What is Delayed Ejaculation (DE)?

The 3 commonest sexual problem among males. It is the direct opposite of premature ejaculation. Even though some men will prefer it to PE, it is still a serious medical condition nonetheless.

Now, even though delayed ejaculation is the 3rd most common male sexual disorder, it is the most underreported and untalked about male sexual disorder! The reason for this may not be unconnected to the fact that mainstream media and pornography constantly depict unrealistic sexual performance feats, hence making most men with delayed ejaculation to consider it a blessing of some sort...a formidable magic wand capable of reviving the boredom and sexual unsatisfaction of women! Not so.

As a matter of fact, some DE sufferers, by the mere act of denying the existence of this problem, often experience severe physical and mental distress and relationship problems with their partners.

So what exactly is Delayed ejaculation (DE), if indeed it exists? What constitutes delayed ejaculation?

Delayed ejaculation, also known as impaired or retarded ejaculation, is defined as prolonged sexual stimulation or intercourse that lasts longer than 30 minutes before ejaculation occurs. So 30mins is the benchmark.

DE can be classified either as lifelong or acquired.

1. Lifelong DE is seen in men who have always had it from day one (from their very first sexual experience).

2. Acquired DE develops later on in men who have had a normal ejaculatory time, hitherto. Although, a handful of sufferers eventually get to achieve ejaculation by masturbation or sexual stimulation without penetrative sex, this is usually not the case.
Now, while most men can reach climax during masturbation, there are plenty who can’t orgasm during intercourse, no matter how hard they try (medically known as anejaculation) and an even larger number who take a very long time to get to the point of orgasm.

Usually and for this group of men, delayed ejaculation becomes problematic and a cause for worry when it starts causing them distress or frustration, or if they have to stop sexual activity due to fatigue, physical irritation, loss of erection or a request from their partners.

That said, it is important to know that most men usually ejaculate at an average time of 5.5 minutes (3-7mins) during the first round of penetrative sex. This very normal. A handful can reach 10 to 15 minutes so during the first round especially when when using thick condoms. So unless you are averaging less than 3 minutes before ejaculation, you shouldn't worry yourself to death out of fear for premature ejaculation (PE).

Knowing all these, one may want to ask: what then is the cause of DE?

There are quite a few of them....but below are the common causes:

Psychological problems: such as depression, anxiety, fear of pregnancy, cultural and religious restrictions, mental conditioning (some men can actually psyche themselves not to cum and this can cause a temporary DE for them), etc are some very common psychological reasons for DE.

Relationship causes: relationship stress, lack of excitement, sex with a new partner (situational delayed ejaculation), poor communication about sex between partners and a host of others all cause DE.

Pornography and masturbation: pornography is like cocaine to the brain! Eventually, the excitement you derive from it is much more than the one you get when you engage in real sex. This often leads to disinterest in real sex leading to DE. Masturbation, on the other hand, reduces the sensitivity of the penis from vigorous and prolonged stimulation with the hands.
Fact:Mind you, pornography can also cause premature ejaculation. The bastard is a double-edged sword. Anyhow, it causes harm.

Old age:this is not necessarily a cause of DE. It is more of a risk factor. DE is more likely to be seen in a 50-year old than in a 25-year old. So the older you are, the more likely you may complain of DE.

Medications: certain antihypertensives for high BP, antidepressants for treating depression and anitconvulsants for treating convulsion have been known to cause DE. In fact, some men suffering from premature ejaculation are now using some of these drugs for their premature ejaculation.

Of course, also included on the list of drugs are those sold as sex performance enhancers a.k.a aphrodisiacs. Our local mallams have their own version as well.

Alcohol:now, chronic and excessive alcoholism, apart from causing other numerous health dangers, is also a cause of DE. This is because alcohol is a CNS depressant and also crashes blood testosterone (a male hormone) levels. These two mechanisms significantly impair normal sexual function and often cause DE.

Medical/surgical causes: diabetes, spinal cord injuries, pelvic injuries (in which pelvic nerves are damaged), hormonal problems such as hypothyroidism, complication of prostate surgery, retrograde ejaculation (a condition in which the semen goes into the urinary bladder instead of getting ejected via the penis), etc all play in major role in the development of DE.

TREATMENT OF DELAYED EJACULATION
     It is important to know that the treatment of DE is mainly dependent on the cause of the DE.

Psychological causes often require the help of a psychiatrist, through counselling and often involving both partners. In fact, most sufferers have been known to significantly do better when they elicit and get the services of a sex therapist (via psychotherapy or behavioral therapy or both). This known treatment modality is known as sex therapy.

Also, treatment can be in the form of discontinuing or replacing any of the above mentioned drugs that are known to cause DE.

Similarly, for an alcoholic, drastically cutting down on the alcohol or outright cessation of alcohol consumption may be the only treatment the person needs.

Finally, for those with medical or surgical causes responsible for their DE, treatment is usually with the aid of medications (e.g cyproheptadine,buspirone) or with surgical intervention or both. After series of tests and detailed investigations, your doctor decides the best treatment plan for you.
In summary,
-DE is any sexual (penetrative sex or masturbation) activity that lasts longer than 30 minutes before ejaculation is achieved.

-It is the 3rd most common male sexual disorder after impotence and premature ejaculation.

-Very often, it results in undue frustration, fatigue, low libido, inability to achieve pregnancy in a couple or other terrible psychological problems.

-Common causes include psychological problems, alcohol, medications, relationship problems and health-related causes such as diabetes, prostate surgery, etc.

-The treatment depends primarily on the of the DE. However, most patients have shown remarkable improvements following sex therapy and behavioral modifications.