Delayed Ejaculation (DE) is a male sexual health condition where ejaculation is significantly delayed or does not occur despite adequate stimulation and desire. It is less common than premature ejaculation but can be equally distressing, affecting confidence, intimacy, and relationship satisfaction.

DE can be lifelong (present from the first sexual experiences) or acquired later in life. In either case, effective treatments exist to address both physical and psychological causes.

What Is Delayed Ejaculation?

Delayed Ejaculation occurs when a man requires unusually long stimulation to reach orgasm—or cannot ejaculate at all. While occasional difficulty is normal, persistent problems that cause distress are considered a sexual dysfunction.

Symptoms of Delayed Ejaculation

• Persistent difficulty or inability to ejaculate during intercourse

• Markedly prolonged time to orgasm despite sufficient stimulation

• Distress, frustration, or avoidance of sexual activity

• Reduced intimacy or relationship strain

Causes of Delayed Ejaculation

Physical Causes

• Neurological conditions (Parkinson’s disease, multiple sclerosis, spinal cord injury)

• Diabetes and related nerve damage

• Low testosterone levels

• Side effects of medications (antidepressants, antipsychotics, blood pressure drugs)

• Prostate or pelvic surgery complications

Psychological Causes

• Performance anxiety

• Relationship difficulties

• Depression and mood disorders

• History of trauma or strict sexual conditioning (e.g., guilt or shame around sexuality)

Lifestyle & Contributing Factors

• Excessive alcohol use

• Recreational drug use

• Long-term masturbation patterns not easily replicated with a partner

• Stress and fatigue

Diagnosis of Delayed Ejaculation

A healthcare provider may:

• Take a detailed medical and sexual history

• Review all current medications

• Conduct blood tests (testosterone, thyroid, metabolic health)

• Evaluate psychological, relational, and lifestyle factors

Treatment Options for Delayed Ejaculation

Medical Treatments

• Adjusting or changing medications that may cause DE

• Testosterone replacement therapy (when indicated)

• Use of certain pharmacological agents under medical supervision (off-label options)

Psychological & Behavioral Treatments

• Sex therapy to address anxiety and improve sexual confidence

• Couples therapy to reduce relational stress and increase intimacy

• Cognitive-behavioral therapy (CBT) for depression, anxiety, or guilt related to sex

• Behavioral exercises to retrain arousal and orgasm response

Lifestyle Changes

• Limiting alcohol and avoiding recreational drugs

• Adopting regular exercise for better circulation and energy

• Adjusting masturbation habits if they interfere with partnered sex

• Stress management strategies (yoga, meditation, breathing exercises)

Outlook

Delayed Ejaculation can be challenging but is highly manageable. Identifying the root cause—whether medical, psychological, or relational—is key to successful treatment. With proper support, most men can achieve improved sexual function and satisfaction.

✅ If you’re struggling with DE, you’re not alone. Our clinic provides confidential, evidence-based support designed to address the underlying causes and restore confidence, intimacy, and sexual well-being.

Dr. Srinivas Rajkumar T
MD (Psychiatry), AIIMS New Delhi
Consultant Psychiatrist – Child, Adult & Geriatric Psychiatry
Apollo Clinic, Velachery, Chennai

📞 Contact/WhatsApp: 85951 55808