to occur in 4-39% of men in the general community.  However, far fewer people are aware of a condition with the opposite effect — delayed ejaculation.

If you suffer from delayed ejaculation, you may find it difficult or impossible to reach orgasm and ejaculate during sex. 

Or, you may be able to successfully reach orgasm and ejaculate, but find it difficult to do so in a normal, reasonable amount of time.

Dealing with delayed ejaculation can be a frustrating experience. However, as with many other sexual health issues, delayed ejaculation is generally treatable. In fact, treatments for delayed ejaculation have an average success rate of around 70 percent to 80 percent.

Below, we’ve explained how and why delayed ejaculation occurs, as well as the symptoms you may notice if you are affected by ejaculation problems. 

We’ve also listed several factors that may increase your risk of being affected by delayed ejaculation at some point in life. 

Finally, we’ve listed the options that are available to treat delayed ejaculation, from medications to psychotherapy, lifestyle changes and more.

What Is Delayed Ejaculation?

Delayed ejaculation is a medical condition in which it’s difficult or impossible to reach an orgasm and ejaculate, or in which reaching ejaculation requires an extended period of sexual stimulation.

Most men can orgasm and ejaculate within a few minutes of "starting to thrust” during sexual activity. 

Although the exact amount of time between initiation of sex and ejaculation varies, research suggests that the average intravaginal ejaculatory latency time (IELT) for men is several minutes — it’s worth generalizing, because some studies say anywhere from five to six minutes, while others put it somewhere around 10 minutes or even longer.

For men with delayed ejaculation, reaching orgasm and ejaculating can take significantly longer than this. For some men, the process takes as long as 45 minutes.

In addition to taking longer to orgasm and ejaculate, men with delayed ejaculation may find the process of orgasm and ejaculation difficult. 

In some cases, men with delayed ejaculation may not be able to orgasm or ejaculate at all, even with significant sexual stimulation.

Others may only be able to reach orgasm and ejaculate through alternative sexual experiences or acts, such as masturbation.

Delayed ejaculation is also known as impaired ejaculation. Historically, it’s been referred to by a large range of different terms, including “diminished ejaculation,” and “inadequate ejaculation”.

While longer-lasting sex may sound like a good thing, the reality is that delayed ejaculation can cause stress, frustration and discomfort, both for men who are affected by this condition and for their partners. 

When sex goes on for too long, it can become physically uncomfortable. Natural factors that are important for pleasurable sex, such as vaginal lubrication, can run out, making what should be a pleasurable experience a frustrating, physically difficult one.

Symptoms of Delayed Ejaculation

Delayed ejaculation can vary in severity and cause several symptoms. While there’s no precise amount of time that’s used to determine whether or not someone has delayed ejaculation, most experts consider the 30+ minute range to indicate that a man has delayed ejaculation.  

You may be affected by delayed ejaculation if you:

• Need 30 minutes or more of sexual stimulation to ejaculate. You may find it difficult to orgasm and ejaculate in a reasonable period of time during sex with your partner, or while masturbating.
  

• Find it difficult or impossible to ejaculate at all. Typically referred to as anejaculation, you may find it difficult to ejaculate following sexual stimulation. Anejaculation can occur with or without orgasm.
  

• Can only ejaculate while masturbating. Some men with delayed ejaculation may find it difficult to orgasm and ejaculate during sexual intercourse, but are able to orgasm and ejaculate normally from masturbation.
  

• Need to stop or take a break from sex due to your symptoms. You may experience fatigue during sex due to exertion. You and/or your partner may feel physically irritated, or you may lose your erection during sex.
  

• Feel distress or frustration. You and/or your partner may feel distressed, frustrated or unhappy about your inability to orgasm and ejaculate. This may even cause relationship problems or tension in your sex life. 

The precise symptoms of delayed ejaculation can vary. To diagnose and treat cases of delayed ejaculation more specifically, most experts categorize delayed ejaculation into the two following categories:

• Lifelong delayed ejaculation. This form of delayed ejaculation occurs from the start of sexual maturity. Men with lifelong delayed ejaculation may have always found it difficult to reach orgasm and ejaculate.

• Acquired delayed ejaculation. This form of delayed ejaculation occurs after a period of being able to orgasm and ejaculate normally.

In addition to being either lifelong or acquired, delayed ejaculation is often categorized as being generalized or situational:

• Generalized delayed ejaculation. Men with generalized delayed ejaculation experience symptoms with all sexual partners and types of sexual stimulation.
  

• Situational delayed ejaculation. Men with situational delayed ejaculation may only find it difficult to orgasm and ejaculate in certain situations, such as with a specific sexual pleasure or with a certain type of sexual stimulation.

What Causes Delayed Ejaculation?

A variety of factors can be underlying causes for delayed ejaculation, from psychological issues to health problems, or even the use of certain types of medication. 

Sometimes, several factors may all play a role in contributing to difficulty reaching orgasm and ejaculating. 

Psychological Causes of Delayed Ejaculation

In many cases, delayed ejaculation is caused by a psychological factor, such as depression or sexual performance anxiety. 

Potential psychological causes of delayed ejaculation include:

• Fear of intimacy, pregnancy or other factors. Certain fears, such as fear of intimacy or concerns about impregnating your sexual partner, may affect your ability to ejaculate and contribute to delayed ejaculation.
  

• Mental health conditions, such as depression or anxiety. A variety of mental health conditions are linked to delayed ejaculation, including depression, anxiety disorders and obsessive-compulsive disorder (OCD).
  

• Sexual performance anxiety. Even if you don’t have an anxiety disorder, it’s common to feel anxious before sex. This is referred to as sexual performance anxiety and it may cause symptoms such as erectile dysfunction or difficulty ejaculating. Our article on ejaculation without erection answers whether or not a man with ED can still come.
  

• Conditioning due to masturbation. If you masturbate frequently or often watch porn, there’s a possibility that it could contribute to sexual dysfunction, including delayed or impaired ejaculation.
  

• Conflict with your sexual partner and/or a lack of attraction. You may find it difficult to have a sexual response long enough to ejaculate if you have a lack of sexual attraction to your partner, or if you feel unhappy with your partner due to a conflict.
  

• Feelings of guilt due to a religious or cultural conviction. If you have a religious or cultural background that makes you view sex as sinful or inappropriate, this may affect your ability to orgasm and ejaculate.
  

• Traumatic events related to sex or masturbation. Certain traumatic events related to sex or masturbation, such as worries about your partner’s sexual life or a negative past experience with sex, may make it harder for you to orgasm and ejaculate.

Physical Causes of Delayed Ejaculation

Sometimes, delayed ejaculation is linked to a physical factor, such as nerve damage or use of a certain type of medication. Potential physical causes of delayed ejaculation include:

• Use of certain medications. Certain medications, such as antidepressants, may affect your ability to orgasm and ejaculate, resulting in delayed ejaculation. Medications associated with delayed ejaculation include antidepressants, diuretics, high blood pressure (hypertension) medications, anti-seizure medications and antipsychotic medications.
  

• Alcohol consumption. Alcohol is associated with a lengthy list of sexual performance issues, including erectile dysfunction. Drinking alcohol frequently or excessively could cause delayed ejaculation.
  

• Nerve damage. Damage to the pelvic nerves responsible for controlling your ability to orgasm and ejaculate can cause delayed ejaculation or an ejaculation. Diseases and neurological issues that can cause nerve damage include stroke, multiple sclerosis, and diabetic neuropathy. A spinal cord injury can also cause delayed ejaculation.
  

• Infections. Some infections, such as urinary tract infections, may make it more difficult for you to orgasm and ejaculate.
  

• Retrograde ejaculation. This condition causes semen to be released into the bladder, instead of outwards from the penis. You may be able to reach orgasm but ejaculate a very small volume of semen, or no semen at all.
  

• Pelvis surgery. Some prostate surgeries, such as prostate removal or transurethral resection of the prostate, may cause delayed ejaculation.
  

• Hormone conditions. Conditions such as low testosterone or hypothyroidism (overly low production of thyroid hormone) may affect your sexual performance and ability to reach orgasm and ejaculate. 

Of course, even though these are some of the common and more well-known causes of delayed ejaculation, these aren’t all of them. 

Some other factors include things like neurobiological factors, certain diseases and even some genetic predispositions.  

Treatments for Delayed Ejaculation

There are several treatments for delayed ejaculation. For some people, delayed ejaculation can be treated using medication. 

Others may benefit from a variety of types of therapy, including sex therapy and relationship-focused therapy. 

Medications

Currently, there aren’t any FDA-approved medications for treating delayed ejaculation. 

However, several medications may be used off-label by a urologist or health care provider with experience in urology to treat delayed ejaculation symptoms. 

These vary in effectiveness and may cause side effects. Medications for delayed ejaculation include:

• Testosterone

• Cyproheptadine

• Cabergoline

• Bupropion

• Amantadine

• Reboxetine

• Lisdexamfetamine dimesylate

• Oxytocin

• Yohimbine

• Pseudoephedrine

• Cyproheptadine

• Bethanechol

• Buspirone

• Ephedrine

• Midodrine

It’s worth nothing that these are just a few of the common medications sometimes associated with the treatment of delayed ejaculation, but the list is actually pretty extensive. 

It’s also worth noting that not all of these medications have proven effective in testing and many are associated with significant side effects.

If your delayed ejaculation is caused by an existing medication, your healthcare provider may recommend switching medications or reducing your dosage.

Therapy

Delayed ejaculation is often treatable through therapy. 

Several different forms of therapy may be helpful for treating delayed ejaculation, including psychotherapy for underlying conditions or sex therapy. 

Therapy can take time, but has a success rate of around 70 percent to 80 percent.

For some people, therapy may involve working with your partner to reduce sexual performance pressure and help you relax during sex. 

If a relationship issue is causing delayed ejaculation, talking to a sex therapist may involve working on your relationship and intimacy with your partner.

Lifestyle Changes

If your delayed ejaculation is caused by a lifestyle factor, such as alcohol consumption or a lack of intimacy with your partner, making certain changes to your lifestyle may help:

• Communicate with your partner. Delayed ejaculation can often be the result of performance anxiety. If you have sex-related worries, try talking openly with your partner to ease anxiety and make sex more relaxing and enjoyable.

• If you have an alcohol or substance use disorder, seek treatment. Alcohol and drug use may contribute to delayed ejaculation and other sexual dysfunction. If you have an alcohol or drug use disorder, consider seeking treatment. 

Treating Delayed Ejaculation

Delayed ejaculation can be frustrating to deal with, especially if it affects your ability to enjoy sex with your partner. 

However, it’s generally treatable, with a variety of options available to help you orgasm and ejaculate more easily during sex.

If you have difficulty ejaculating or are experiencing weak ejaculation, it’s best to talk to your healthcare provider. You can also talk to a licensed primary care provider online to talk through your symptoms and learn more about the treatment options that may work for you.

FAQs About Delayed Ejaculation

How is delayed ejaculation diagnosed?

When you visit a healthcare professional, you will undergo a physical examination and discuss your symptoms. 

To rule out any underlying health conditions that may be the cause of delayed ejaculation, your provider may request urine samples and blood tests. 

During the physical examination, your provider may test the sexual response of your penis when stimulated by a vibrator. 

This will help determine if your delayed ejaculation is rooted in a mental or physical cause. 

When is it time to see a healthcare professional for delayed ejaculation?

In general, you should see your provider when delayed ejaculation is an issue for your sex life. 

If you have any health conditions or are taking medications that list sexual dysfunction as a side effect, it may be time to speak with a healthcare professional as well. 

What are the complications of delayed ejaculation? 

Although there are no major health complications of delayed ejaculation, there are several emotional complications to look out for: 

• Decreased sexual pleasure for both you and your partner

• Relationship issues 

• Being unable to get your partner pregnant

• Stress and anxiety based on sexual underperformance