Why Does Ejaculation Take so Long? Finding Help for Delayed Ejaculation (DE)
It is a common problem: you feel frustrated because it takes you a very long time to finish sexual activity, or maybe you cannot ejaculate at all. This situation is called Delayed Ejaculation (DE). If the difficulty you have releasing semen causes stress for you or your partner, it is important for you to get medical help. DE is an ejaculatory problem that medical science still needs to understand better. We must find the reason why this is happening to you so we can start treatment.
What Delayed Ejaculation Actually Means
We call DE an ejaculatory disorder. It means a man needs a much longer time than normal, requiring lots of sexual touching, to finally reach climax and release semen. If you cannot ejaculate at all, doctors call that condition anejaculation. There is no specific number of minutes that makes a diagnosis; instead, the issue must be ongoing, and it must cause you distress. Often, men and their partners stop sexual activity because they are tired, or the erection is lost, or the partner wants to quit. Doctors classify DE as either Lifelong (it started when you were sexually mature) or Acquired (it started later after you had normal function). It can also be Generalized (it happens every time, no matter the partner) or Situational (it only happens in certain circumstances, like with a partner but not when you masturbate).
The Many Reasons Ejaculation Takes Too Long
The cause of DE is rarely simple, often involving many things at once, which we call a multifactorial origin.
- Common Causes: Medications and Substances- Prescription drugs are a very frequent cause of DE that starts later in life because certain chemicals confuse the nerves that control ejaculation. This includes many Antidepressants, especially Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine or paroxetine, which are highly known for causing delayed orgasm. Other medications that can be the culprit are some Blood Pressure Medicines (antihypertensives), Alpha-blockers (used for prostate problems, like tamsulosin), certain Antipsychotics, and Diuretics (water pills). We also know that drinking too much alcohol over a long time or using nonprescription drugs heavily can hurt ejaculatory function.
- Physical Health and Nerve Problems- Any condition that damages your nerves or changes your hormones can lead to DE. Damage to the pelvic nerves, which are necessary for orgasm, can happen if you have chronic diseases like diabetes, multiple sclerosis, or if you have a history of stroke or spinal cord injury. Hormones are vital: low levels of testosterone (hypogonadism) or an underactive thyroid (hypothyroidism) are both strongly linked to DE because testosterone helps the ejaculatory reflex work properly. We also see that as men get older, it naturally takes more time and stimulation to ejaculate because sensitivity goes down. Sometimes, prior operations, especially prostate surgery like transurethral resection of the prostate (TURP), can be the cause.
- Your Thoughts and Feelings- Psychological issues have a deep effect on how DE develops. If you have feelings of depression or anxiety, they can directly suppress your sexual desire and function. Worrying too much about how you perform during sex (Performance Anxiety) is a big factor. Problems in your relationship, such as stress or anger with your partner, can also block your ability to climax. Lastly, if you have strong feelings of guilt about sex from your culture or religion, that can contribute.
What We Do to Treat Delayed Ejaculation
The treatment we choose must exactly match the reason why you have DE. It is important to know that the US FDA has not officially approved any medicine specifically for treating DE. But we use several effective strategies.
For problems caused by medicine, your doctor may suggest lowering the dose or switching to a different drug that is known to have fewer sexual side effects. For example, the drug Bupropion is often a better choice than some SSRIs. If your DE is caused by a hormone issue, treating that is key: correcting low thyroid function or raising low testosterone levels often solves the problem. In specific cases, doctors sometimes use medicines approved for other things, like Buspirone (for anxiety) or Amantadine (for Parkinson’s disease), as an outside-the-label treatment.
When the cause is your mental state, counseling is necessary. A therapist who specializes in sex problems can help you deal with guilt, anxiety, or relationship issues. Working with a Couples Counselor usually leads to better results because both partners can address their shared concerns. If your DE only happens with a partner, we can use behavioral techniques to help you increase stimulation during sex and close that gap.
When to Talk to a Doctor
If your Delayed Ejaculation is constant and making you upset, you must talk to a medical professional. We need to do a full check-up, including your history, a physical exam, and lab tests (blood and urine), to make sure there are no serious nerve or hormone problems hiding.
You must seek professional help if: your DE causes relationship trouble or great stress; you think your current medicine is the reason; you also have other issues like Erectile Dysfunction (ED); or you are concerned about being infertile
StrideRx: Your Private and Expert Treatment Option
Managing DE absolutely requires a correct medical diagnosis and a plan made just for you. StrideRx is a specialized online health platform in India focused on private, expert care for men’s sexual health problems. Our doctors in India can talk to you confidentially online to review your full health history and symptoms. We will create an evidence-based treatment strategy for you, which might include changing prescriptions, giving you new medication where appropriate, or referring you to a specific therapist. We guarantee your privacy as we work to meet your health needs.
Take the most important step today. Talk to a StrideRx doctor online now for a private consultation about getting your Delayed Ejaculation treated.
Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice.
References
- Cleveland Clinic. (2024). Delayed Ejaculation: Causes, Diagnosis & Treatment. Retrieved from https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation
- Corona, G., & Mannucci, E. (2016). Epidemiology of delayed ejaculation. Translational Andrology and Urology, 4(2), 279–290. (Source: PMC ID: PMC5002002)
- Corona, G., Mannucci, E., Jannini, E. A., Lotti, F., Ricca, V., Sforza, A., Gacci, M., Vignozzi, L., & Maggi, M. (2008). Different testosterone levels are associated with ejaculatory dysfunction. The Journal of Sexual Medicine, 5(6), 1419–1428. (Source: PubMed ID: 18399946; DOI: 10.1111/j.1743-6109.2008.00803.x)
- Healthdirect. (2024). Delayed ejaculation: treatment, causes and diagnosis. Retrieved from https://www.healthdirect.gov.au/delayed-ejaculation
- Healthline. (2019). Delayed Ejaculation: Causes, Symptoms, & Diagnosis. Retrieved from https://www.healthline.com/health/delayed-ejaculation
- Martin-Tuite, P., & Shindel, A. W. (2020). Management Options for Premature Ejaculation and Delayed Ejaculation in Men. Sexual Medicine Reviews, 8(3), 473–485. (Source: PubMed ID: 31668585; DOI: 10.1016/j.sxmr.2019.09.002)
- Mayo Clinic. (2024). Delayed ejaculation – Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358
- Perelman, M. A. (2021). Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment. Translational Andrology and Urology, 4(2), 291–311. (Source: PMC ID: PMC5756804)
- Shamloul, R., & Ghanem, H. (2015). The pathophysiology of delayed ejaculation. Translational Andrology and Urology, 4(2), 273–278. (Source: PMC ID: PMC5002008)
- Testa, C., Caltabiano, B., Cella, S., & Scaccianoce, S. (2016). Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. Mental Health Clinician, 6(4), 191–201. (Source: PMC ID: PMC6007725; DOI: 10.9740/mhc.2016.07.191)
