Learn what could be causing delayed or absent ejaculation and how it can be treated.
Delayed ejaculation — sometimes called impaired 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.
Delayed ejaculation can be temporary or a lifelong problem. Possible causes of delayed ejaculation include certain chronic health conditions, surgeries and medications. Treatment for delayed ejaculation depends on the underlying cause.
It's normal for men to have delayed ejaculation from time to time. Delayed ejaculation is only a problem if it's ongoing or causes stress for you or your partner.
Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate. Other men might not be able to ejaculate at all (anejaculation).
But, there's no specific time that indicates a diagnosis of delayed ejaculation. Instead, you are probably experiencing delayed ejaculation 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.
Often, men might have difficulty reaching orgasm during sexual intercourse or other sexual activities with a partner. Some men can ejaculate only when masturbating.
Delayed ejaculation is divided into the following types based on symptoms:
These categories help in diagnosing an underlying cause and determining what might be the most effective treatment.
Your primary care doctor is a good place to start when you have delayed ejaculation. See your doctor if:
Delayed ejaculation can result from medications, certain chronic health conditions and surgeries. Or it might be caused by substance misuse or a mental health concern, such as depression, anxiety or stress. In many cases, it is due to a combination of physical and psychological concerns.
Psychological causes of delayed ejaculation include:
Medications and other substances that can cause delayed ejaculation include:
Physical causes of delayed ejaculation include:
For some men, a minor physical problem that causes a delay in ejaculation might cause anxiety about ejaculating during a sexual encounter. The resulting anxiety might worsen delayed ejaculation.
A number of things can increase your risk of having delayed ejaculation, including:
Complications of delayed ejaculation can include:
A physical exam and medical history might be all that are needed to recommend treatment for delayed ejaculation. However, if delayed ejaculation appears to be caused by an underlying problem that might need treatment, you might need further tests or you might need to see a specialist.
Tests for underlying problems can include:
Delayed ejaculation treatment depends on the underlying cause, but it might include taking a medication or making changes to medications you currently take, undergoing psychological counseling, or addressing alcohol or illegal drug use.
If you're taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. Sometimes, adding a medication might help.
There aren't any drugs that have been specifically approved for the treatment of delayed ejaculation. Medications used to treat delayed ejaculation are primarily used to treat other conditions.
Medications sometimes used to treat delayed ejaculation include:
Psychotherapy can help by addressing underlying mental health problems leading to delayed ejaculation, such as depression or anxiety. It's also used to address psychological issues that directly affect your ability to ejaculate.
Counseling might involve seeing a psychologist or mental health counselor on your own or along with your partner. Depending on the underlying cause, you might benefit most from seeing a sex therapist — a mental health counselor who specializes in talk therapy for sexual problems. The type of counseling that's best for you will depend on your particular concerns.
If it's an ongoing concern, delayed ejaculation can cause mental and emotional stress for you and your partner. If you have delayed ejaculation only on occasion, try not to assume that you have a permanent problem or to expect it to happen again during your next sexual encounter. Remember, occasional delayed ejaculation due to stress or other temporary factors might improve when the underlying cause gets better.
In addition, if you experience occasional or persistent delayed ejaculation, it's important to reassure your sexual partner. Your partner might think your inability to reach climax is a sign of diminished sexual interest.
Communicate openly and honestly with your partner about your condition. Treatment is often more successful if couples work together as a team. You might even want to see a counselor with your partner. This can help you address concerns you both might have about delayed ejaculation.
If you've been having trouble achieving orgasm, talk with your primary care doctor. Your doctor might refer you to a specialist — such as a doctor who specializes in male genital problems (urologist), a doctor who specializes in the hormonal systems (endocrinologist), a doctor who diagnoses and treats mental health problems (psychiatrist), or another type of specialist.
Here's some information to help you get ready for your appointment and know what to expect from your doctor.
To prepare for your appointment:
For delayed ejaculation, some basic questions to ask your doctor include:
Being ready to answer your doctor's questions might allow time to go over any points you want to spend extra time on. Your doctor may ask: