Opinion article
Delayed ejaculation: a lesser-known sexual dysfunction
Delayed ejaculation is a marked delay in, or inability to, ejaculate despite adequate stimulation and the presence of sexual desire, causing significant distress, on most or all occasions of sexual activity, for at least six months.
Common causes
- Medication-related: a known side effect of several antidepressants, particularly selective serotonin reuptake inhibitors.
- Hormonal: low testosterone or thyroid changes.
- Neurological: long-standing diabetes, pelvic surgery or neurological injury.
- Masturbation patterns: very specific or intense stimulation that’s hard to reproduce during partnered sex.
- Psychological: anxiety, difficulty relaxing during sex, or relationship conflict.
Treatment
- Reviewing, with the prescribing doctor, whether related medication can be adjusted or switched, never stopping it on your own.
- Treating any identified hormonal or neurological cause.
- Sex therapy, to retrain stimulation patterns and reduce anxiety tied to intercourse.
- Communication with a partner about the type of stimulation needed.
An antidepressant should never be stopped on your own because of this side effect. There are alternatives and adjustments a doctor can offer without compromising the underlying treatment.
This article is for information only and does not replace a medical consultation.
Sources
- American Urological Association, Sexual Medicine Society of North America. Disorders of Ejaculation: An AUA/SMSNA Guideline. The Journal of Urology. 2020.
- American Urological Association