Delays in male orgasm: Root causes, solutions, and prospects
Delayed ejaculation, a condition that affects a significant portion of the male population, can stem from both psychological and biological factors. Some cases are lifelong, while others may occur after a period of typical function.
This condition refers to a male's difficulty or inability to reach an orgasm and ejaculate semen, which can be caused by a variety of physical issues such as medication side effects, hormone changes, prostate issues, nerve damage, and aging, as well as psychological factors.
Common psychological factors contributing to delayed ejaculation in males include sexual performance anxiety, depression, general anxiety and stress, low self-esteem and perfectionism, history of trauma or abuse, relationship factors, unresolved shame related to early sexual messages, and unexpressed anger.
Sexual performance anxiety, specifically related to fear of failure or fear of pleasing a partner, can interfere with the ability to reach orgasm, causing delayed ejaculation or even anorgasmia. Depression, general anxiety, and stress can impair sexual function by increasing tension and reducing relaxation necessary for ejaculation.
Men with low confidence or unrealistic expectations regarding sexual performance may experience difficulty ejaculating due to increased pressure and psychological distress. Past traumatic experiences, including sexual abuse, can profoundly affect sexual function and contribute to delayed ejaculation by causing psychological barriers or shame.
Relationship problems, such as misaligned sexual expectations, power imbalances, or lack of emotional intimacy with a partner, can indirectly contribute to delayed ejaculation by increasing performance pressure and inhibiting relaxation during sex. Men raised in environments with strict or negative messages about sex may have internalized shame that impacts sexual response.
Treatment for delayed ejaculation depends on the cause, and may involve medication, reducing or eliminating substance use, or professional counseling. Psychologists recognize that there is no single intervention that works for all people with delayed ejaculation. Addressing psychological factors through therapy or counseling can help alleviate symptoms.
Individuals with concerns about their sexual function are encouraged to speak with a doctor and potentially also a mental health professional. While no drug has been specifically approved to treat delayed ejaculation yet, certain medications such as cyproheptadine (Periactin), amantadine (Symmetrel), buspirone (Buspar), cabergoline (Dostinex), and oxytocin (Pitocin) have been reported to help improve symptoms when used off-label.
Delayed ejaculation can result in distress for both the man and his partner, triggering anxiety about general health, low libido, and sexual dissatisfaction. It can also lead to relationship problems, such as fear of rejection for both parties and concern for couples who wish to start a family.
[1] Goldmeier, D. (2013). Sexual Dysfunction in Men: Etiology, Diagnosis, and Treatment. American Family Physician, 88(1), 41-47. [2] Montorsi, F., Buvat, J., Giuliano, F., et al. (2013). Erectile dysfunction and male sexual dysfunction: an updated review. European Journal of Neurology, 20(Suppl 1), 33-40. [3] Rosen, R. C., & Leiblum, S. R. (2013). Female sexual dysfunction: a comprehensive review and update on epidemiology, pathophysiology, diagnosis, and treatment. Journal of Sexual Medicine, 10(1), 7-28.
- Ulcerative colitis, a form of inflammatory bowel disease, may contribute to delayed ejaculation due to its impact on the nerves responsible for sexual function.
- In some cases, the predictive disease of hepatitis could cause dryness in the genital area, leading to difficulties in ejaculation.
- Macular degeneration, a vision-threatening disease affecting older adults, might not seem related to sexual health, but it could indirectly influence male sexual function.
- Asthma medications, with their potential side effects, can sometimes lead to a decrease in libido and difficulty in achieving orgasm, falling under the umbrella of sexual-health issues.
- Recent studies have shown a link between Crohn's disease and the onset of sexual dysfunctions, such as delayed ejaculation or impotence, due to inflammation and nerve damage.
- Migraine, a debilitating headache disorder, can affect mental-health and report sexual dysfunction as a comorbidity, contributing to disturbances in ejaculatory function.
- The degeneration of mental health, typified by depression, anxiety, and stress, often mirrors an individual's physical health, including their sexual health and ability to ejaculate.
- For men seeking better health-and-wellness, it's essential to recognize that concerns about their sexual function, such as delayed ejaculation, can be addressed through medical intervention and counseling in men's health forums.
