What Is Delayed Ejaculation?: Treatment, Causes And Diagnosis

We speak of delayed ejaculation when – during masturbation , sexual intercourse or any other appreciable and adequate sexual stimulation – the ejaculatory reflex does not arise or occurs only after an excessively prolonged period of time.

Delayed ejaculation represents a common disorder of the orgasmic phase, although less frequent than premature ejaculation : the delay of the ejaculatory act, therefore of the emission of semen from the penis , results in a recurring orgasmic postponement which often degenerates into a real anorgasmia (inability to reach the peak of pleasure ).


There is no single form of delayed ejaculation: the problem must be distinguished according to the moment of appearance of the disorder (during the subject’s life) and according to the characteristics of the same; also the situation that has arisen, and the degree of intensity of the same, represent two useful parameters for cataloging the different forms of ejaculatory delay.

  1. Classification based on when the disorder occurs

Delayed ejaculation is divided into primary and secondary, based on the moment of life in which it occurs . We speak of ” primary “, when the delayed ejaculation appears from the very first sexual intercourse, and of ” secondary ” if the ejaculatory delay begins after an appreciable period of normal sexual activity.

  1. Classification according to the situation created

When considering the situation, delayed ejaculation is defined as ” situational ” when it occurs occasionally, based on the environment, the partner and the situation; instead, it is a matter of absolute delayed ejaculation when the man, during the sexual act or masturbation, is unable to reach orgasm when he wishes it.

  1. Classification according to the triggering causes

A further classification of the disorder must be carried out according to the characteristics of the same: in this regard, we distinguish delayed ejaculation on an organic basis – the less frequent form, caused by the intake of certain drugs, neurological diseases or diabetes – from ‘ psychological delayed ejaculation , the origin of which has its roots in the male psyche.

  1. Classification according to the degree of intensity of the disturbance

The mild or moderate form of delayed ejaculation is divided into two further degrees:

  • Grade 1: the sexual act lasts for a long time and the man’s coital thrusts are particularly energetic, in order to reach orgasm faster.
  • Grade 2: Man with delayed ejaculation cannot consummate intercourse naturally, but manual mechanical stimulation is an effective alternative solution.

Both degrees of intensity are strongly conditioned both by psychological factors – especially related to work stress – and by organic causes.
The severe form of delayed ejaculation is generally related to diseases of neurological origin or to the administration of serotonergic drugs, factors attributable to the increase in the thresholdbeyond which the ejaculatory mechanisms are triggered (thus prolonging the duration of sexual intercourse). In this particularly delicate phase, the man finds himself in an unmanageable situation, since ejaculation is impossible in the presence of the female figure: the ejaculatory act can only take place through masturbation (grade 3). The most problematic phase occurs when the man is totally unable to ejaculate: in similar situations it is a real anejaculation (grade 4).

Organic Delayed Ejaculation

As described above, delayed ejaculation of an organic nature is the least common form; in any case, the organic causes that provoke it are multiple and heterogeneous.
Among the endocrine-mediated causes of an organic nature are diabetes and hypothyroidism . Parkinson’s disease , neuropathies and multiple sclerosis are instead included among the neurological-organic causes , while operations at the pelvic, abdominal and perianal level are the main factors of the organic-surgical causes . Finally, the pharmacological specialties: among the most dangerous drugs from this point of view we mention ineuroleptics , narcotics , cannabinoids, and especially serotonergic and tricyclic antidepressants . Even alcohol , when taken in excessive quantities, could cause ejaculatory problems.

Psychological Delayed Ejaculation

Many studies have shown that the human psyche has such a force as to also influence the body and its functions: even the excitatory impulses and the ejaculatory act are strongly manipulated by the mind. Strictly speaking, it is clear that even delayed ejaculation can result in mental disorders , which often turn out to be unjustified. It is not infrequent, in fact, that the ejaculatory delay is directly connected to mental conditions inherent, in particular, to the possibility/ability to remove the inhibitory brakes during the embrace with the female partner.

Anxiety too performance can negatively affect the sexual act: commonly, this particular “anxiety” before a relationship is considered the main cause of premature ejaculation; however, few are aware that this particular preliminary anxious state can also be responsible for the opposite problem: ejaculatory delay.

Digging deeper into the depths of the male psyche, the mental reasons responsible for delayed ejaculation reflect the fragility of the male: for some, ejaculation corresponds to an anxious moment not so much for the act itself, rather for the ‘inability to control the body. In other words, orgasm is synonymous with loss of control and, paradoxically, some men feel helpless in the face of all this, precisely because they are no longer able to manage their sensations. For still others, ejaculatory delay reflects an unconscious selfish act, almost as if the emission of sperm represented the loss of a part of oneself.

In these last two conditions, ejaculation is unknowingly postponed in order to maintain strict control of one’s actions and avoid “losing” or “giving” a part of oneself.

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