Delayed ejaculation: symptoms, causes and treatment

Sexual dysfunctions are alterations of normal sexual behavior and can affect the different stages of the act: desire, arousal, orgasm and resolution. Among them, there are those that affect both sexes, women, or exclusively men, as is the case of delayed ejaculation (also known as anejaculation or delayed ejaculation ).

Delayed ejaculation is a dysfunction that affects between 4% and 10% of men. It is diagnosed when a man has difficulty ejaculating after having gone through a normal arousal phase during a sexual act. That is, despite being excited, ejaculation is delayed or, directly, it does not occur.

Delayed ejaculation symptoms

The main symptom of delayed ejaculation is the recurrent absence or delay of ejaculation . In some men, this can occur after 20 or 30 minutes of sexual stimulation, or not at all. However, there is no specific reference time.

Thus, the main factor that determines the presence of this dysfunction is that this delay causes anguish or frustration . Therefore, the sexual act is interrupted, since fatigue, physical irritation, discomfort or loss of erection do not allow it to continue normally. All of this creates a stressful situation for both the man and his partner, eventually causing other psychological or relationship problems.

To diagnose delayed ejaculation, psychological and physical examinations are carried out, collecting the patient’s clinical history. The physical examination aims to rule out that it is due to an underlying medical condition. If this were the case, it would be treated as a symptom and not sexual dysfunction itself.

Causes

Behind anejaculation there may be one or more reasons . Thus, its causes are usually grouped into physical, psychological or behavioral factors.

Physical causes

It is important to study and rule out whether the condition may be due to one of the following causes:

• Hormonal changes , since they can alter the process of sexual arousal and its resolution.
• Nervous alterations , especially of the sensory afferents in the spinal cord. In this sense, diseases such as multiple sclerosis or diabetes can cause it.
• Consumption of substances and medicines . Drugs such as antidepressants, anxiolytics or substances such as cocaine decrease sexual desire and response, and dysfunction can develop over time.

Psychological causes

Delayed ejaculation has its origin in psychological aspects that interrupt or hinder the normal development of the sexual act. Among the main reasons are the following:

• Anticipatory and performance anxiety . Paying too much attention to the evolution of arousal, erection, orgasm and performance can prevent a man from enjoying and disconnecting. This increased anxiety in turn can be a factor that helps maintain and worsen the problem.
• Lack of trust and fear of intimacy . Having gone through negative experiences or unsatisfactory encounters can affect the ability to enjoy and flow in the sexual act.
• Stress is one of the worst enemies of pleasure , as it leads to body tension, distraction, anxiety and impatience.
• Conflicts with sexual desire . It may be that there are some internal conflicts regarding identity or sexual orientation or negative beliefs related to sexuality.
• couple problems The affective relationship with the partner also affects the development of sexual activity , for example if there is a lack of attraction towards the partner and even resentment or feelings of contempt.
• Fear of pregnancy . Concern about the risk of pregnancy can cause a man, consciously or unconsciously, to delay the moment of ejaculation.

Behavioral causes

In this category are those behavioral habits that can cause a delayed ejaculation problem in the long run. Among them are the following:

• Frequent and routine masturbation can cause decreased sexual arousal, especially when having sex with a partner.
• Delay ejaculation as a strategy . Many men think that voluntarily delaying ejaculation is good for the sexual act, as it lengthens the relationship and they believe it provides more pleasure. However, doing it repeatedly can cause you to have problems ejaculating later.
• Intense, vigorous masturbation with a lot of pressure , because during penetration it is difficult for the same conditions to occur, so the excitement is less intense.
• Excessive consumption of pornography.

Delayed ejaculation treatment

The treatment of delayed ejaculation will depend on its cause. Thus, if its origin is physical, a pharmacological or other treatment will probably be prescribed to help alleviate the symptoms of the underlying disease. However, pharmacological treatment is usually not as effective as psychological treatment.

In psychological therapy for delayed ejaculation, three aspects are mainly addressed: individual aspects, aspects of the couple’s relationship, if applicable, and sexual therapy exercises.

Among the individual psychological aspects, those beliefs and thoughts that are causing anxiety in men and that do not allow them to develop sexual activity will be discussed .

For example, dismantle some beliefs about the duration of intercourse or irrational ideas regarding their sexuality. Likewise, exposure exercises can be carried out to eliminate the anxiety generated by facing the sexual act.

In couples therapy, we will work on how the problem affects the affective and sexual relationship , as well as the possible difficulties between the two that are causing the dysfunction in the man.

Lastly, sexual therapy exercises are carried out with the aim of decoiting, focusing the sexual act and reducing attention towards orgasm. That is, this type of exercise is focused on lengthening the stimulation prior to penetration and ejaculation.

Likewise, exercises to bring ejaculation closer to the moment of penetration are indicated, such as the “bridge maneuver”.

A problem that usually has a solution

Delayed ejaculation is a sexual dysfunction that, although it can cause a lot of anguish and anxiety, has a high percentage of success if psychological help is sought .

For the most part, it is caused by certain ideas that block being able to enjoy yourself in a relaxed way, as well as by learned behaviors. Fortunately, these aspects can be reversed with the right intervention.

So, if you have problems of this type, look for verified information and go to a professional psychologist specialized in sexual therapy. With a little effort, patience, and work, you could soon be back to enjoying yourself as you wish.