Delayed Ejaculation: Causes, Symptoms, Diagnosis, and Treatment

Delayed ejaculation is a disorder of sexual function in men, characterized by difficulties in ejaculation. With delayed ejaculation, a man experiences sufficient sexual arousal and has a full erection, but stimulation of the penis does not lead to the desired release of seminal fluid for a long time from the beginning of sexual intercourse. Delayed ejaculation is accompanied by difficulties in achieving orgasm, physical and psychological dissatisfaction of partners. 

To determine the causes of delayed ejaculation, a man may need to consult an andrologist, sexologist, psychotherapist, neurologist, endocrinologist; conduct an ultrasound of the penis and scrotum, tests for sexually transmitted infections and hormones. The algorithm for treating delayed ejaculation depends on the causes of the disorder and may include drug therapy, psychotherapy, and physiotherapy.

Causes and Contributing Factors

Delayed ejaculation can be caused by psychological and organic reasons. In many cases, there is a combination of several factors, that requires examination of the man by various specialists.

Psychological causes are also prevalent but often underestimated by men. Chronic stress, anxiety about performance, emotional conflicts, a partner's coldness during intercourse, or strict moral views can all inhibit sexual arousal.

Other causes include antidepressants, antipsychotics, hypertension medications, diabetic or alcoholic neuropathy, low testosterone levels, spinal cord injuries, pelvic surgeries, and rare anatomical abnormalities.

Symptoms of Delayed Ejaculation

The primary symptom is ejaculation delayed by 30 minutes or more despite adequate stimulation. In some cases, men may not ejaculate at all (anejaculation). Types of delayed ejaculation include:

• Situational: Occurs only under specific conditions or with certain partners.
  
  
• Persistent: Present in all circumstances.
  
  
• Lifelong: Caused by developmental factors or psychological conditions.
  
  
• Acquired: Resulting from illnesses or environmental factors.

Statistics show that 75% of men with delayed ejaculation manage the issue independently through masturbation and visual stimuli.

Diagnosis

The main task of diagnostics is to identify the causes of delayed ejaculation. To do this, if a man has ejaculation problems, he should consult a urologist, andrologist, or andrologist-sexologist. After finding out the anamnesis and examining the external genitalia, the specialist will determine the appointment of tests, diagnostic studies and additional consultations. Blood tests help determine testosterone levels and hormonal status. Ultrasound and MRI of the pelvic area may be necessary for further investigation.

Treatment

Treatment involves addressing underlying causes: adjusting medications, normalizing blood sugar and hormone levels, and improving erectile function with prescribed drugs. 

Relationship issues should be addressed with a psychotherapist. Therapy is tailored individually and is most effective when the condition is not linked to chronic illnesses. Self-treatment is discouraged as it may lead to complications like infertility or relationship problems.

Prevention

Preventive measures include regular sexual activity, stress management techniques, avoiding alcohol and smoking, maintaining physical activity, and timely treatment of chronic diseases. Men should seek medical advice at the first sign of symptoms to prevent complications.