Delayed ejaculation, also known as impaired ejaculation, is a condition in which it takes an extended period of time, or maybe impossible, for a man to ejaculate during sexual activity, despite normal sexual function and desire. This can lead to frustration and difficulty in achieving sexual satisfaction for both the man and his partner.

Delayed ejaculation can be caused by a variety of factors, including physical and psychological issues. Physical causes may include certain medications, nerve damage, or hormonal imbalances. Psychological factors that may contribute to delayed ejaculation include anxiety, depression, relationship problems, or a history of sexual trauma.

Treatment for delayed ejaculation depends on the underlying cause. In some cases, it may involve a change in medications or a referral to a specialist. Therapy may also be recommended, such as cognitive behavioral therapy, which can help to identify and address psychological factors that may be contributing to the condition. In some cases, medications such as antidepressants may be used to help manage the condition.

In some cases, delayed ejaculation may not require treatment, especially if it does not cause distress for the individual or their partner. If delayed ejaculation is causing distress or difficulty in achieving sexual satisfaction, it is important to speak with a healthcare professional to identify the underlying cause and discuss treatment options.

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:

• Depression, anxiety or other mental health conditions
• Relationship problems due to stress, poor communication or other concerns
• Anxiety about performance
• Poor body image
• Cultural or religious taboos
• Differences between the reality of sex with a partner and sexual fantasies

Medications and other substances that can cause delayed ejaculation include:

• Some antidepressants
• Certain high blood pressure medications
• Certain diuretics
• Some antipsychotic medications
• Some anti-seizure medications
• Alcohol — particularly drinking too much (excessive alcohol use or alcoholism)

Physical causes of delayed ejaculation include:

• Certain birth defects affecting the male reproductive system
• Injury to the pelvic nerves that control orgasm
• Certain infections, such as a urinary tract infection
• Prostate surgery, such as transurethral resection of the prostate or prostate removal
• Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord
• Hormone-related conditions, such as low thyroid hormone level (hypothyroidism) or low testosterone level (hypogonadism)
• Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis

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.

Delayed ejaculation treatment depends on the underlying cause, but it might include taking a medication or making changes to medications you currently take, undergoing psychological counseling, or addressing alcohol or illegal drug use.

Medications

If you're taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. Sometimes, adding a medication might help.

There aren't any drugs that have been specifically approved for the treatment of delayed ejaculation. Medications used to treat delayed ejaculation are primarily used to treat other conditions.

Medications sometimes used to treat delayed ejaculation include:

• Amantadine, a Parkinson's medication
• Buspirone, an anti-anxiety medication
• Cyproheptadine, an allergy medication

Psychological counseling (psychotherapy)

Psychotherapy can help by addressing underlying mental health problems leading to delayed ejaculation, such as depression or anxiety. It's also used to address psychological issues that directly affect your ability to ejaculate.

Counseling might involve seeing a psychologist or mental health counselor on your own or along with your partner. Depending on the underlying cause, you might benefit most from seeing a sex therapist — a mental health counselor who specializes in talk therapy for sexual problems. The type of counseling that's best for you will depend on your particular concerns.