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Delayed or Absent Ejaculation

To make an appointment at the Men's Health Center, call 1-877-641-4636 or fill out our form.

What Is a Delayed or Absent Ejaculation?

A delayed or absent ejaculation happens when a man takes an especially long time to ejaculate or can't come at all.

It can be a short-lived or lifelong problem.

The causes of delayed ejaculation (DE) vary but may be due to:

  • Chronic health conditions
  • Surgeries
  • Medicine

Treatment depends on the cause of the problem and how long it's been going on.

Delayed ejaculation risks

DE tends to get worse with age.

Other risk factors include:

  • Mental health issues, such as depression and anxiety.
  • Chronic illnesses, such as diabetes and MS.
  • High blood pressure medicine or antidepressants.
  • Excessive alcohol use.
  • Relationship problems, such as anger or poor communication skills.

DE isn't a life-threatening condition. And by itself, it doesn't lead to any serious illness.

But it can add stress to your relationship and lower your self-esteem. It may also affect a couple's ability to conceive. 

Delayed or Absent Ejaculation Diagnosis

It's normal to have delayed ejaculation (DE) from time to time, just like it's normal to have erectile dysfunction during your lifetime.

DE is only a problem when it goes on for a long time or causes stress for you or your partner.

Though what's “normal” in sexual behavior ranges, most men climax within a few minutes during intercourse.

Men with DE often need 30 minutes or more of sexual stimulation to have an orgasm. Some can only come when masturbating.

What causes delayed ejaculation?

Physical causes of DE include:

  • Blocks in the ducts that semen passes through.
  • Nervous system diseases.
  • Nerve damage to the pelvis from surgery.
  • Anti-seizure drugs or antidepressants.
  • Alcoholism.
  • Urinary tract infections.
  • Hormone issues, such as low thyroid or low testosterone.
  • Birth defects to the male reproductive system.

Mental causes include:

  • Depression or tension.
  • Cultural or religious taboos.
  • When the fantasy differs from the sex partner.
  • Relationship problems, such as problems bonding.
  • Poor self-confidence.

Diagnosing DE

There's no simple test for DE. If it causes distress or physical discomfort to you or your partner, you should see your doctor.

Your doctor will listen to your symptoms and do an exam. He or she may also order blood and urine tests to rule out issues like infections and hormone imbalances.

Delayed or Absent Ejaculation Treatment

Treatment for delayed ejaculation (DE) depends on what caused the problem. Once doctors find the cause, they're often able to resolve the issue.

If it's a lifelong issue, a UPMC urologist might:

  • Check if you have a birth defect.
  • Adjust your drug regimen if a prescription is the cause.
  • Suggest surgery to treat DE.

Based on the cause, your doctor may:

  • Prescribe medicine. Some drugs for other diseases — such as Parkinson's — have helped men with DE.
  • Help you find a treatment program if your DE stems from drug or alcohol use.
  • Suggest counseling if depression or other mental health issues are the root cause.
  • Refer a sex therapist. Either going alone or with your partner can also help if sexual dysfunction is the cause.