Premarital screening in Men

Delayed Ejaculation

Next to erectile dysfunction, ejaculatory disorders are the most common health concerns that affect
men.

They can be divided into 2 categories, delayed ejaculation, and premature ejaculation. You most likely
would have heard about premature ejaculation. Delayed ejaculation on the other hand is not as well
known.

You probably wondering why would delayed ejaculation be a problem if a man is lucky enough to be
able to achieve it. However, it is a valid complaint that men struggle with and the condition can be
quite uncomfortable and embarrassing. It can be the cause of much emotional and mental stress and
can even result in a strained relationship.

What exactly is Delayed Ejaculation?

Delayed ejaculation (impaired ejaculation) describes the condition where a man is consistently unable
to achieve an orgasm and ejaculate regardless of stimulation and sexual arousal. Statistics show that
Delayed ejaculation impacts 4% of sexually active men. While 20-30% of sexually active men suffer
from premature ejaculation. Ordinarily, men are able to orgasm with a fair number of minutes of
penetrative sex.

However, with Delayed ejaculation, orgasm, and eventually, ejaculation takes 20-30
minutes or even longer. Some men are unable to ejaculate at all. This condition is called
anejaculation. Delayed ejaculation can persist throughout a man’s life, that is to say from when he
reached sexual maturity and onward or acquired only surfacing after a normal sexual experience.

It can also be classified as generalized that is to say during every sexual encounter or situational, only
occurring under certain circumstances. Examples of those circumstances are changes in sexual
partners or different sexual stimulation.

What are the known causes of Delayed Ejaculation?

The factors that cause Delayed ejaculation can be categorized as medication-related, physical or
psychological, or a combination of some or all.

Psychological causes are as follows:

• Anxiety, depression, or other mental health issues.
• Relationship problems i.e. poor communication or stress
• Performance anxiety
• Differences between sexual fantasies and sexual reality
• Cultural or religious restrictions

Medication and other substances that cause delayed ejaculation include:

• Antihypertensive medications
• Antipsychotic, ant-depressive and anti-seizure medications
• Excessive alcohol use
• Opioid painkillers such as morphine

Physical causes of delayed ejaculation are as follows:

• Prostate surgery
• Urinary tract infection
• Hormonal conditions such as low testosterone or hypothyroidism
• Pelvic nerve injury
• Birth defects that affect the reproductive system
• Retrograde ejaculation (a condition where semen travels backward into the bladder instead of outward through the penis.
• Neurological diseases such as stroke, diabetic neuropathy, or spinal cord damage.

How is delayed Ejaculation diagnosed?

Firstly, we will have a discussion with you aout your medical history and a physical examination will
be performed. There will be some laboratory tests that are necessary.

What treatments are available for Delayed Ejaculation?

Fortunately, treatment of any underlying health conditions may resolve the delayed ejaculation in
many cases. Your doctor will advise you to stop or change any medications that may be contributing
to the delayed ejaculation. There are medications that have been touted as being effective against
delayed ejaculation. Unfortunately, they have proven to be unreliable and unsuccessful. So, the
foundations of treatment are sexual counseling and psychotherapy.

Psychotherapy includes examining current and past factors that may cause delayed ejaculation,
including performance anxiety, past unpleasant sexual experiences, underlying psychological issues,
etc.

What are the possible complications of Delayed Ejaculation?

If delayed ejaculation is left unaddressed the following complications can occur:

• Anxiety or stress brought on by concerns about sexual performance
• A sub-standard sex life for one or both partner, this may culminate in relationship or marital problems.
• Male infertility (inability to conceive with a partner)

If you are struggling with the symptoms of Delay ejaculation, we encourage you to discuss this further
with your doctor. Our team is ready to help.