The opposite of premature or rapid ejaculation is delayed ejaculation. This can be as, if not more, frustrating than its opposite. Delayed ejaculation is the inability of a man to achieve climax within a reasonable amount of time. As is true in rapid ejaculation, that timeframe can vary and be different for the partner. From a female’s perspective, if she has achieved climax well before her man, her vaginal lubrication can run out and sex can be uncomfortable without relubricating. Some men cannot achieve ejaculation through vaginal penetration and must rely on alternative sexual acts to climax. Some men will lose their erection prior to achieving climax and be left frustrated. Some men will reach the point of orgasm but just can’t finish and are left feeling very uncomfortable.
What are the Causes of Delayed Ejaculation?
Delayed ejaculation is a neurological, hormonal and psychological event. If a man has had damage to the nerves in his pelvis or had a spinal cord injury below the lower thoracic spinal level, he may suffer from inability to ejaculate. He lacks the nerve connection from the ejaculation nerves at the tip of his penis back to his spinal cord. More commonly, he may have a hormonal imbalance in serotonin, prolactin or testosterone. Men taking antidepressants whose serotonin levels are skewed by the pills, frequently suffer from delayed or loss of ejaculation. Men with low testosterone also can have difficulty ejaculating.
Treatment Options for Delayed Ejaculation at UCLA
Treatment for delayed ejaculation depends on its cause. For men with nerve injuries, sometimes they respond to medical vibrators placed at the tip of the penis to retrain the nerves to fire more rapidly. Some couples will incorporate vibrators into their sexual activity to help stimulate the man to climax during intercourse.
For men with hormone imbalances, the doctor needs to run some laboratory tests, specifically testosterone and prolactin levels to see if there’s an imbalance. Testosterone therapy can elevate blood flow to the penis, engorging it more and making the nerves more sensitive. Men with high prolactin levels can have a non-cancerous tumor in the pituitary gland that churns out prolactin and blocks ejaculation. Treatment with either medicine or surgery to reduce prolactin levels will help a man climax easier.
If a man has diminished penile hardness, he may respond to oral impotence drugs like sildenafil or tadalafil to increase penile engorgement and sensitivity.
If a man suffers delayed or loss of ejaculation caused by antidepressants, he may want to discuss alternative treatments with his psychiatrist or prescribing physician. There are a few antidepressants that may not be as harmful to ejaculation but still effective in treating depression. Psychological treatments for delayed ejaculation revolve around exploring reasons why a man may not be able to achieve climax. A sexual therapist is a great resource to explore these issues and come up with a good treatment plan.
Delayed ejaculation is a frustrating clinical condition for the man and his partner. Thankfully, there are treatment options that qualified physicians at UCLA Health-The Men’s Clinic can offer.
Board-certified urologists staff The Men’s Clinic at UCLA and you can be assured you are getting an experienced physician performing your evaluation and procedure in a relaxed and comfortable environment. For more information and to schedule an appointment, please call the UCLA Urology Appointment line at (310) 794-7700.