Is ejaculation delayed? (Delayed Ejaculation) Let's talk about this!

Do you sometimes feel like you can't ejaculate , or that

What is Delayed Ejaculation?

Simply put, Delayed Ejaculation is when it takes a long time for a man to ejaculate after reaching orgasm, whether during sexual intercourse or masturbation. Sometimes, no matter how much stimulation you receive, you may not ejaculate at all. This is actually what doctors call an ejaculatory disorder.

It's normal for this to happen from time to time. That means there's no set time frame that says "I should ejaculate in this amount of time." But if this condition is causing you stress or has become a chronic problem, it's best to seek medical advice.

This is called something else, you may have heard of it:

• Delayed orgasm
• Impaired ejaculation
• Male orgasmic disorder
• Slow ejaculation

How common is this condition?

A 2023 study suggests that at least 5% to 10% of men suffer from this condition of delayed ejaculation. So as you can see, this is not a rare occurrence.

What are the symptoms? How do you recognize it?

The main symptom is difficulty ejaculating. Normally, a man can ejaculate within a few minutes of sexual stimulation. However, for someone with this condition, it can take 30 minutes or even longer .

There may also be other physical symptoms:

• Feeling extremely tired.
• Pain during sexual intercourse (dyspareunia).

In addition to these physical symptoms , there are also psychological effects that can affect you and your partner. These include:

• Fear and anxiety that arise in vain.
• Feeling inadequate about yourself, feeling like you're not good enough for anything.
• Feelings like they are not attractive and their partner does not like them.
• Severe mental stress (`(Stress)`).

Your feelings are very important. If you or your partner are feeling anxious or worried about your ejaculation timing, it's worth talking to a doctor about it.

What are the causes of delayed ejaculation?

This can be caused by both physical and psychological factors. Let's look at both of them separately.

Physical reasons

• Conditions that affect the nervous system: For example , stroke, spinal cord injury, or multiple sclerosis (MS). People with diabetes can develop nerve damage as a complication. Some surgeries can also cause nerve damage.
• Hypothyroidism: This can also affect the thyroid gland .
• An obstruction in the penis: For example, if there is an ejaculatory duct obstruction.
• Certain medications: Some medications you take can also cause this. Examples include some antibiotics, antidepressants, antihypertensives, and alpha blockers (such as tamsulosin (Flomax®)).
• Excessive alcohol consumption or use of other drugs: These can have a direct impact.
• Aging: This condition can also occur due to changes in the body's hormone levels (testosterone), decreased sensitivity of the penis, and decreased sexual desire (libido) as we age.

Psychological reasons

• Guilty feelings about sex: Perhaps the environment you grew up in, along with your religious beliefs, has ingrained in your mind that sex is something wrong and sinful. Imagine if you have been taught that sex is something very bad since childhood, then when you grow up and get married, those thoughts may still be somewhere in your mind. So, things like that can also cause this problem.
• Anger or irritability with your partner: If there are problems in the relationship, that can also affect you.
• Fear of something: For example, fear of contracting sexually transmitted diseases (STIs), fear of unwanted pregnancy, fear of childbirth (tokophobia), or fear of hurting your partner emotionally or physically through your actions.
• Sexual performance anxiety: Stress caused by thoughts like "Will I not be able to perform properly?" and "How will I please him?"
• Being addicted to watching pornography or having sex: These things can also affect you.

A doctor may say that there is no physical cause and that it could be psychological, especially if you can have an orgasm without any problems when masturbating alone, but this problem only occurs when you are with your partner. Or, you may have a method that is easy for you, that you like, but this problem may occur because your partner cannot do it, or because you are uncomfortable talking about it.

Do men have difficulty ejaculating as they age?

Yes, many men can experience these problems as they age. It may take longer and require more stimulation to ejaculate. You may also notice that the speed and quantity of semen you ejaculate decreases.

At what age does ejaculation stop in men?

This varies from person to person. The hormone `(Testosterone)` is essential for sperm production and sexual desire. Usually, after the age of 30, this `(testosterone)` production starts to decrease gradually. Some men may experience this problem in their 40s. But others can ejaculate without any problems even when they are 70 years old or even older.

Who does this situation affect?

This can affect anyone. Some men may have this problem their entire lives. Others may only have it occasionally, or it may start to become more common as they get older.

How does a doctor diagnose this?

When you see a doctor, he or she will ask you questions about your medical history, sexual habits, and ejaculation patterns . These questions may include:

• When did you first realize you had this ejaculation problem?
• Does this happen all the time, or just occasionally?
• Do you ejaculate when you masturbate?
• Does semen come out during sex?
• If ejaculation occurs, how long does it take?
• Do you have any other penile disorders? For example, erectile dysfunction or penile fracture.
• Are there any new changes in your sexual desires?
• What medication are you currently taking?
• How much alcohol do you drink?
• Do you use any other nonprescription drugs?

These questions may seem awkward or unnecessarily personal to you. But answering these questions honestly is very important for the doctor to make a diagnosis. Even if you feel embarrassed, tell the truth.

The doctor will then do a physical examination (``physical examination``), and may also order some tests to check for other medical conditions. These may include:

• Blood tests
• Urinalysis
• Semen analysis – This is especially important if you are hoping to have a child.

What are the treatments for this? (Treatment)

Your doctor may suggest various treatments for you. But there is no one-size-fits-all solution. However, if it is determined that a medication, drug, or alcohol use is the cause, you may need to stop taking that medication and start a different one, stop using drugs, or cut down on alcohol.

Your doctor may also suggest that you see a therapist or sex therapist. If this problem mainly comes up when you are with your partner, you may be asked to go to counseling together.

A sex therapist may recommend that you and your partner use things that increase sexual arousal. Examples:

• Movies or books that arouse erotic feelings.
• Sex toys.

Is there a medicine for this?

The U.S. Food and Drug Administration (FDA) has not approved any medication for treating delayed ejaculation. You should also be careful with some herbal remedies you may have heard of, as they are not regulated by the FDA.

However, some doctors prescribe certain medications on an "off-label" basis, and some have had some success with them. "Off-label" means that the medication is not intended to treat this condition, but may help with your condition. Such medications include:

• Testosterone (as an injection or as a tablet placed under the skin)
• `(Cyproheptadine)` (a type of antihistamine)
• `(Buspirone)` (anxiety medication)
• `(Amantadine)` (a medicine for Parkinson's disease)
• `(Oxytocin)` (This is a hormone that helps the uterus contract during childbirth and let down milk after the baby is born. It is also produced by the body during orgasm.)
• `(Cabergoline)` (a drug that increases dopamine levels)

These medications may or may not help. If a doctor prescribes a medication for you, they will also explain to you the possible side effects.

If you are having difficulty conceiving because of this delayed ejaculation, your doctor may suggest methods to collect sperm from your testicles and use them for fertilization. Examples: `(microsurgical testicular sperm extraction (microTESE))` or `(testicular sperm aspiration (TESA))`.

Does exercise help?

Kegel exercises can help strengthen your pelvic floor muscles. When these muscles are strong, they can help you control your ejaculation to some extent.

Can this situation be prevented? (Prevention)

This depends on the cause. Some causes, for example, nerve damage or aging, cannot be prevented. However, controlling alcohol consumption can reduce the risk of this condition.

It's also important to maintain an open, honest relationship with your partner. Good communication between you can help prevent this problem from occurring or from getting worse.

What can be expected with this situation?

This also depends on the cause. Your body is unique, so the way it responds to the cause may be different from others. Your doctor will explain this to you.

In general, delayed ejaculation caused by physical causes depends on the severity of the cause. In severe cases, such as a spinal cord injury or stroke, treatment may not completely cure the problem. However, if the problem is caused by medications, drugs, or alcohol, there is a good chance that your condition will improve if you can stop or change those things.

Delayed ejaculation caused by aging may not show much improvement even with treatment. Conditions caused by psychological causes may be cured through counseling (`(therapy)`).

How do I take care of myself?

Talk to a doctor as soon as you realize you are having problems with ejaculation. If you are having this problem with your partner, talking to a counselor can be helpful. You can go to counseling alone or with your partner, depending on your preferences.

When should I see a doctor?

If you first notice that you are not ejaculating, or that it is very difficult, talk to a doctor. Especially if this is causing you or your partner distress or frustration, you should definitely go. The doctor can then find the cause and prescribe the right treatment.

What questions should you ask the doctor?

You can ask the doctor questions like:

• What is causing my delayed ejaculation?
• Is this temporary or ongoing?
• What kind of treatment do you recommend for me?
• What kind of tests do you expect to do?
• Do I need to see a specialist, for example a therapist, a urologist, or an endocrinologist?

Can medications like Viagra® help with this?

Sildenafil (Viagra®) is a medication used to treat erectile dysfunction (impotence). It works by increasing blood flow to the penis, helping it to remain erect for longer. It has not been studied for its effects on delayed ejaculation.

However, a 2013 study showed that tadalafil (Cialis®), another drug used to treat erectile dysfunction, may promote ejaculation.

How can I help my partner if he/she has this problem?

If your partner is struggling with this, support them. Ask them if there is anything specific you can do to help them. Or, gently encourage them to see a doctor and get tested. Be willing to go to counseling together. It is not a defeat or a failure. It will help you understand your partner better, understand their needs, and strengthen your relationship.

What happens if you don't ejaculate for seven days?

It's not a problem if you don't ejaculate for seven days. The sperm you don't ejaculate is absorbed by your body. Your testosterone levels may also increase slightly.

Shall we learn some more relevant words?

There are a few other words you might want to know related to this topic:

• Anejaculation: This is the inability to ejaculate even after orgasm. It can be caused by nerve damage, cancer treatments, certain medications, stress, and anxiety.
• Anorgasmia: This is the inability to achieve orgasm, no matter how much stimulation or pleasure you receive. It can be caused by certain medical conditions, as well as physical, mental, or emotional factors.
• Retrograde ejaculation: This is when semen does not come out of the penis during orgasm, but instead goes back into the bladder. This can be caused by certain medications and medical conditions such as diabetes.

Talking to a doctor about something like this for the first time can be a daunting experience. Many people find it difficult to talk about their sexual habits, especially with a doctor. However, while delayed ejaculation is not a common topic of conversation, it is a distressing condition for many people. So if this is a problem for you or your partner, it is important to take the first step by talking to a doctor about it.

Final Take-Home Message

Okay, so, let me ask you to remember some of the most important things from what we've talked about:

• Delayed ejaculation is not as uncommon as you might think. It affects many men.
• Don't be ashamed or sad about this. This is a medically explainable condition.
• If you have this problem, definitely see a doctor. They can find the cause and give you the right treatment.
• There are often treatments for this, so don't give up hope.
• It's very important to talk openly about this with your partner . This requires both of you to support each other.
• Psychological factors can also have a major impact on this. Therefore, if necessary, do not hesitate to seek psychological counseling.

You are not alone. The most important thing is to be aware of this and take the necessary steps.

` Delayed Ejaculation, Ejaculation Problems, Sexual Impotence, Men's Health, Orgasm, Ejaculation