Why Am I Having Trouble Coming?

For most men, taking some time before arriving at the finish line during sex is always a plus.

On average, this time can run anywhere between five to seven minutes, but it may also last longer, with around 30 minutes of sexual activity being the expected duration in some individuals.

However, while having impressive stamina may prolong sexual satisfaction — finding it difficult or even impossible to ejaculate following intercourse could be less about endurance and more about signalling possible sexual dysfunction. 

In particular, it could be an indicator of delayed ejaculation.

Delayed ejaculation is a condition marked by a persistently stalled or absent orgasm following penetration. 

Ejaculation may be classified as delayed when it takes longer than 20 to 25 minutes of sexual activity following penetration, to achieve orgasm. Other sources put it closer to 30 to 45 minutes from when thrusting begins during intercourse.

If you're a man having trouble coming during sex, this can greatly affect the satisfaction you and your partner experience during intercourse. It can also cause serious difficulties in couples looking to get pregnant.

We'll be exploring the types of delayed ejaculation, its causes, and possible treatment methods to help with managing this condition.

Types of Delayed Orgasms

A delayed or impaired orgasm is perhaps the least common form of sexual dysfunction. 

Between one percent and five percent of sexually active men are affected by this condition. 

These numbers are spread across two types of delayed ejaculation: lifelong and acquired delayed ejaculation.

Lifelong delayed ejaculation. This is otherwise known as primary delayed ejaculation. It is a condition where difficulty in ejaculating has always occurred during intercourse. 

Acquired delayed ejaculation. Here, ejaculation may have once happened normally, but somewhere along the line, difficulties developed in achieving orgasm during penetrative sex.

Delayed ejaculation may also be limited to one or more partners, and may not occur with every sexual partner you have. It could also occur in specific and not all sexual situations.

Causes of Delayed Orgasms

Routinely engaging in sex without the satisfaction of an orgasm, or taking too long before an orgasm and ejaculation occur could be the result of physical and psychological factors — just like in the psychological factors of erectile dysfunction.

Psychological Causes of Delayed Orgasms

Relationship Factors

A number of factors within a relationship could prevent the typically expected timing for ejaculation. 

These include a number of fears such as:

• Impregnation

• Hurting a partner

• Performing poorly

• Intimacy

• Abandonment 

Losing your attraction to your partner could also affect your chances of reaching orgasm and ejaculating within normal limits.

Excessive Masturbation

Masturbating is an easy way to let off some steam. However, where this practice is frequent to the point of becoming excessive, it may lead to difficulty when reaching orgasm during sex.

This can happen when masturbation becomes preferred to sexual intercourse. 

This is especially true where techniques are used which aren't easily replicated with a partner. 

Likewise, masturbating frequently can cause the penis to become less sensitive. 

Where this happens, it isn't uncommon to increase the force used when masturbating to make up for the reduced responsiveness. 

Again, this can worsen delayed orgasms because a partner may be unable to keep up with these specific requirements.

We’ve covered excessive masturbation more in our guide to Masturbation, Porn and ED.

Sexual Orientation Conflicts

Failing to achieve orgasm, or experiencing consistent delays in reaching orgasm and ejaculating, may result from having sex with a gender different from one you're intimately attracted to.

Delayed ejaculation can apply to heterosexual and homosexual men, but research has shown that it may be significantly more pronounced in homosexual men.

Physical Causes of Delayed Orgasms

Diseases of the Nervous System

Certain conditions that affect the functioning of the nerves may be responsible for delays in reaching orgasm. 

These include disorders like multiple sclerosis, spinal cord injuries, nerve damage brought on by diabetes, etc.

In some cases, undergoing adult circumcision, could be responsible for the difficulties in coming.

Endocrine Diseases

Conditions that affect the production and secretion of hormones/glands in the body may have a role to play in ejaculatory difficulties. 

These include diseases like testosterone deficiency, where the body lacks sufficient amounts of the sex hormone, testosterone. 

It also includes disorders like hypo and hyperthyroidism, where the thyroid gland fails to produce enough, or produces too much of the thyroid hormone respectively. This hormone is necessary for regulating the body’s metabolic processes, as well as functions of the heart, muscles and digestive system.

Other endocrine conditions such as hyperprolactinemia where the body generates too much prolactin — a hormone necessary for milk production, may also cause challenges for ejaculation.

Medication

Drugs are a common first resort for managing pain, as well as conditions such as depression and psychosis. 

However, while there is no question of their effectiveness, pain medication like opiods, antidepressants such as SSRIs, as well as antipsychotics may produce adverse reactions in users. 

One commonly shared side-effect in men is persistent delays in ejaculating. It is suspected that these drugs interfere with the ability to control ejaculation.

In addition to these factors, the chances of experiencing delays in ejaculation may increase with age. Trouble with ejaculation may also be caused by possible genetic predisposition.

How to Treat Delayed Ejaculation

Living in uncertainty about reaching orgasm, or constantly prepping your mind for lengthy sessions of intercourse can negatively affect your sex life. 

This is why getting the right treatment when you have trouble coming is so important.

Managing this condition usually requires a proper diagnosis to be made. This can be made through a physical examination of the symptoms. 

Where delayed ejaculation is confirmed, the following treatment methods may be adopted:

Psychological Treatment

In instances where psychological factors are most likely responsible for delays in ejaculating, treatment options that target the specific cause are usually recommended.

This includes methods such as cognitive behavioral therapy which can help to change negative notions about sex. It may also provide sex education.

In cases where masturbation may be worsening the chances of ejaculating suitably, masturbatory retraining may be adopted to teach more traditional forms of self-pleasure. 

This can help with aligning sexual fantasies and expectations with more realistic outcomes.

Circumstances where performance anxiety overextends the expected orgasm time, mindfulness and breathing techniques can help to teach couples to be more at ease during intercourse. 

Couples therapy and interaction exercises to examine relations between partners can also help with managing delayed ejaculation.

Medication

There are multiple medication treatment options for premature ejaculation. Sertraline for premature ejaculation (premature ejaculation pills) is one option, and premature ejaculation spray (lidocaine spray) is also a common treatment option for PE.

Testosterone Therapy

Testosterone is a big factor in promoting sexual activities in the body. It is important for regulating sex drive, sperm production, as well as fertility. 

It is also useful for managing the body's orgasm response system. 

Studies have shown that supplementing the body's supply of testosterone may be useful in improving sexual function in people with low testosterone levels.

We’ve talked more about testosterone’s role in sexual health in our guide to the symptoms of low testosterone.

Penile Vibratory Stimulation

In cases where delayed orgasms are the result of decreased sensitivity, applying a vibrator to a specific portion of the penis head can help to mechanically trigger orgasms. 

Adopting this method can help to restore orgasmic function in the body.

Having Trouble Coming? There Are Options

Sex is fun, and in some cases sessions that go on and on can be enjoyable. Other times, it could be a sign of ejaculatory trouble.

Delayed ejaculation may be caused by a number of psychological or physical factors.

To help with fast-forwarding orgasm and ejaculating time, psychological activities like therapy and masturbatory retraining can be effective. 

Similarly, reducing or discontinuing a drug that could possibly be responsible for delays could help with managing the condition.

Seeking professional help to assist with delayed ejaculation is always advisable where this condition is suspected.