Ejaculation occurs when semen is released from the penis. Most men ejaculate within a few minutes of starting to thrust during intercourse.
Premature Ejaculation occurs when a man releases semen sooner during intercourse than he or his partner wishes. This is a common condition. It is only rarely caused by a physical problem.
Premature ejaculation early in a relationship is often caused by anxiety and too much stimulation. Guilt and other psychological factors may also be involved. The condition usually improves without treatment.
Delayed ejaculation is a medical condition in which a male cannot ejaculate, either during intercourse or by manual stimulation. Men with delayed ejaculation may be unable to ejaculate or may only be able to ejaculate with great effort after having intercourse for a long time (30 to 45 minutes). Delayed Ejaculation can have psychological or physical causes.
Common psychological causes include:
- Religious background that makes the person view sex as sinful
- Lack of attraction for a partner
- Conditioning caused by certain masturbation habits
- Traumatic events (such as being discovered masturbating or having illicit sex, or learning one's partner is having an affair)
- Factors, such as anger toward the partner, or other emotions
Physical causes may include:
- Blockage of the ducts that semen passes through
- Use of certain drugs
- Nervous system disorders, such as a stroke or nerve damage to the spinal cord or back
Following a discussion and physical evaluation, there usually are no abnormal medical findings with this condition.
Practice and relaxation should help. Some men try to distract themselves by thinking nonsexual thoughts to avoid getting excited too fast. Condom use can also delay ejaculation for some men.
These techniques can also help:
- The "stop and start" method involves sexually stimulating the man until he feels like he is about to reach orgasm (ejaculate). Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
- The "squeeze" method involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
Antidepressants and other selective serotonin reuptake inhibitors (SSRIs) are often prescribed. As a side effect, these medicines increase the time it takes to reach ejaculation.
Your Ohio State urologist can help determine the cause of your ejaculation condition by discussing your health history and a physical examination. Stimulating the penis with a vibrator or other device may help determine whether you have a physical (often nervous system or neurological) concern. A neurological examination may reveal other nerve problems that are associated with delayed ejaculation.
Your treatment plan will be based upon the causes of your condition. Sometimes, counseling helps improve this condition. If a medication is believed to be the cause of the problem, discuss other medication options with your doctor.