Delayed ejaculation, also referred to as retarded ejaculation, is sexual dysfunction in about 1-4% of men. It consists of a person being unable to ejaculate in a reasonable time in sexual activity. This sexual dysfunction may be frustrating for the man in terms of sexual satisfaction and distressing for both the individual and his partner. In this paper, we are going to discuss symptoms, causes, and treatment of delayed ejaculation.
Symptoms:
Delayed ejaculation is a condition that is defined by the inability to ejaculate within a reasonable amount of time during sexual activity. This time frame is subjective and can vary from person to person. However, it is generally considered to be a delay of at least 30 minutes or more during sexual intercourse, or the inability to ejaculate at all. In some cases, men may be able to ejaculate only through masturbation or with the help of a partner’s manual or oral stimulation.
Causes:
There are various factors that can contribute to delayed ejaculation. These can be psychological, physical, or a combination of both. Some common causes include:
Psychological Factors
Psychological issues are probably the most frequent cause of delayed ejaculation. Certain conditions, like stress, anxiety, and depression, heighten tension and make it impossible for a man to relax with his partner during sexual activity. This may be due to previous experiences in past sexual relations, fear of not meeting expectations, and unresolved issues between partners. These emotional and mental blocks result in a cycle of concern and question, making sexual encounters even more difficult and, therefore, plunging one into much greater difficulty in achieving ejaculation.
Medications
A very common cause of DE emanates from certain medications, especially those resulting from the treatment of mental and chronic conditions. Antidepressants, antipsychotics, and some blood pressure medicines may disturb the conduction of the nerve impulses that cause a man to ejaculate. Men who are experiencing DE due to such medications might discuss with a healthcare provider alternative modes of treatment, which may alleviate the problem and reinstate sexual function to normal.
Hormonal Imbalances
The basis of sexual health is hormones, and among these, testosterone is the main one. This important hormone is responsible not only for the development of male secondary sexual characteristics but also highly contributes to sexual desire and function. Low or high levels of testosterone can lead to Delayed Ejaculation. Low testosterone levels may cause a spectrum of sexual dysfunctions including DE, erectile dysfunction, and diminished libido. On the other hand, high levels of prolactin—a hormone secreted by the pituitary gland—may impede the production of dopamine. As dopamine is believed to be an essential element during sexual arousal and ejaculation, high prolactin may also be a contributing factor to a man’s condition of delayed ejaculation.
Neurological Damage
Optimal sexual functioning depends on the health of the nerves. Any trauma or injury to the nerves supplying these organs for ejaculation can cause retarded ejaculation. This may be due to disease conditions like diabetes, multiple sclerosis, or spinal cord injuries which interfere with the complex neural pathways for normal physiological ejaculation.
Age
Delayed ejaculation can also be part of aging due to the natural decline in testosterone levels. While aging does not singly govern sexual function, it is a contributing factor. Prevalence among studies indicates an increase with age in erectile dysfunction, underlining that aging may be partly connected to changes in hormones and sexual health problems. The same study also showed that 8.4% of men aged 40-49 reported difficulty with erectile dysfunction, but that figure increases to 17% for men aged 70-79. Thus, older men will have to consider how changes in physiology with age impact their sexual experiences, including the ability to ejaculate.
Treatments:
Treatment for delayed ejaculation depends on the underlying cause. In some cases, the condition may resolve on its own with time or with the help of therapy. However, if the problem persists, the following treatment options may be recommended:
Therapy: The psychological factors include anxiety, depression, or even past traumas that may be causing the delayed ejaculation. More often than not, therapy is a helpful first step into resolving deeper issues. Cognitive-behavioral therapy and sex therapy allow one to understand feelings and beliefs surrounding sex that will help with identifying and reforming any negative thought patterns that bring about sexual dysfunction.
Medications: Sometimes, medications can be helpful to treat delayed ejaculation. One class of medications known as selective serotonin reuptake inhibitors, generally used for treating depression and anxiety disorders, is useful in treatment. These drugs act by adjusting serotonin levels in the brain that may enable one to have better sexual function. It’s important to consult with a health professional, since these drugs can cause side effects or may not be indicated in all individuals.
Hormone Therapy: Low levels of testosterone are another cause of delayed ejaculation. For this, hormone therapy is recommendable by replacing testosterone with the help of testosterone replacement therapy. It would restore the level to normal and could positively influence libido and functioning, hence improving sexual health overall. Those suspecting hormonal issues should discuss this possibility with their healthcare provider for appropriate testing and guidance.
Nerve Stimulation: For some men, techniques to stimulate nerves that normally help achieve ejaculation are necessary. The techniques that might be used include penile vibratory stimulation or electroejaculation when other treatment options do not yield any success. These methods function to stimulate the nerves responsible for ejaculation and are therefore effective where everything else has failed.
Couples Therapy: In the case where delayed ejaculation is associated with the state of the relationship, couples therapy may be recommended. The goal of couples therapy is to strengthen communication between partners and enhance intimacy. This will no doubt help the couple develop a healthy sexual life. Many of the pressures that would result in the condition would have been dissipated with increased awareness and closeness.
Conclusion
Delayed ejaculation is a comparatively common sexual dysfunction. It may play a very important role in the satisfaction of a man’s sexual satisfaction and general well-being. Therefore, this condition is in dire need of treatment, as it can lead to frustration and strained relationships. Delayed ejaculation, with the right approach for treatment, can be dealt with and managed well; hence, people can lead full and satisfying sex lives. One can consult a general physician if such symptoms of delayed ejaculation are diagnosed in a person.
