Delayed ejaculation (DE) refers to a condition in which a person takes an extended of time to reach ejaculation during sexual activity, or who may be unable to ejaculate altogether. As with other sexual issues, DE can arise from either physical or psychological factors.

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Physical Causes of Delayed Ejaculation

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It is always helpful to visit your GP if you are experiencing a sexual function problem, to rule out physical causes. Common physical causes of delayed ejaculation include:

• Injury to the pelvic nerves that control orgasm

• Urinary tract infections

• Prostate surgery

• Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord

• Hormone-related conditions, such as low thyroid hormone level (hypothyroidism) or low testosterone level (hypogonadism)

• Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis

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Medical Treatments

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Treatment for delayed ejaculation varies based on the underlying cause. It may involve taking new medications, adjusting your current prescriptions, or addressing issues related to alcohol or illegal drug use. Some medications that can contribute to delayed ejaculation include certain antidepressants, specific high blood pressure medications, diuretics, antipsychotics, anti-seizure drugs, and alcohol.

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​How Sex Therapy can help with delayed Ejaculation

Once you have the all clear from your GP that there are no physical causes for DE, then sex therapy is the next step. Psychological causes of DE include:

• Depression, anxiety or other mental health conditions

• Relationship problems due to stress, poor communication or other concerns

• Anxiety about performance

• Poor body image

• Cultural or religious taboos

• Differences between the reality of sex with a partner and sexual fantasies

• Performance anxiety due to the pressure of trying to conceive a baby

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