Sex - delayed ejaculation
Key points
- Delayed ejaculation refers to an inhibition of ejaculation.
- Most men ejaculate within 2 to 4 minutes after onset of active thrusting in intercourse.
- If the man is unable to ejaculate in a reasonable length of time with some form of stimulation (as with masturbation), it is a good indicator that organic factors are likely to play a role in the problem.
- If the man has never ejaculated through any form of stimulation (such as wet dreams, masturbation, or intercourse) in his life, a urologist should be consulted to determine if there is a congenital or physical abnormality.
Alternative names
Ejaculatory incompetence; Delayed ejaculation; Retarded ejaculation
Definition
Delayed ejaculation refers to an inhibition of ejaculation. The male is unable to ejaculate, either during intercourse, or with manual stimulation in the presence of a partner.
Causes, incidence, and risk factors
Most men ejaculate within 2 to 4 minutes after onset of active thrusting in intercourse. Men with retarded ejaculation may be entirely unable to ejaculate in some circumstances (for example, during intercourse), or may only be able to ejaculate with great effort and after prolonged intercourse (for example 30 to 45 minutes).
The most common causes are psychological. Common psychological causes include:
- A strict religious background causing the person to view sex as sinful
- Lack of attraction for a partner
- Conditioning caused by unique or atypical masturbation patterns
- Traumatic events (such as being discovered in masturbation or illicit sex, or learning one's partner is having an affair)
Some factors such as anger toward the partner may be involved; however, organic causes are sometimes present. A variety of drugs (such as Prozac, Mellaril and guanethidine) may sometimes impair ejaculation. Neurological disease may also cause delayed or inability to ejaculate such as strokes and nerve damage to the spinal cord or back.
Signs and tests
If the man is unable to ejaculate in a reasonable length of time with some form of stimulation (as with masturbation), it is a good indicator that organic factors are likely to play a role in the problem.
Stimulation of the penis with a vibrator or other increased stimulatory device may determine if an underlying physical often neurological problem exists. A neurological examination may uncover other neurological defects associated with delayed ejaculation.
Treatment
If the man has never ejaculated through any form of stimulation (such as wet dreams, masturbation, or intercourse) in his life, a urologist should be consulted to determine if there is a congenital or physical abnormality.
If, however, he is able to ejaculate in a reasonable period of time by some form of stimulation, he should seek sex therapy from a therapist specializing in this area. Treatment usually includes both partners.
The therapist will usually educate the couple about the fundamentals of sexual response and how to communicate and guide the partner to provide ideal stimulation, rather than trying to will a sexual response to occur.
Frequently asked questions
What is sex?
Delayed ejaculation refers to an inhibition of ejaculation. The male is unable to ejaculate, either during intercourse, or with manual stimulation in the presence of a partner.
What are the risk factors for sex?
Most men ejaculate within 2 to 4 minutes after onset of active thrusting in intercourse. Men with retarded ejaculation may be entirely unable to ejaculate in some circumstances (for example, during intercourse), or may only be able to ejaculate with great effort and after prolonged intercourse (for example 30 to 45 minutes). The most common causes are psychological.
What are the symptoms of sex?
If the man is unable to ejaculate in a reasonable length of time with some form of stimulation (as with masturbation), it is a good indicator that organic factors are likely to play a role in the problem. Stimulation of the penis with a vibrator or other increased stimulatory device may determine if an underlying physical often neurological problem exists. A neurological examination may uncover other neurological defects associated with delayed ejaculation.
How is sex treated?
If the man has never ejaculated through any form of stimulation (such as wet dreams, masturbation, or intercourse) in his life, a urologist should be consulted to determine if there is a congenital or physical abnormality. If, however, he is able to ejaculate in a reasonable period of time by some form of stimulation, he should seek sex therapy from a therapist specializing in this area. Treatment usually includes both partners. The therapist will usually educate the couple about the fundamentals of sexual response and how to communicate and guide the partner to provide ideal stimulation, rather than trying to will a sexual response to occur.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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