Sometimes called impaired ejaculation is a condition in which it takes an extended period of sexual stimulation for a man 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.
Delayed ejaculation can result from certain chronic health conditions, surgeries, and medications. Or it may be caused by substance abuse or mental health concern, such as depression, anxiety, or stress. In many cases, delayed ejaculation is due to a combination of physical and psychological concerns.
Physical causes of delayed ejaculation include:
- Certain birth defects affecting the male reproductive system
- Injury to the pelvic nerves that control orgasm
- Certain infections, such as a urinary tract infection
- Prostate surgery, such as transurethral resection of the prostate (TURP) or prostate removal
- Neurological diseases, such as diabetic neuropathy, stroke, or nerve damage to the spinal cord
- Hormone-related conditions, such as low thyroid hormone (hypothyroidism) or low testosterone (hypogonadism)
- Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis
Psychological causes of delayed ejaculation include:
- Depression, anxiety, or other mental health conditions
- Relationship problems due to stress, poor communication, or other concerns
- Anxiety about performance
- Poor body image
- Cultural or religious taboos
- Differences between the reality of sex with a partner and sexual fantasies
Medications and other substances that can cause delayed ejaculation to include:
- Some antidepressants
- Certain high blood pressure medications
- Certain diuretics
- Some antipsychotic medications
- Some anti-seizure medications
- Alcohol — particularly drinking too much (alcohol abuse or alcoholism)
For some men, a minor physical problem that causes a delay in ejaculation may cause anxiety about ejaculating during a sexual encounter. The resulting anxiety may worsen delayed ejaculation.