Premature or Delayed Ejaculations

Premature ejaculation is a common issue in which a man ejaculates during sexual intercourse sooner than normal. As many as one in three men say they have experienced this problem at some time. Occasional premature ejaculation is normal, but if you always or almost always ejaculate within one minute of beginning intercourse, you may need to see a specialist to alleviate the condition.

Premature ejaculation is most often caused by a combination of psychological and biological factors. Embarrassment and frustration can also contribute to making the condition worse. But in most cases, medication and treatment can help improve sexual intercourse for you and your partner.

The main symptom of premature ejaculation is the inability to delay ejaculation for more than one minute during intercourse. It’s only considered a diagnosable problem if it occurs every time or almost every time a man is engaged in sexual intercourse.

Causes of Premature Ejaculation

The exact cause of premature ejaculation isn't known, but it’s thought to be caused by a complex combination of psychological and biological factors.

Psychological factors may include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Anxiety about sexual experiences
• Stress or anxiety related to sexual relationships or ED

Biological factors may include:

• Abnormal hormone levels
• Abnormal levels of neurotransmitters in the brain
• Inflammation and infection of the prostate or urethra
• Genetic factors

Combination of Treatment

After diagnosis, your doctor may use any combination of treatment options, including behavioral techniques, topical anesthetics, medications, and counseling.

• Behavioral techniques – May include altering your sexual practices, using condoms, performing pelvic exercises, and other methods
• Topical anesthetics – Applied to the penis prior to intercourse to numb the area and delay ejaculation
• Medications – Antidepressants, analgesics, and/or phosphodiesterase-5 inhibitors (such as Viagra)
• Counseling – May be used in conjunction with other treatments to help reduce performance anxiety and depression

Delayed Ejaculation

Delayed ejaculation is a condition in which it takes an extended period of sexual stimulation for a man to reach sexual climax and ejaculate. In some cases, the man may be unable to ejaculate at all.

Delayed ejaculation can be temporary or a lifelong problem. It’s normal for men to experience delayed ejaculation from time to time, but an ongoing problem may require treatment.

Typically, men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or they may not be able to ejaculate at all. The time it takes isn’t as much of a determining factor as the stress, frustration, or fatigue the condition causes.

Causes of Delayed Ejaculation

In many cases, delayed ejaculation can be caused by a combination of physical and psychological factors. Use of certain substances can also contribute.

Physical causes may include:

• Certain birth defects
• Injury to the pelvic nerves that control orgasm
• Certain infections, such as a urinary tract infection
• Prostate surgery or prostate removal
• Neurological diseases
• Hormone-related conditions
• Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis

Psychological causes may include:

• Depression, anxiety, or other mental health conditions
• Relationship problems
• Anxiety about performance
• Poor body image
• Cultural or religious taboos
• Unrealistic sexual expectations

Substances that can contribute to delayed ejaculation include:

• Some antidepressants
• Certain high blood pressure medications
• Certain diuretics
• Some antipsychotic medications
• Some anti-seizure medications
• Alcohol abuse

Delayed Ejaculation Treatment

If medication is a factor in delayed ejaculation, your doctor may reduce your dosage or switch medications.

While there aren’t any medications specifically approved for the treatment of delayed ejaculation, the following are sometimes used to help treat the causes and symptoms of delayed ejaculation:

• Amantadine (Parkinson’s medication)
• Buspirone (anti-anxiety medication)
• Cyproheptadine (allergy medication)
• Psychological counseling

If you’re experiencing the symptoms of premature ejaculation or delayed ejaculation, the Urology specialists at Kelsey-Seybold Clinic in Houston can pinpoint the cause and help you return to a more satisfying sexual experience.