What Is Delayed Ejaculation?
Delayed ejaculation (DE) is a sexual dysfunction that can have a significant impact on a person’s quality of life. It is characterized by a delay or difficulty in achieving ejaculation, even during sexual activity that is satisfactory to both partners.
Delayed Ejaculation Causes
There are several causes of DE, including psychological and physical factors. One of the most common causes is hormonal disorders or imbalances.
Physical Causes
There are several physical causes of DE. These include:
Neurological Disorders
Neurological disorders can cause a wide range of sexual dysfunction, including delayed ejaculation. DE is a condition in which a man is unable to ejaculate or has difficulty reaching orgasm. This can be caused by a variety of neurological conditions, including spinal cord injury, multiple sclerosis, and Parkinson’s disease.
Spinal Cord Injury
Spinal cord injury can cause DE by damaging the nerves that control ejaculation. This can happen as a result of a traumatic injury to the spinal cord, or from conditions such as spinal stenosis or herniated disc. In cases of spinal cord injury, ejaculation may be possible but may require a longer period of stimulation than usual.
Multiple Sclerosis
Multiple sclerosis is a chronic autoimmune disorder that affects the central nervous system. It can cause a wide range of symptoms, including DE. This is caused by damage to the nerves that control ejaculation, which can lead to a lack of sensation and a reduced ability to reach orgasm.
Parkinson’s Disease
Parkinson’s disease is a degenerative disorder of the nervous system that affects movement and balance. It can also cause DE by damaging the nerves that have control over ejaculation. Parkinson’s disease can cause a loss of sensation in the genital area, which can make it difficult to reach orgasm.
Other neurological disorders that can cause DE include:
Stroke
Traumatic brain injury
Alzheimer’s disease
Spinal cord tumors
DE is not always caused by a neurological disorder, it can also be caused by psychological factors, such as anxiety and depression. In case of DE, a visit to a urologist or a sexual health specialist is recommended. They will perform a physical exam and may order tests, such as nerve conduction studies, to help determine the underlying cause of the condition. Treatment options include medication, therapy, and lifestyle changes
Hormonal Disorders
Hormonal imbalances can occur due to a variety of reasons, such as aging, certain medical conditions, and medications. Testosterone, the primary male sex hormone, plays a crucial role in sexual function. A decrease in testosterone levels can lead to a decrease in libido, erectile dysfunction, and DE.
Other hormones that play a role in sexual function include prolactin and thyroid hormones. High levels of prolactin, a hormone that regulates milk production in women, can lead to DE. Hyperthyroidism, or an overactive thyroid gland, can also cause DE.
Medications
There are several medications that have been linked to DE as a side effect. These include antidepressants, antihistamines, anti-anxiety medications, and blood pressure medications.
Antidepressants
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, are commonly used to treat depression and other mental health conditions. These medications can affect the levels of serotonin in the brain, which can lead to DE.
Antihistamines
Antihistamines, which are used to treat allergies and cold symptoms, can also cause DE. These medications work by blocking the effects of histamine, a chemical in the body that causes inflammation and swelling. However, they can also affect the nerve signals that control ejaculation.
Anti-anxiety medications
Anti-anxiety medications, such as benzodiazepines, can also cause DE. These medications work by calming the nervous system and reducing anxiety. However, they can also affect the nerve signals that control ejaculation.
Blood pressure medications
Blood pressure medications, such as alpha-blockers, can also cause DE. These medications work by relaxing the blood vessels and lowering blood pressure. However, they can also affect the nerve signals that take care of ejaculatory control.
Prostate surgery
Prostate surgery, also known as prostatectomy, is a common procedure used to treat prostate cancer and other prostate-related conditions. While it can be a life-saving procedure, it can also have significant side effects, including DE.
The exact cause of DE after prostate surgery is not well understood, but it is thought to be related to nerve damage. The prostate is surrounded by several nerves that are responsible for controlling ejaculation. During surgery, these nerves may be damaged or removed, leading to ejaculation concerns.
In addition, the surgery may affect the muscles and tissues in the prostate and surrounding area, which can also contribute to DE.
Some men may experience a temporary delay in ejaculation after surgery, while others may have a permanent problem. In general, the younger a man is and the less extensive the surgery, the more likely he is to regain normal ejaculation.
Chronic Health Conditions
Diabetes
One of the most common chronic illnesses that can cause DE is diabetes. Men with diabetes often experience nerve damage, which can affect the ability to ejaculate. This is because the nerves that control ejaculation are located in the penis, and when they are damaged, it can result in difficulty reaching orgasm.
Multiple sclerosis (MS)
Another chronic illness that can cause DE is multiple sclerosis (MS). MS is a neurological condition that affects the communication between the brain and the body, and it can cause concerns with sexual function. Men with MS may experience DE due to nerve damage or muscle weakness.
Prostate cancer
The prostate is a gland located near the bladder that produces semen, and when it is cancerous, it can cause concerns with ejaculation. Men who have had surgery to remove their prostate may also experience difficulty with ejaculation.
Depression and anxiety
Depression and anxiety are also common chronic illnesses that can cause DE. These conditions can affect a man’s ability to become aroused and achieve orgasm.
Pelvic Infections
Pelvic infections, such as prostatitis or epididymitis, can cause a number of sexual dysfunction symptoms in men, one of which is DE.
Prostatitis is an infection or inflammation of the prostate gland, which is located just below the bladder and surrounds the urethra. Symptoms of prostatitis include chronic pain or discomfort in the pelvic area, difficulty urinating, and concerns with sexual function, such as DE. Epididymitis is an infection or inflammation of the epididymis, which is a small duct located behind the testicles that helps to transport sperm. Symptoms of epididymitis include pain or discomfort in the testicles, difficulty urinating, and concerns with sexual function, such as DE.
Both prostatitis and epididymitis are caused by bacterial infections, and treatment typically includes antibiotics to clear the infection. However, in some cases, DE may persist even after the infection has been treated. This is because the pelvic infection can cause damage to the nerves and muscles that take care of ejaculatory control, leading to permanent sexual dysfunction.
To help prevent DE caused by pelvic infections, it is important to practice safe sex, and to see a healthcare provider if you experience any symptoms of an infection, such as pain or discomfort in the pelvic area, difficulty urinating, or concerns with sexual function.
If you have been diagnosed with a pelvic infection and are experiencing DE, it is important to work with a healthcare provider to determine the best course of treatment. This may include antibiotics to clear the infection, as well as physical therapy or other forms of rehabilitation to help improve sexual function.
Psychological Causes
Anxiety
Anxiety can affect men in many different ways, and it can cause a range of physical and emotional symptoms. When a man is anxious, his body releases stress hormones, such as adrenaline and cortisol. These hormones can cause physical changes in the body, such as increased heart rate, blood pressure, and muscle tension. These changes can make it difficult for men to relax and enjoy sexual activity, which can cause DE.
Anxiety can also affect men emotionally. When a man is anxious, he may struggle to focus on sexual activity, and he may have negative thoughts and feelings about himself and his sexual abilities. This can make it difficult for him to achieve or maintain an erection and can cause DE.
Depression
Depression is a common among many mental disorders – it affects millions of people worldwide. It is characterized by feelings of sadness, hopelessness, and a lack of interest in daily activities. Along with these emotional symptoms, depression can also cause physical symptoms, including DE.
Depression and DE are linked in a number of ways. One of the most significant ways is through changes in brain chemistry. Depression is characterized by an imbalance of neurotransmitters, including serotonin, dopamine, and norepinephrine. These chemicals play a crucial role in regulating sexual function, and when they are out of balance, it can lead to sexual dysfunction.
Depression can also cause physical symptoms that can impact sexual function. For example, depression can lead to fatigue, which can make it difficult for a man to maintain an erection. Additionally, depression can cause a lack of interest in sexual activity, which can lead to a lack of desire for sex and difficulty reaching orgasm.
Another way depression can contribute to DE is by causing stress and anxiety. Stress and anxiety can cause physical changes in the body that can impact sexual function, such as muscle tension and decreased blood flow to the genitals. This can make it more difficult to reach orgasm.
Effective treatments for depression and DE typically involves a combination of therapy, medication, and lifestyle changes.
Antidepressant medication can help to balance neurotransmitters and improve mood.
Therapy can help to identify and address underlying emotional concerns that may be contributing to sexual dysfunction.
Lifestyle changes, such as regular exercise and stress management techniques, can also help to improve sexual function.
Stress
When an individual is stressed, their body’s natural response is to release a hormone called cortisol. Cortisol is known as the “stress hormone” and is responsible for the “fight or flight” response. It is released in response to a stressful situation and is intended to help an individual cope with the stressor. However, when cortisol levels are too high, it can cause a number of negative effects on the body.
One of the negative effects of high cortisol levels is that it can interfere with the normal functioning of the sexual organs. It can cause the blood vessels in the penis to constrict, which can make it difficult for an individual to achieve and maintain an erection. This can make it difficult for them to reach orgasm and ejaculate.
Additionally, stress can also affect an individual’s mental state, making it difficult for them to focus on sexual activity. This can lead to a lack of desire and difficulty getting in the mood for sex.
If you’re experiencing DE and suspect that stress may be a contributing factor, it’s important to address the underlying stressors in your life. This can include identifying and addressing the source of the stress, using stress management techniques such as meditation and exercise, and seeking help from a therapist or counselor.
Trauma
Sexual abuse and trauma can have a significant impact on an individual’s sexual functioning, including the ability to ejaculate.
Research has shown that sexual abuse and trauma can lead to a range of psychological and physical symptoms that can affect sexual functioning, including DE. Some of the key factors that contribute to this condition include:
Post-traumatic stress disorder (PTSD): Sexual abuse and trauma can lead to the development of PTSD, which can include symptoms such as anxiety, depression, and flashbacks. These symptoms can make it difficult for an individual to relax and fully engage in sexual activity, leading to difficulty or inability to ejaculate.
Guilt and shame: Many individuals who have experienced sexual abuse or trauma may feel guilty or ashamed about their sexuality or sexual desires. This can lead to difficulty becoming aroused or reaching orgasm during sexual activity, including DE.
Physical trauma: Sexual abuse and trauma can also lead to physical injury, such as damage to the penis or prostate. These physical injuries can affect the ability to ejaculate.
Medications: Certain medications, such as antidepressants, can also cause DE as a side effect.
It’s important to note that DE caused by sexual abuse and trauma is a treatable condition. Therapies such as cognitive-behavioral therapy (CBT) and trauma-focused therapy can help individuals manage the psychological symptoms of PTSD and other related conditions. Additionally, working with a healthcare professional to address any physical trauma or medication side effects can also help improve ejaculatory function.
Lifestyle Causes
While there are various underlying medical causes of DE, such as prostate surgery or diabetes, lifestyle factors can also play a significant role.
Stress
Stress can have a negative impact on a man’s sexual health by causing tension and anxiety, which can lead to difficulty achieving and maintaining an erection. Additionally, stress can also affect a man’s ability to ejaculate, as it can interfere with the body’s natural response to sexual stimulation.
Alcohol & Drug Use
Alcohol and drugs can affect a man’s sexual function by slowing down the nervous system, which can lead to difficulty achieving and maintaining an erection, as well as difficulty ejaculating. Additionally, chronic excessive alcohol and drug use can also lead to physical and psychological dependence, which can further complicate the problem.
Smoking
Smoking can affect a man’s sexual health by narrowing the blood vessels and reducing blood flow to the penis, which can lead to difficulty achieving and maintaining an erection. Additionally, smoking can also affect a man’s ability to ejaculate by damaging the nerves and blood vessels that are responsible for ejaculation.
Other lifestyle causes of DE include poor diet, lack of exercise, and lack of sleep. These factors can affect a man’s sexual health by affecting his overall health and well-being, and can lead to difficulty achieving and maintaining an erection, as well as difficulty ejaculating.
Genetic Causes
Recent research has identified several genetic risk factors that may contribute to the development of DE. One study found that men with DE have a higher prevalence of a specific genetic variant in a gene called SLIT2. This gene is involved in the regulation of nerve growth and function, and the researchers suggest that the genetic variant may disrupt normal nerve signaling in the ejaculatory system.
Another study identified a genetic variant in a gene called PRKG1 that was associated with DE. This gene plays a role in the regulation of blood flow in the pelvic region, and the researchers suggest that the genetic variant may disrupt normal blood flow to the ejaculatory organs, leading to DE.
A third study found that men with DE have a higher prevalence of a specific genetic variant in a gene called KAL1. This gene is involved in the development of the hypothalamus, a part of the brain that plays a key role in regulating sexual function. The researchers suggest that the genetic variant may disrupt normal hypothalamic function, leading to DE.
In addition to these genetic factors, environmental and lifestyle factors may also play a role in the development of DE. For example, certain medications, such as antidepressants, may affect ejaculation. Stress and anxiety can also contribute to DE, as well as certain medical conditions, such as diabetes and prostate concerns.
Overall, while more research is needed to fully understand the genetic factors that contribute to DE, it is clear that this condition is not solely caused by psychological or lifestyle factors. Therefore, it is important for healthcare providers to consider the possibility of a genetic component when evaluating and treating men with DE.
Delayed Ejaculation Risk Factors
There are several risk factors that can contribute to the development of DE. These include:
Psychological factors
Men who have anxiety, depression, or other mental health conditions may be at a higher risk of developing DE. Stress, guilt, or fear of sexual performance can also contribute to this condition.
Medical conditions
Certain medical conditions such as diabetes, high blood pressure, and spinal cord injuries can affect a man’s ability to ejaculate. Certain medications used to treat these conditions can also contribute to DE.
Substance Use
The use of alcohol, tobacco, and illicit drugs can have a negative impact on a man’s sexual function and may lead to DE.
Relationship Concerns
Relationship concerns or dissatisfaction with a partner can also contribute to DE.
Age
As men age, they may experience a decline in their sexual function, which can lead to DE.
