Delayed ejaculation (also known as male orgasmic disorder) occurs when a man experiences a significant delay before ejaculation or is unable to ejaculate at all, despite wanting to and having a normal erection. Ejaculation problems of this kind are very common and can affect men of any age who are undergoing significant stress, experiencing depression or facing a wide range of psychological or physical factors.
How Do I Know if I Am Experiencing Delayed Ejaculation?
While every person is different, according to NHS guidelines, you may be experiencing delayed ejaculation if you repeatedly face an unwanted delay of 30-60 minutes before ejaculation, or if you’re unable to ejaculate at least half of the times you have sex.
Why Do Problems Ejaculating Occur?
There are many psychological and physical factors that can cause delayed ejaculation. Situational factors such as stress, depression or relationship issues can cause short-term ejaculatory problems, which can be resolved by addressing the root cause of the issue. Physical causes of failure to ejaculate include diabetes, spinal cord injuries, multiple sclerosis, and surgery to the bladder or prostate gland.
Certain medicines can also cause delayed ejaculation or failure to ejaculate, particularly selective serotonin reuptake inhibitors used as antidepressants, and beta-blockers used to treat high blood pressure. Your doctor will always check with you whether your medication has changed when assessing the reason for your ejaculatory delay and may recommend a change in medication if this is likely to be a cause.
If you are able to ejaculate normally when masturbating but not during sexual intercourse or during foreplay, there may be a psychological cause. In this instance, you might want to consider sex or couples therapy to address the issues and identify ways you can experience greater satisfaction during intercourse with your partner.
A rare form of delayed ejaculation is retrograde ejaculation, which occurs when semen travels back into the bladder instead of through the urethra. Symptoms include producing no semen during ejaculation and having cloudy urine when you first go to the toilet after having sex. Retrograde ejaculation doesn’t hurt or impact your sexual satisfaction, but as sperm does not exit through the urethra, it can affect your ability to father a child.
Does Delayed Ejaculation Happen More When You Get Older?
Unfortunately, delayed ejaculation does become more common as you age, and men over the age of 50 are more likely to experience difficulties orgasming. This is because the penis needs more stimulation to trigger ejaculation. Ageing also weakens the pelvic floor, which triggers ejaculation by contracting.
What Are the Side Effects of Not Ejaculating?
Not ejaculating does not have physical health implications, but it can cause a build-up of frustration and tension. If this is something that worries you and begins to affect your relationship or, as frustration can do, other areas of your life, we recommend consulting an expert in men’s sexual health.
What Treatments Are There for Ejaculation Problems?
We know that alcohol is a depressant, which works by slowing down the body’s processes — and this can affect your ability to orgasm. Excessive use of alcohol or drugs can cause delayed ejaculation, as well as a wide range of other issues, so reducing your intake of these substances can improve your ability to ejaculate — if this is the main cause.
Sex therapy or couples counselling could help to address any relationship problems that are impacting your sex life. During therapy, you’ll be able to discuss emotional or psychological issues related to your relationship and be recommended activities you can try at home with your partner.
Increasing the feeling of stimulation before having sex can help to improve the issues you are experiencing with delayed ejaculation. Viewing erotic videos and magazines before sex, participating in exciting new activities during intercourse and using lubricating creams or jellies can all help to improve your satisfaction and heighten pleasure.
The Mann Clinic offers Pseudoephedrine tablets as a treatment for delayed ejaculation and can provide advice on other medications to treat the condition, some of which may not yet be available on the NHS but are perfectly safe for application.