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Delayed Ejaculation

Delayed Ejaculation involves a marked delay in ejaculation that may include regular infrequency or a total absence of ejaculation during all partnered sexual activity (i.e., more than 75% of the time).  Delayed Ejaculation involves great difficulty achieving orgasm for the male (that is, the male isn’t just exercising control over orgasm but actually can’t orgasm or finds it extremely difficult to do so when he desires it).  On average, most men engage in sex for a period of 3 to 6 minutes before achieving orgasm.  A problem with delayed ejaculation is assumed if a man is unable to achieve orgasm within 25 minutes of commencing intercourse with his partner.

Sexual problems can be influenced by many factors including medical issues (e.g., medication or the after effects of a medical procedure), alcohol or other drug use and physical factors such as tiredness and stress.  Hence, some men may have short periods in which they experience sexual problems that resolve in their own time.  Therefore, Delayed Ejaculation is only considered a psychological condition if it persists for a minimum duration of 6 months. Difficulties ejaculating is only considered a psychological problem if it causes the individual significant emotional distress.  For example, some men may not be able to ejaculate before a certain amount of time during intercourse has passed (10, 15 or 20 minutes).  However if this does not lead to any distress in the relationship then it is not considered problematic.

Like many other psychological problems, Delayed Ejaculation can result in mild, moderate or severe levels of emotional distress depending on the individual and couple concerned.  Other factors include whether the problem is lifelong or acquired.  If the problem has been present since the individual became sexually active it is considered lifelong.  If the problem commenced after some months or years of normal sexual functioning it is considered acquired.  The condition may also be situational or generalised.  If situational, the problem only occurs with certain types of stimulation, situations or partners.  If generalised, the problem is not limited to specific types of stimulation, occurs in different situations and/or with different partners.

What causes Delayed Ejaculation?

Delayed Ejaculation can be caused either by psychological or physical factors or a combination of both.  A good place to start if you suspect you are experiencing Delayed Ejaculation is to speak with your GP or a sexual health physician firstly to determine if there is a physical basis for the problem.

Physical causes of Delayed Ejaculation:

Nerve injury resulting from accidents or medical procedures, excessive alcohol use, Diabetes and Multiple Sclerosis can effect a man’s ability to ejaculate.  Some medications including antidepressants, antipsychotics and opioids may cause ejaculatory difficulties.  Illegal substances (e.g., Cannabis, Amphetamines) may also influence delays in ejaculation.

Psychological counselling may still be important even if the cause of Delayed Ejaculation is physical or medical.  Physical causes of Delayed Ejaculation can create anxiety, which in turn can make the problem worse.  A psychologist will be able to provide you with information and support to manage the effects of Delayed Ejaculation on your relationship and ensure each of you can still enjoy a fulfilling sex life.

Psychological causes of Delayed Ejaculation:

Relationship factors can play a role in Delayed Ejaculation and involve such issues as discrepancies in desire for sexual activity or recurrent arguments and unresolved relationship problems.  Other influences include Individual factors such as poor body image or a history of sexual or emotional abuse.  Psychological problems such as depression or anxiety may influence sexual functioning – many men experience a loss of sexual desire in the context of very low mood (i.e., when feeling sad or miserable more days than not).  Cultural or religious influences may also affect sexual problems – for example religiously based values and attitudes toward sexuality or certain activities can influence a person’s ability to experience sexual pleasure.

Other factors may include excessive internet pornography use, which may result in a need to have a certain type of stimulation in order to more easily achieve orgasm (e.g., watching models of a certain build or body type different to one’s partner).  Highly regular masturbation may also lead to delays in achieving orgasm during partnered sex, in which case simply reducing frequency of masturbation resolves the problem.

How common is Delayed Ejaculation?

Delayed Ejaculation is relatively rare and some research has estimated that this problem effects less than 1% of men over periods lasting longer than 6 months.  Problems with Delayed Ejaculation tend to become more common for men as they age, particularly for those over the age of 50 years.

What are the steps in treatment for Delayed Ejaculation?

Steps taken in treatment depend on the cause of the Delayed Ejaculation.  Drug treatments exist, however these may also include unwanted side effects and it is uncertain how effective they are in the treatment of Delayed Ejaculation – these medications include, Amantadine, Bupropion, Busperione, Cyproheptadine, Yohimbine and Oxytocin.

Psychological treatments focus on exploring how Delayed Ejaculation is effecting each partner (e.g., some women state that they would like their partner to come earlier during sex while others are quite happy with sex taking some time).  Counselling will also generally cover what the man needs to increase his ability to come more quickly – such as exploring those activities that increase (e.g., fantasies or activities he can enjoy with his partner) or dampen (e.g., guilt, worry, anxiety or depression) his arousal.  Counselling for Delayed Ejaculation can be conducted with each partner in the relationship present or individually.

Disclaimer:  The information covered on this website is for educational purposes only.  A diagnosis of any psychiatric or medical condition must only be made by a medical or mental health specialist.  Diagnosing a psychiatric concern is a complex process that involves formal training, do not ‘diagnose’ yourself.  If you have concerns that a particular disorder or condition applies to you, please speak with your General Practitioner for further assessment and medical/psychological care.

Individual counselling appointments are 50 minutes long.
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