There are many potential causes of DE, including psychological hang-ups, chronic health conditions, and reactions to medications.
Psychological causes for DE can occur due to a traumatic experience regarding sex. Cultural or religious taboos can give sex a negative connotation. Anxiety and depression can both suppress sexual desire, which may result in DE as well.
Relationship stress, poor communication, and anger can make DE worse. Disappointment in sexual realities with a partner compared to sexual fantasies can also result in DE. Often, men with this problem can ejaculate during masturbation, but not during stimulation with a partner.
Certain chemicals can affect the nerves involved in ejaculation. This can affect ejaculation with and without a partner. Medications such as antidepressants (Prozac), antipsychotics (Mellaril), high blood pressure medications (guanethidine), diuretics, and alcohol can all cause DE.
Surgeries or trauma may also cause temporary DE. Physical causes of DE may include:
- certain prostate surgeries that cause nerve damage
- neuropathy (nerve damage) or stroke
- birth defects that impair the ejaculation process
What Are the Symptoms of Delayed Ejaculation?
Delayed ejaculation occurs when a man requires more than 30 minutes of sexual stimulation to orgasm and ejaculate. Ejaculation is when semen is discharged from the penis. Some men can only ejaculate with manual or oral stimulation. Some men cannot ejaculate at all.
A lifelong problem with DE is very different from an acquired problem later in life. Some men have a generalized problem in which DE occurs in all sexual situations. For other men, it may only occur with certain partners or in certain circumstances.
If you feel that this condition is a significant problem, you should see your doctor. In some cases, DE may be a sign of a worsening health problem, such as heart disease or diabetes.
How Is Delayed Ejaculation Diagnosed?
A physical examination and explanation of your symptoms are necessary to make an initial determination. If a chronic health problem is suspected, more testing may need to be done. This includes blood and urine tests for infections, hormonal imbalances, etc.
Testing the reactions of the penis to a vibrator may reveal if the problem is psychological or physical.
What Treatments Are Available for Delayed Ejaculation?
Treatment will depend on the suspected underlying cause.
Some drugs have been used to attempt to help with DE, but no drug has been specifically approved for this use. According to the Mayo Clinic, a drug to treat Parkinson’s disease (amantadine), an antianxiety drug (buspirone), and an allergy drug (cyproheptadine) have been tried (Mayo Clinic, 2012).