Do you mostly have difficulty in reaching climax even though everything seems alright? Then you might be experiencing Delayed ejaculation (DE). It’s not always talked about, but it’s not uncommon, as you’d think. Delayed ejaculation is when you ejaculate late or for some men, never during sexual activity, despite getting the right arousal and stimulation. And it can be frustrating for both the person experiencing it and their partner.

In this blog, we’ll talk about what delayed ejaculation means, why it happens and what can be done about it. 

What is Delayed Ejaculation? 

Delayed Ejaculation (DE) is a sexual dysfunction in which there is a delay or inability to get ejaculation during sexual activity always or most of the time, even if there is enough sexual stimulation and arousal. In some cases, one might not get any ejaculation at all- it is known as anejaculation. It is one of the less common forms of sexual dysfunction in men and can cause quite emotional distress for the person suffering and their partner.

There’s no universally agreed-upon duration that defines DE. However, the average time needed to ejaculate during penetrative sex (intravaginal ejaculatory latency time, or IELT) is about 5-7 minutes. And it can vary for different people. If it takes longer sometimes- it’s totally normal and needs no medical help unless you are distressed about it.

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But if you take 30 minutes or longer to ejaculate during any sexual activity or it doesn’t happen at all, despite giving sufficient arousal and stimulation- then you should talk to a medical professional about this.

Note: DE is not about an exact time frame but more about the person’s and his partner’s perception of delay. If it’s causing distress in your intimate relationship, get HELP.

Types of Delayed Ejaculation

Unlike erectile dysfunction (ED) and premature ejaculation (PE), men suffering from DE usually have normal sexual desire and don’t have a problem holding an erection. But they struggle to ejaculate at the desired time or cannot ejaculate at all. The condition is seen while having vaginal penetration, oral sex, or masturbation. DE can be of 2 types:

1. Lifelong (Primary) Delayed Ejaculation: A person suffers from this type of delayed ejaculation from the time of their sexual maturity. They haven’t ejaculated once in their life during any sexual encounters.

Common Causes:

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• Congenital anomalies in the genital tract or nervous system
• Genetic factors
• Early-life psychological factors or trauma
• Underlying medical conditions like hypogonadism or undiagnosed neurological conditions

2. Acquired (Secondary) Delayed Ejaculation: This type of DE happens later in life after the person has had a normal sex life for some time. This is known to be linked to some medical conditions, medications, or psychological issues.

Common Causes:

• Medical conditions (like diabetes, multiple sclerosis)
• Side effects from some medications, mainly selective serotonin reuptake inhibitors (SSRIs) and other antidepressants
• Stress, relationship concerns, or performance anxiety
• Substance use (taking excessive alcohol or recreational drugs)

Note: Delayed ejaculation (DE) is seen in different patterns for different people. It may be intermittent, which happens only in certain situations or with some partners. It can also be consistent, when it happens all the time, regardless of the situation or partner. It’s important to know your pattern to get the right treatment.

Allo Health experts specialise in the treatment of Delayed Ejaculation in a holistic way. The experts first work with you to determine the type of DE you have and run a thorough root cause assessment to give you a personalised treatment suited to your exact needs.

Symptoms of Delayed Ejaculation (DE)

Delayed ejaculation (DE) can be seen in many ways, and men suffering from it feel frustrated and uncertain. One of the main symptoms of this disorder is that men are unable to ejaculate most of the time or always, despite being in a prolonged sexual activity or getting enough stimulation. For some men, it might take a longer time to ejaculate which makes them and their partner lose interest during intimacy. Others might struggle to ejaculate only at the time of penetrative sex and may not have the same problem with other forms of stimulation.

Primary Symptoms

• Men Might Have a Problem Reaching Climax: 
  • Men with DE take an unusually long time to ejaculate, even with sufficient arousal and stimulation.
• Not Being Able to Ejaculate:
  • Men not being able to ejaculate at all during sexual intercourse.
  • May only be able to ejaculate through other forms of stimulation like masturbation.
• Constantly Having Low Sexual Satisfaction:
  • Feeling frustrated or dissatisfied to continue any sexual activity.
  • This can bring dissatisfaction to both the individual and their partner.
• Less or No Sensation During Ejaculation:
  • After some time ejaculation may feel less intense or pleasurable.
  • Some men might not feel any typical physical and emotional release that comes with orgasm.

Other Associated Symptoms

• Sexual Activity Lasting For Longer Time:
  • Sexual encounters last longer than desired by both partners which in turn makes the couple exhausted and more in pain.
• Losing Erection Even Before Ejaculation:
  • Men lose their erections due to getting stimulation for a long time without reaching their climax.
• Men Avoid Any Form of Sexual Activity:
  • Men lose their interest in sex due to anxiety, embarrassment or frustration.
• Men Face Relationship Problem:
  • Both partners will have some unmet expectations due to delays in ejaculation causing some stress in their intimate relationship.
• Specific Situational Issues:
  • Some men have difficulty ejaculating only during intercourse but not while masturbating (situational DE).
  • Some might have a delay in ejaculation only in certain situations or with certain partners.

Possible Physical or Psychological Accompaniments

• Physical Symptoms:
  • Men feel pain or discomfort due to getting aroused for a long time without any ejaculation.
  • Men can get pelvic pain or blue balls (epididymal hypertension).
• Psychological Symptoms:
  • Performance anxiety.
  • Low self-esteem or feelings of inadequacy.
• Behavioural Symptoms:
  • Some men can focus too much on the need to ejaculate which gives them more anxiety.

If your DE continues and keeps affecting your quality of life or relationships, it’s important to consult a sexual health professional. You can now consult a sexual health doctor at any one of 20 Allo Sexual Health Clinics for a full diagnosis at just Rs. 499 or through an online consultation at just Rs. 199.

Causes of Delayed Ejaculation

Delayed ejaculation (DE) can happen due to many reasons and is usually due to a mix of both physical and mental factors. Figuring out the root cause of your DE is necessary, and it’s about finding a balance between your physical health and mental well-being.

Physiological Causes:

• Nerve damage: When there’s any damage to the nerves from conditions like diabetes, multiple sclerosis or spinal cord injuries. It can disrupt the signal from the brain needed for ejaculation.
• Chronic health concerns: Blood flow to the penis and energy level can get affected due to some diseases- like cardiovascular problems, liver disease, or kidney disorders.
• Hormonal imbalances: Men’s libido and ejaculating time can change with low testosterone levels, thyroid problems, or high prolactin levels.
• Side effects of some medications:  Some medications- like antidepressants (especially SSRIs), antipsychotics, beta-blockers, or opioids may alter sexual function as their side effects.
• Changes due to ageing: Some people have slow responses to many bodily functions due to ageing.
• Substance use: Alcohol intoxication or chronic drug use causes nerve damage and lower sensitivity.

Psychological Causes:

• Stress and anxiety: Performance anxiety or other mental health concerns distract the mind and change the reflexes needed for ejaculation
• Depression: Low motivation or interest in sexual activities affects our focus and sexual performance
• Past trauma: Sexual expression and ejaculation time changes with negative past experiences, cultural taboos, or feelings of guilt and shame about sex 
• Relationship issues: No emotional connection or unresolved conflicts between couples make men lose their interest in sex which in turn delay ejaculation.

Other Causes:

• Lifestyle factors: Poor health, lack of physical activity, or chronic illnesses give their hand in delaying ejaculation in the long run.
• Infrequent sexual activity: Not getting to do sex regularly may reduce sexual responsiveness.

When to See a Doctor?

Sometimes, delayed ejaculation feels like one of those things you’d rather not talk about- but knowing when to see a doctor can be quite helpful and reassuring. If it’s been happening to you for a while and is starting to mess up your relationship and your confidence, it’s best to check in with a pro now. If ejaculating takes forever (or doesn’t happen at all) at the time of any sexual activities, even when everything seems fine. Bottom line: if it’s affecting your life and relationships- don’t ignore it. A quick consultation with a sexual health expert may help you if:

• You are having delayed ejaculation most of the time or always at the time of sex.
• If this condition is affecting your relationship with your partner(s).
• If you think you may have other underlying medical conditions like diabetes or a hormonal disorder.
• If you have recently started a new medication and saw some changes in your sexual function.
• If you are having some pain, discomfort or erection problems due to DE.

Early help will help to treat your DE along with other underlying issues and improve your sexual health.

How to Find Out If You Have Delayed Ejaculation / Diagnosis

If you’re thinking you might have delayed ejaculation (DE), there are many ways to figure it out. DE happens when it takes a long time to ejaculate during sex, or you might not be able to ejaculate at all, despite feeling aroused and stimulated enough. If this sounds familiar, it might be the time to confirm it.

Allo Health experts use great protocols to make you comfortable in this conversation while still collating all the information needed for your diagnosis. Some of the information required for a proper diagnosis will include:

1. About Your General Health:
   Your sexual health expert might ask you questions like: 
   • Have you ever been diagnosed with any chronic illnesses like diabetes or cardiovascular diseases?
   • Do you take any medications (e.g., antidepressants) that could delay ejaculation?
   • Have you had any hormonal imbalances diagnosed (like having low testosterone)?
   • Have you had any recent injuries, surgeries, or medical treatments that might affect your sexual health?

These questions will help your doctor to rule out any underlying medical causes.

• About Your Sexual History: 

1. • How long have you been getting these symptoms?
   • When was the last time you ejaculated normally?
   • Is this something that happens every time, or only sometimes?
   • Does this affect your relationship with your partner(s)?
   • Have you had any past sexual experiences that were traumatic or negative?

These help your doctor to know about your personal and relational experiences with DE.

1. About Your Emotional And Mental Wellbeing
   • Do you often feel anxious, mainly at the time of sex?
   • Do you feel stress or pressure to perform during intimacy?
   • Have you ever been diagnosed with depression or anxiety?
   • Are you comfortable talking about your sexual concerns with your partner(s)?
   • Do you have any fears of rejection or insecurities regarding your performance?
2. About Your Lifestyle
   • How many times a week do you exercise?
   • What type of diet do you eat on a daily basis?
   • Do you smoke, drink alcohol, or use other recreational drugs?
   • Do you usually get stressed in your daily life?
   • Do you sleep well and get enough rest?
3. Physical Examination (If Needed):
   • Blood tests are prescribed to check your hormone levels (like testosterone, and thyroid).
   • Neurological tests are done if any nerve damage is suspected.
   • Tests for other underlying conditions like diabetes or cardiovascular diseases.

Once your diagnosis is done, your doctor will guide you through your treatment options as per your needs. A thorough evaluation of medical history and lifestyle factors is done at Allo Health to find out the main cause of our patient’s DE. With 30+ clinics and a team of 30 specialised doctors, we give proven and personalised treatment plans to treat both physiological and psychological factors of DE.

Treatment Methods for Delayed Ejaculation

Dealing with delayed ejaculation (DE) is frustrating for the one suffering and his partner(s). But here’s the good news, there are plenty of treatment options for DE. If your problem comes from physical factors, it might be as simple as changing some of your current medications (since some of them can cause DE) or taking prescribed treatments to improve your nerve sensitivity or blood flow. It is a mix of medical support, mental health care and some healthy habits. It’s all about finding what works for you.

1. Medical Treatments:

• Adjusting medications: If your DE is caused by medications (antidepressants like SSRIs), just adjusting the dosage or switching to alternatives (like bupropion) can help.
• Testosterone Replacement Therapy (TRT): It is used if low testosterone levels are contributing to your DE.
• Treating other underlying conditions: Managing diabetes (controlling blood sugar levels), neurological disorders, or infections.

2. Psychological Interventions:

• Cognitive Behavioral Therapy (CBT): It helps to treat performance anxiety or change some of your negative thought patterns and behaviours.
• Couples therapy: It can help you to emotionally connect with your partner and resolve any relationship conflicts.
• Mindfulness techniques: These exercises help to reduce any stress and increase sexual focus.

3. Other Devices That Can Help:

• Vibratory stimulation: This device may help to stimulate ejaculation.
• Vacuum erection devices: In some cases, these can bring responsiveness and stimulate erection which in the long run may help to reduce ejaculation time.

Over the years, Allo Health has helped more than 75,000 patients with sexual wellness concerns. Our personalised treatment plan gives a high success rate in improving sexual function and the overall health of our patients. Book an online consultation with one of Allo’s leading experts.

Lifestyle Changes Recommended for Delayed Ejaculation

While tackling delayed ejaculation, changing a few lifestyle habits can make a lot of difference.

• Stress alone can throw your entire body off balance, including your sexual health. There are ways to keep it in check by practising yoga, meditating or even just taking a few deep breaths when overwhelmed. 
• Regular exercise doesn’t just keep you fit- it boosts blood flow, energy levels, and mood, all of which are good for a healthy sex life.
• What you eat matters- a diet loaded with nutrients like zinc and magnesium (think nuts, seeds, leafy greens, and lean meats) can help keep your hormones in check.
• Cut back on alcohol, stop smoking, and stay clear of recreational drugs- keep your nerves and overall sexual health better.
• One underrated tip- Talk it out. Talk about all your sexual concerns with your partner. It helps.
• A study published in the Archives of Sexual Behavior in June 2024 examined how some unusual masturbation habits might be linked to male sexual problems like delayed ejaculation (DE). The researchers found that some unique ways of self-stimulation could make it harder for some men to climax during sexual activity with a partner. Understanding these habits could help in treating DE better.

How to address these atypical masturbation habits and treat delayed ejaculation (DE) better:

• Try to find out which specific techniques or habits of yours differ from your partnered sexual activity.
• Try to limit your reliance on fantasies, pornography or overly firm grip during self-stimulation.
• Talk it out with your partner about your needs and desires.
• Use pelvic floor exercises (Kegels) and relaxation techniques to bring better sexual control.
• Remember- improvement takes time and effort.

Key Takeaways (Summary)

• Delayed Ejaculation (DE) is not just a physical concern- it’s often tied to deeper emotional or psychological factors like stress, anxiety, or even unresolved relationship conflicts. 
• DE doesn’t always mean there’s a “problem”- for some men, it’s just how their body works and that’s perfectly fine. 
• Symptoms include prolonged ejaculation time or inability to ejaculate.
• Treatment for Delayed Ejaculation is never one way or another- it’s always a mix of medication, therapy and lifestyle changes.
• Instead of brushing it off- get medical advice if DE is giving you distress or causing relationship issues. An online consultation with Allo Health’s sex experts from the comfort of your own home gives you more control of your health.

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