Delayed/Inhibited Orgasm

What is Delayed Ejaculation?

Orgasm is the climax phase of sexual arousal and excitement. It can include pleasurable sensations, rhythmic contractions of the pelvic muscles, and is often accompanied by ejaculation. It is important to note that ejaculation and orgasm are not necessarily synonymous. They often happen at the same time, but one can happen without the other present. Delayed/inhibited orgasm is when ejaculation is markedly delayed or is completely absent during masturbation and/or intercourse. The most current medical term for this issue is Delayed Ejaculation. Some other common terms associated with this issue are:

  • Male inhibited orgasm
  • Inhibited ejaculation
  • Impaired ejaculation
  • Retarded ejaculation
  • Retrograde ejaculation: This occurs when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis. This condition can be mistaken for the absence of or delayed ejaculation.

The most common complaint is the delay or inability to ejaculate during intercourse. Having this issue from time to time does not necessarily warrant concern. However, if symptoms are ongoing and it causes stress for you or your partner it may be time to seek assistance from your primary medical provider. Your doctor may ask you questions about how long, when, and severity to gather more information about your condition. Delayed ejaculation is generally categorized by the following:

  • How long it has been present
    • Lifelong: Issue has been present since first becoming sexually active.
    • Acquired: The issue began after a relatively normal period of sexual functioning.
  • When it happens
    • Generalized: Not limited to types of situations, stimulations, or sexual partners.
    • Situational: Issue only happens in certain situations or sexual partners.
  • Severity
    • Mild: The delay, infrequency or absence of ejaculation causes you or your relationships mild distress.
    • Moderate: Delayed ejaculation symptoms cause you or your relationships moderate distress.
    • Severe: Delayed ejaculation symptoms cause you or your relationships severe or extreme distress.

It is important to remember that orgasmic experiences range on a continuum from very mild to extreme. Many concerns couples express about orgasm are actually quite normal. For example, the absence of simultaneous orgasms and orgasms during penetration are common experiences for most couples. However, if your experience of sexual climax is markedly distressing or painful you should seek assistant or care from a primary medical provider.

What causes Delayed Ejaculation?

  • Incorrect or lack of sexual stimulation.
  • Unmanaged depression, stress, and anxiety.
  • Anxiety about performing in the bedroom.
  • Relationship issues related to trust, communication, or other concerns.
  • Differences between the reality of sex with a partner and sexual fantasies.
  • Alcohol or substance abuse.
  • Obesity or sedentary lifestyle.
  • Certain Medications:
    • Antidepressants
    • Some antipsychotics
    • Some high blood pressure medications
    • Certain diuretics
  • Medical conditions:
    • Infections of the prostate or urethra
    • Birth defects that affect the male genitals
    • Surgery on or complete removal of the prostate (prostatectomy, transurethral resection of the prostate (TURP), etc.)
    • Heart disease
    • Hormonal imbalances
    • Surgeries or injuries that affect the pelvic area or spinal cord

Treatments for Delayed Ejaculation

  • Communicate openly and honestly with your partner about sexual needs, wants, and desires. Read more on Tips for Talking With Your Partner.
  • Focus on erotic touch, having fun with your partner, and pleasure rather than orgasm. Making orgasm the goal of sex can be incredibly limiting and stressful.
  • Explore ways to create more fun and pleasure in bed with personal lubricant, new sexual positions, sexual education, and toys.
  • Use and practice the Sensate Focus Technique with your partner.
  • Exercise and eat a heart healthy diet.
  • Seek counseling or therapy for relationships, and/or sexual issues from a licensed mental health professional or certified sex therapist.
  • Seek treatment for depression, anxiety, or other mental health issue.
  • Seek treatment for an existing medical condition.
  • Talk with your doctor about making changes in your current medications.