Delayed Ejaculation

Delayed ejaculation (DE) is a common but often underreported condition that can affect sexual satisfaction and relationships. It is characterized by a prolonged period required to reach ejaculation or the inability to ejaculate during sexual activity. According to the American Urological Association, DE affects up to 4% of men.

Symptoms of Delayed Ejaculation

DE is characterized by the following symptoms:

• Inability to ejaculate despite adequate sexual stimulation and arousal
• Significantly prolonged time (may be upwards of 20-30 mins) to achieve ejaculation during intercourse
• Distress or frustration related to the difficulty in reaching ejaculation and reduced sexual satisfaction for both the individual and their partner

Etiologies (Causes) of Delayed Ejaculation

DE can have various underlying factors, including:

• Psychological or Social Causes:
• Anxiety, stress, or depression
• Specific sexual preferences
• Relationship issues or conflicts
• Past traumatic sexual experiences
• Performance anxiety
• Physical Causes:
• Prostate issues or previous prostate surgery
• Chronic medical conditions (e.g., diabetes, multiple sclerosis)
• Surgery or injury affecting the pelvic area or spinal cord
• Certain prescription medications (e.g., antidepressants, blood pressure medications)
• Substance abuse (e.g., alcohol, opioids, recreational drugs)

Investigations and Diagnosis

Diagnosing DE typically involves:

• Medical History and Physical Examination: Identifying factors contributing to DE, such as medical conditions, medications, and lifestyle habits. Assessing overall health and evaluating genitalia for any physical abnormalities
• Psychological Evaluation: Exploring emotional factors and mental health conditions contributing to DE
• Laboratory Tests: Blood tests to check for underlying health conditions and hormone levels. Urine tests to look for signs of infection, diabetes and other underlying health issues

Treatment Options for Delayed Ejaculation

Of note is that most cases of DE are usually psychosocial in nature. Effective management of DE often involves a combination of approaches tailored to individual needs:

• Therapy:
• Psychological counseling for anxiety, depression, or relationship issues
• Cognitive behavioral therapy (CBT) to address underlying psychological factors contributing to DE
• Sex therapy to improve sexual techniques and communication between partners
• Lifestyle Changes:
• Reducing alcohol consumption and avoiding recreational drugs
• Improving overall physical health through exercise and a balanced diet
• Devices:
• Use of vibratory stimulation devices to enhance arousal and assist in achieving ejaculation
• Medications:
• Adjusting or changing medications that may be causing DE
• Prescription medications to enhance sexual function (but may be limited in its effectiveness)

Follow-Up and Management

After initiating treatment, regular follow-up is important to monitor progress and make adjustments as necessary:

• Assessing treatment effectiveness and any side effects and modifying treatment plans based on response
• Providing ongoing support and counseling to address any new concerns or challenges

Empower Yourself

Understanding delayed ejaculation is the first step toward effective management and improved sexual satisfaction. If you or your partner are experiencing symptoms of DE, Dr Chester Lan is here at Freia Medical (Wisma Atria) for personalized diagnosis and treatment.