Delayed Ejaculation: Symptoms, Causes and Treatment
Sexual dysfunctions are alterations in normal sexual behavior. They can affect the different stages of the sexual act. For example, desire, arousal, orgasm, and resolution. Some of these disorders are experienced by both sexes. However, others are suffered exclusively by women or men. One such instance suffered by men only is delayed ejaculation (also known as anejaculation).
Delayed ejaculation is a dysfunction that affects between four to ten percent of men. It’s diagnosed when a man has difficulty ejaculating after having gone through a normal arousal phase during sexual intercourse. In other words, despite being aroused, ejaculation is delayed or doesn’t occur at all.
Symptoms of delayed ejaculation
The main symptom of delayed ejaculation is the absence or delay of ejaculation on a recurring basis. In some men, ejaculation may occur after 20 or 30 minutes of sexual stimulation. In other cases, it doesn’t happen at all.
The presence of this dysfunction is determined by the anxiety or frustration caused by the delay in ejaculation. For this reason, the sexual act is interrupted. That’s because fatigue, physical irritation, discomfort, or loss of erection prevent it from continuing normally. This generates a stressful situation for both the man and his partner. Furthermore, it may eventually cause other psychological or relationship problems.
To diagnose delayed ejaculation, clinicians carry out both psychological and physical examinations. They also examine the patient’s medical history. They undertake a physical examination to rule out that the fact that the disorder isn’t due to any underlying medical condition. In fact, if this were to be the case, doctors would treat it as a symptom and not as a sexual dysfunction per se.
Behind delayed ejaculation, there may be one or more causes. These are usually grouped into physical, psychological, or behavioral factors.
It’s always important for a doctor to study and rule out whether the condition may be due to one of the following reasons:
- Hormonal changes. They can alter the process of sexual arousal and its resolution.
- Nerve disorders. This is especially relevant regarding sensory input in the spinal cord. It could be due to diseases like multiple sclerosis or diabetes.
- Consumption of substances and medicines. Drugs such as antidepressants, anxiolytics, or substances like cocaine decrease sexual desire and response. In these instances, sexual dysfunction may develop over time.
Delayed ejaculation has its origins in psychological aspects that interrupt or hinder the normal development of the sexual act. Among the main reasons are the following:
- Anticipatory and performance anxiety. Paying too much attention to the evolution of arousal, erection, orgasm, and performance can prevent a man from enjoying and letting himself go. In turn, this increased anxiety may well act as a factor in maintaining and worsening the problem.
- Lack of trust and fear of intimacy. Having gone through negative experiences or unsatisfactory encounters can affect a man’s ability to enjoy and engage in sex.
- Stress is one of the worst enemies of pleasure. It leads to body tension, distraction, anxiety, and impatience.
- Conflicts with sexual desire. The sufferer may have some internal conflicts regarding sexual identity or orientation. Or, they might possess negative beliefs related to sexuality.
- Relationship problems. The emotional relationship with a partner also affects the development of sexual activity. For example, if there’s a lack of attraction toward the partner or even feelings of resentment or contempt.
- Fear of pregnancy. Concern about the risk of pregnancy can cause a man, consciously or unconsciously, to delay the moment of ejaculation.
In this category are those behavioral habits that can cause long-term problems of delayed ejaculation. Among them, the following stand out:
- Frequent and routine masturbation can cause decreased sexual arousal, especially when having sex with a partner.
- Delaying ejaculation as a strategy. Many men think that voluntarily delaying ejaculation is good for the sexual act. That’s because it lengthens the sexual encounter which they believe provides more pleasure. However, doing it repeatedly can cause them to have trouble ejaculating later.
- Intense and overly vigorous masturbation. They then find penetrative sex problematic because they’re unable to reach the same levels of arousal.
- The excessive consumption of pornography.
Treatment of delayed ejaculation
Treatment of delayed ejaculation will depend on its cause. If its origin is physical, the doctor will prescribe a pharmacological or other treatment to help alleviate the symptoms of the underlying disease. However, drug treatment is usually not as effective as psychological treatment.
In psychological therapy for delayed ejaculation, therapists usually address three areas. Firstly, aspects of the individual, secondly, aspects regarding the couple’s relationship (if it applies), and, thirdly, sexual therapy exercises.
Among the individual psychological aspects that the therapist addresses, are the beliefs and thoughts causing the anxiety that’s preventing the patient from enjoying normal sexual activity.
For example, the therapist may dismantle certain beliefs about the duration of intercourse or any irrational ideas the patient has regarding their sexuality. In addition, the therapist may suggest exposure exercises to eliminate the anxiety the patient feels when facing the sexual act.
In couples therapy, therapists work on how the problem is affecting the couple’s emotional and sexual relationship. For example, there may be difficulties between the couple that are causing the man’s sexual dysfunction.
Finally, therapists might suggest they perform sexual therapy exercises. These aim to decouple the sexual act and reduce attention towards orgasm. In other words, they focus on lengthening the stimulation prior to penetration and ejaculation.
Likewise, there are exercises for approaching ejaculation at the moment of penetration. One such exercise is the “bridge maneuver”.
A problem that can usually be solved
Without a doubt, delayed ejaculation is a sexual dysfunction that can cause a lot of anguish and anxiety. However, if the sufferer seeks psychological help, the chance of treatment being successful is high.
For the most part, premature ejaculation is caused by certain ideas that block the sufferer’s ability to enjoy relaxed, as well as learned behaviors. Fortunately, these aspects can be reversed with the appropriate intervention.
If you have problems of this type, look for proven information and go to a psychology professional who specializes in sex therapy. With a little effort, patience and work, you could soon be back to enjoying yourself exactly the way you want to.It might interest you...
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- Sarquella J, et al. Trastornos de la eyaculación. Revista Médica Clínica Las Condes 2014;25(1):129-137. Disponible en: https://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-articulo-trastornos-eyaculacion-S0716864014700197.