What Causes Delayed Ejaculation In Men?
Delayed ejaculation (also sometimes referred to as the retarded ejaculation) is an uncommon male sexual dysfunction that is often ignored or overlooked. Delayed ejaculation is clinically defined as a significant delay in ejaculation after adequate sexual excitement (in terms of duration and intensity). In fact, in some cases, there is no ejaculation at all. This situation is often also associated with defects or delays in the male orgasm. It is imperative to mention that orgasm and ejaculation are two separate processes but they may coexist in some cases.
Limited data is available regarding to epidemiology and prevalence of DE, but according to some studies, approximately 3% of the male population suffers from DE at some point in life, according to a study reported in the Journal of Sexual Medicine (1).
What Are Some Factors That May Contribute To Delayed Ejaculation?
Following etiological and risk factors may aggravate the risk of developing delayed ejaculation:
1. Intake Of SSRIs And Some Other Drugs:
Regardless of age, many men rely on SSRIs- a class of antidepressants that is indicated for a number of other indications as well (2). Several clinical studies indicates that chronic use of SSRIs such as Prozac, Zoloft or Paxil not only delays orgasm and ejaculation but can also interfere with sexual functions (such as penile erection during intercourse, nocturnal erections etc.) Other common drugs that may also cause delayed ejaculation include; Alpha blockers (prescribed to treat swelling of prostate), diuretics and other antihypertensive agents, alcohol, antipsychotics and antiepileptic drugs.
2. Excessive Dependence On Pornography:
Research indicates that men who are addicted to porn are at high risk of developing delayed ejaculations. Experts explains that men who are habitual to intense visual stimulation faces great difficulty in achieving height of sexual arousal with their real sex partners. In addition, frequent masturbation also causes a delay in orgasm and ejaculation during real sex. This is because a greater deal of friction and pressure is applied during masturbation as compared to real sex. When men masturbates frequently, they get used to specific type of stimulation due to which when they have sex in real, there is delay in orgasm and ejaculation.
3. Psychological Pressure Or Stress:
Worrying about impregnating the female partner, unexpressed active/ passive anger, financial stress or having control issues makes men mentally disconnected due to which they cannot focus well on the climax. They might be physically aroused but not mentally which usually results in delayed ejaculation.
4. Having An Erection, But Not Being Sufficiently ‘Turned On’ To Reach Orgasm:
The amount of stimulation needed to cause erection in men can be reduced by consuming drugs like phosphodiesterase inhibitors (such as Viagra, Levitra and Cialis etc.) or other strategies to manage erectile dysfunction. Although these medications may make a guy think that he’s “turned on”; the reality may be different. This is mainly because, sometimes consumption of pharmacological preparation may cause sexual excitement physically (i.e. penile erection) but does nothing to address the psychological elements of sexual excitement, which may lead to delayed ejaculation.
5. Delayed Ejaculation Due To Guilt And Shame
Cultural and psychosocial factors also have a very important role in the pathophysiology of delayed ejaculation. For example, in some religions masturbation and sex outside of marriage is forbidden. This restricts the capacity of an individual to seek sexual pleasure if sexual intercourse is performed outside of marriage (or in certain unconventional/ forbidden ways). It also creates hindrance in sexual self-expression and the shame and guilt may prevent from immersing into the sexual practice both mentally and emotionally. In chronic cases, this may affect the capacity to reach orgasm even when sex is consensual. Your partner may think that they are not attractive anymore or someone else has captured your attention.
In short, a lot of factors may contribute to delayed ejaculation. Since these issues can be physical or psychological (or both) it is always a good idea to talk to your partner about it and consult a healthcare professional.
References
1. Rodríguez‐Manzo, G., & Canseco‐Alba, A. (2015). Anandamide reduces the ejaculatory threshold of sexually sluggish male rats: possible relevance for human lifelong delayed ejaculation disorder. The journal of sexual medicine, 12(5), 1128-1135.
2. Kotlyar, M., & Vuchetich, J. P. (2013). Selective Serotonin Reuptake Inhibitors (SSRIs). In Encyclopedia of Behavioral Medicine (pp. 1728-1730). Springer New York.
3. Butcher, M. J., Welliver, R. C., Sadowski, D., Botchway, A., & Köhler, T. S. (2015). How is delayed ejaculation defined and treated in North America?. Andrology, 3(3), 626-631.
4. Althof, S. E., & McMahon, C. G. (2016). Contemporary Management of Disorders of Male Orgasm and Ejaculation. Urology.