Delayed ejaculation is a condition that takes an extended period of sexual stimulation for a man to ejaculate, or in some instances, he cannot ejaculate at all.  It is essential to be clear about the distinction between erectile dysfunction and delayed ejaculation.  With delayed ejaculation, men can obtain and sustain an erection.  However, the problem persists with orgasm and ejaculation.

Many men who suffer from premature ejaculation will often say, “oh, if only I had that.” Unfortunately, the reality is that neither situation is ideal.  Both conditions emphasize sexual performance on the male’s ability to ejaculate.   This focus, often embellished and set by cultural and social norms, compounds the very psychological issues we see correlated to these conditions, such as performance anxiety, stress, etc.

If I can’t come one day, does that mean I have it?

There are two primary types of delayed ejaculation: lifelong and acquired.  Unfortunately, very little research has been conducted into delayed ejaculation, which is still poorly understood.  However, most causative theories are aligned with common sexual dysfunction issues.  In addition, there are no absolute guidelines for how long it should take you to orgasm and ejaculate, which makes the whole situation quite individualistic and subjective.  What is assessed is the level of stress the perceived delay is causing to the individual and the relationship. 

Human beings seem to be fascinated and obsessed with time.  Is it because of the construct of our “time on earth?” Or how our days and lives are structured around time variables, i.e., morning, afternoon, night, changing seasons, years, etc.  This fascination with time is no more evident when we discuss sex.  How long should I do oral for a woman?  How long should I be having sex?  How long should I take to reach orgasm?  How long should foreplay be?  The list of questions structured around time is endless.  The debate about how time should not be an element in sexual intimacy is for another blog post.  Still, you can see how quickly this expectation is set for men regarding orgasm and ejaculation.  Issues in this area can be pretty debilitating from a mental and masculine perspective.

If you are hellbent on having a quantifiable time to define delayed ejaculation, then, on average,  most men (please take note of the terms’ average’, ‘most,’ which basically means not scientifically proven) can last somewhere between 3-8 minutes during intercourse.  Some researchers even went as far as to say that if you are not ejaculating by 25-30 minutes, then you have delayed ejaculation.  But as we all know, there are different strokes for different folks, and 25-30 minutes could be a warm-up round for some, while for others way too prolonged and excessive. 

So that is why most of the assessment is done regarding the perceived stress level being determined from the issue and that both you and your partner confer a problem regarding the ejaculation.  As a side note, ejaculation delayed due to decreased sensitivity from wearing a condom is not considered delayed ejaculation.  Nor is the occasional differences experienced from different sexual positions, partners, arousal, etc.  Instead, delayed ejaculation is observed over time and considers your and your partner’s experiences. 

What causes delayed ejaculation?

There can be many issues, from a biological perspective to psychological factors.  For example, some men only experience delayed ejaculation with a partner, with no problems ejaculating from masturbation.  For others, they can only ejaculate if A, B, C, and D are done.  Identifying the causative reason will be subjective and quite individualistic.

From a biological perspective, you may be predisposed to delayed ejaculation if your penis is not as sensitive as other guys.  This reduced sensitivity reduces the overall sensation of arousal, leading to a longer time to reach peak climax.  Alternatively, for some men, how their body processes sexual excitement, so we are talking about the neural pathways, requires a higher level or different than the ‘normal’ approach for the outcome.

What does the doctor do?

A healthcare professional will want to look at all the possible linked causes of why you might be experiencing delayed ejaculation.  They will examine medications, alcohol intake, illegal substances, and overall lifestyle choices.  This assessment is focused on eliminating some of the main causative reasons for sexual dysfunction. 

If your condition is acquired, they will focus on when it started and what was going on in your life before this occurred.  Ultimately they are looking for what triggered this.  For example, were there new medications, environmental stressors, lifestyle changes, etc.?  They will want to talk to not just you but your partner as well.  The limited research on delayed ejaculation has proven that the best results from sexual dysfunction issues occur when the partner is supportive and involved in treatment options.

While sexual dysfunction issues can often feel demoralizing, it is essential to remember that they are prevalent and there is help.  You deserve a fulfilling sex life, and I believe a healthy sex life contributes to your overall health and well-being.  If you feel you are experiencing delayed ejaculation, my advice is to talk to your healthcare professional about your concerns.