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Sexual dysfunctions. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org/. Accessed Feb. 25, 2018.
Wein AJ, et al., eds. Disorders of male orgasm and ejaculation. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed May 7, 2018.
Ferri FF. Ejaculation and orgasm disorders. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Feb. 25, 2018.
Abdel-Hamid IA, et al. Delayed ejaculation: Pathophysiology, diagnosis, and treatment. World Journal of Men's Health. 2018;36:22.
Sadowski DJ et al. A review of pathophysiology and management options for delayed ejaculation. Sexual Medicine Reviews. 2016;4:167.

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Delayed ejaculation — sometimes called impaired ejaculation — is a condition in which it takes an extended period of sexual stimulation for men to reach sexual climax and release semen from the penis (ejaculate). Some men with delayed ejaculation are unable to ejaculate at all.
Delayed ejaculation can be temporary or a lifelong problem. Possible causes of delayed ejaculation include certain chronic health conditions, surgeries and medications. Treatment for delayed ejaculation depends on the underlying cause.
It's normal for men to have delayed ejaculation from time to time. Delayed ejaculation is only a problem if it's ongoing or causes stress for you or your partner.
Some men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate. Other men might not be able to ejaculate at all (anejaculation).
But, there's no specific time that indicates a diagnosis of delayed ejaculation. Instead, you are probably experiencing delayed ejaculation if the delay is causing distress or frustration, or if you have to stop sexual activity due to fatigue, physical irritation, loss of erection or a request from your partner.
Often, men might have difficulty reaching orgasm during sexual intercourse or other sexual activities with a partner. Some men can ejaculate only when masturbating.
Delayed ejaculation is divided into the following types based on symptoms:
These categories help in diagnosing an underlying cause and determining what might be the most effective treatment.
Your primary care doctor is a good place to start when you have delayed ejaculation. See your doctor if:
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Delayed ejaculation can result from medications, certain chronic health conditions and surgeries. Or it might be caused by substance misuse or a mental health concern, such as depression, anxiety or stress. In many cases, it is due to a combination of physical and psychological concerns.
Psychological causes of delayed ejaculation include:
Medications and other substances that can cause delayed ejaculation include:
Physical causes of delayed ejaculation include:
For some men, a minor physical problem that causes a delay in ejaculation might cause anxiety about ejaculating during a sexual encounter. The resulting anxiety might worsen delayed ejaculation.
A number of things can increase your risk of having delayed ejaculation, including:
Complications of delayed ejaculation can include:
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Have you ever finished too quickly during sex?
For even the most experienced guys, there may have come a point in time where you were just too excited in the bedroom and climaxed sooner than you should. If it happens infrequently, it’s usually not a cause of concern. Most guys also tend to be able to control it later on.
However, if you continuously fail to tame the time you orgasm, it might be a sign of something bigger.
Premature ejaculation occurs when a man ejaculates too quickly during sex. It’s commonly perceived as an undesirable sexual health condition that can be a source of shame and guilt for an individual.
Men who have this problem feel like they can’t enjoy sex to the fullest due to the inability to control ejaculation. This condition is one of the major causes of frustration in the bedroom, damaging the sexual intimacy and relationship between partners.
According to a recent study published in the National Institutes of Health , it’s estimated that around 4% of men have difficulty controlling when they finish. Moreover, 30% of men have experienced premature ejaculation before, making it fairly common.
While experiencing premature ejaculation can be difficult, there are ways that men can control and prolong an orgasm effectively. Get your premature ejaculation diagnosed.
Here are some ways that you can delay ejaculation and achieve better sex.
Pelvic floor (or “Kegel”) exercises are done to strengthen the pelvic floor muscles. They help improve impaired and weak pelvic floor muscles that may cause premature ejaculation. They’re generally painless and can be performed anywhere.
You can feel your pelvic muscles by contracting the muscle that controls your urine flow. This exercise is also known to help men improve various forms of urinary and sexual function problems. In fact, a published study that has been medically reviewed concluded that performing Kegel exercises is an effective way to treat men with sexual health and ejaculatory problems .
Here are the steps to correctly perform pelvic floor exercises at home:
To locate your pelvic muscles, stop the flow of your urine mid-stream. Once you have identified the muscle that controls this contraction, you may perform this routine in other positions.
Be aware not to tighten the buttocks, leg or abdominal muscles during this exercise.
You can perform pelvic muscle exercises in almost any position, including:
For this method, you can try lying down.
Contract and lift your pelvic floor muscles for five seconds. Then as you cool off, relax for five seconds, then repeat. Perform three sets of ten repetitions each day. Over time you will identify the best Kegel exercise for your specific situation.
The squeeze method is used to stop the urge to climax when the penis is sexually stimulated.
You or your partner gently press down the back of the penis head until the desire goes away.
This is performed right before the brink of ejaculation, effectively decreasing sensitivity and reducing the desire to climax. Once you regain control, you can resume sexual activity.
You may repeat the cycle as many times as long as you and your partner remain satisfied. Three to four times is the usual amount.
Once you get used to using this method, you can continue doing this for the following sessions. This way, you can improve your sexual endurance and last longer in bed.
The start-stop technique is when you stop any form of sexual stimulation to the penis for 30 seconds. After that period, or until you feel like you’re not as stimulated anymore, you can regain control and resume sexual activity.
You may repeat this method as many times as you deem necessary until you and your partner are satisfied.
Condoms may help lessen penile sensitivity, which can contribute to delaying premature ejaculation. Certain types of condoms may also contain numbing agents to stop premature ejaculation.
This includes the following brands:
There are medical therapies specifically suited to improving male sexual dysfunction and delaying premature ejaculation (PE).
While topical creams and sprays, ingredients such as benzocaine, lidocaine or prilocaine are popular for treating premature ejaculation, these reduce the pleasurable feelings and are not long term solutions.
Other popular options include ED pills, however, these prescriptions often lead to men experiencing certain side effects, like headaches and indigestion.
For a long term medical treatment to fight premature ejaculation that targets the underlying causes of dysfunction, consult a medical professional specializing in PE for a proper diagnosis and treatment plan.
To improve your sex life and combat male sexual dysfunction, it’s essential to cover all bases and improve your lifestyle as well.
By being proactive with your health, you’ll help slow down the development of diseases like erectile dysfunction and premature ejaculation. In fact, men who quit smoking have shown positive improvements in their sexual function. You’ll also be more energized and active— boosting your confidence and reducing your performance anxiety in bed.
This can make the time in the bedroom a much more satisfying place to be with you and your sexual partner.
Lifelong premature ejaculation can be a pain to deal with, but don’t lose hope. It’s more than possible to treat premature ejaculation and attain sexual satisfaction with the right behavioral techniques.
The medical professionals at Prestige Men’s Medical Center in Tampa specialize in treating conditions that impact men’s health. Our concierge approach positions your unique case at the centerpoint of our focus. We don’t just give you a pill for ED and send you on your way. We treat the underlying issues that led to conditions such as erectile dysfunction , premature ejaculation , low testosterone , and more. Contact our office today to schedule an appointment.

Medically reviewed by
Dr Roger Henderson and words by Karen Gordon

The essential orgasm guide for women
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Low libido: how to increase sex drive for women
Dr Roger Henderson
Dr Roger Henderson is a Senior GP, national medical columnist and UK medical director for LIVA Healthcare
He appears regularly on television and radio and has written multiple books.

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