Delayed Ejaculation

Home » Delayed Ejaculation » Overview, Causes and Risk Factors

Overview

Delayed ejaculation is a term used to describe a medical condition in which a man is unable to ejaculate (i.e., eject semen from the penis) during sexual activity, or requires a long period of stimulation to ejaculate. Delayed ejaculation also is called retarded ejaculation.

Ejaculation is an involuntary response (reflex) to sexual stimulation. In most cases, the penis, which is the male sexual organ, becomes hard and stiff prior to ejaculation. This process, called erection, involves the nervous system (brain, spinal cord, and nerves) and the vascular system (blood vessels; i.e., veins, arteries).

Erection is initiated by chemicals in the brain (neurotransmitters), in response to physical or psychological stimulation (arousal). During arousal, nerves send messages to the vascular system, increasing blood flow to the penis (i.e., corpus spongiosum, corpora cavernosa). The organ becomes engorged and expands and fibrous elastic sheathes (called tunicae) in the erectile tissue close to prevent blood from leaving the penis until stimulation ends or ejaculation occurs.

Ejaculation occurs in two stages. First, semen (sperm) and other secretions pass from the prostate gland and seminal vesicles into the urethra. Next, the seminal fluid is expelled from the urethra. Ejaculation occurs as a result of muscle contractions. Sensations associated with ejaculation make up the male orgasm.

In most cases, men ejaculate after about 4 minutes during intercourse. Men who experience delayed ejaculation may require prolonged intercourse (e.g., up to 45 minutes), or may be unable to ejaculate during sexual intercourse or through manual stimulation.

Incidence and Prevalence
Sexual responses change with age in both men and women. It is normal for men to require more stimulation to achieve erection and ejaculation as they age; however, delayed ejaculation is not part of the normal aging process. This medical condition is relatively rare and affects approximately 1–4% of men.

Causes and Risk Factors

A number of physical and psychological factors can increase the risk for delayed ejaculation. Factors that affect how a man views sexual activity, such as religious background or a strict upbringing, often contribute to the condition. In many cases, stress is a contributing factor.

Other psychological causes include the following:

• Anger toward a partner
• Atypical masturbation habits (e.g., using a very fast motion to stimulate the penis)
• Fear of pregnancy
• Lack of attraction
• Traumatic event involving sex (e.g., being caught in an illicit situation)

Physical causes for delayed ejaculation can include neurological conditions (e.g., stroke, spinal cord injury), trauma or disease that results in nerve damage (e.g., diabetes), and alcohol and drug use. Medications, including antidepressants and selective serotonin reuptake inhibitors (SSRIs) also can cause delayed ejaculation. These drugs include thioridazine (Mellaril®), sertraline (Zoloft®), paroxetine (Paxil®), and fluoxetine (Prozac®).

Men who have never ejaculated through any means (e.g., sexual intercourse, masturbation, nocturnal emissions [wet dreams]) may have a congenital (i.e., present at birth) abnormality in the reproductive system.

Delayed Ejaculation Resources

	Join Our Delayed Ejaculation Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
Are you interested in becoming a nurse? Take this test. Advertising Disclaimer To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar.