What is delayed ejaculation? Here's what you need to know about this little-talked about problem

Delayed ejaculation
Delayed ejaculation has several possible causes, including certain prescription drugs and medical issues, like low testosterone. (Photo illustration: Mark Harris for Yahoo News; photo: Shutterstock)

While guys who climax too quickly, like the high school teen who can’t even get his pants off before it’s all over, is a well-known issue, there’s a flip side to that problem: being able to go and go and go without reaching orgasm, a condition known as delayed ejaculation.

There isn’t a lot of research on it, but a 2016 study estimated that between 1% and 4% of men experience delayed ejaculation all the time or when with a partner. The researchers also noted that it’s the “least studied and least understood of male sexual dysfunctions.”

Delayed ejaculation is the inability to climax within a reasonable amount of time. What’s reasonable varies for each person, but some experts cite needing more than 30 minutes of sexual stimulation to reach orgasm as a sign of a problem. There’s no need to get out a stopwatch; the real test of whether this is an issue is how often it’s happening and how you and your partner feel about it.

We rarely talk about men’s sexual health, and the feelings of failure that can come with not being able to climax mean we talk about this issue even less than others like premature ejaculation or erectile dysfunction. Ignoring it, however, may trap couples in a cycle of anxiety that ends with one or both partners deciding it’s better to avoid sex altogether than have this happen again. Spoiler alert: It’s not.

Here are some ways to break that cycle.

Talk to your partner

Don’t let this become the elephant in the room — or in your bed. “Without talking about the issue, our minds are left to speculate and ruminate,” Ian Kerner, a sex therapist and author of She Comes First, tells Yahoo Life. “A partner may start to worry that maybe the person with DE is no longer attracted to them or is bored by the sex.”

Communication is crucial, and Kerner notes that how we address these subjects matters. “When having these sorts of conversations, always begin with how you’re feeling and your own vulnerability,” he says. “Start with ‘Hey, I’ve been feeling anxious.’ Generally talking about the elephant in the room is a relief and gets you on the same team.”

Rule out medical issues

Medical issues known to cause delayed ejaculation include low testosterone, spinal cord injuries and certain infections. DE can also be a side effect of common prescription drugs, such as antidepressants and blood pressure medications. A new study found that DE is associated with more underlying health issues — both physical, such as testicular dysfunction, and emotional, such as anxiety — than premature ejaculation or erectile dysfunction.

Dr. Michael Eisenberg, a urologist at Stanford University, says that a health care provider can assess whether a medical problem is causing delayed ejaculation. “We will evaluate the timing of the condition, determine if it’s situational, assess hormones and determine underlying health conditions,” he tells Yahoo Life.

Change your routine

Delayed ejaculation can also be caused by desensitization of the penis. Dr. Jesse Mills, director of the UCLA Men’s Health Clinic, tells Yahoo Life that, like all other parts of our bodies, penises can lose sensitivity as we age. They can also get used to certain triggers: “The key to orgasm is friction,” Mills explains. “There’s no orifice as tight as a man’s own hand. If that’s what he’s used to, he may have sensitivity issues he has to overcome.”

Masturbation is good for you, but if you suspect desensitization, consider cutting back, especially when you’re expecting to have partnered sex soon.

Resetting your expectations can also help. Remember that penetrative sex isn’t everything. Just as many women need clitoral stimulation to orgasm, you may need something more intense as well. Consider adding some sex toys, such as a prostate massager or a vibrating sleeve, which can amp up your orgasm. There’s also nothing wrong with finishing using your own hands while your partner curls up next to you.

Find an expert

If you are still having trouble finishing, it may be time to see an expert, whether that’s a sexual medicine doctor or a sex therapist.

Mills is a member of the Sexual Medicine Society of North America, a group that includes urologists, gynecologists, neurologists and sex therapists. He says this is a great place to start, since the website can help you find providers in your area. The American Association of Sex Educators, Counselors and Therapists can also help you find a certified sex therapist near you. “Anybody that has specialized training and interest in sex can get the workup rolling,” he says.

A sexual medicine expert can also help couples who are dealing with DE while they are trying to get pregnant. Eisenberg says there are medical ways to assist with ejaculation or sperm extraction, which can help couples separate fertility issues and sexual concerns.

Sex is supposed to be pleasurable and relieve our stress, not cause it. If you’re having trouble reaching orgasm, talk to your partner and reach out to medical and mental health experts for help.

Martha Kempner is a writer and sexual health expert. She is the author of the weekly newsletter Sex on Wednesday.