Delayed ejaculation can result from certain chronic health conditions, surgeries and medications. Or it may be caused by substance abuse or a mental health concern, such as depression, anxiety or stress. In many cases, delayed ejaculation is due to a combination of physical and psychological concerns.
Physical causes of delayed ejaculation include:
- Certain birth defects affecting the male reproductive system
- Injury to the pelvic nerves that control orgasm
- Certain infections
- Prostate surgery, such as transurethral resection of the prostate (TURP) or prostate removal
- Heart disease
- Prostate infection or urinary tract infection
- Neurological diseases, such as diabetic neuropathy, stroke or nerve damage to the spinal cord
- Hormone-related conditions, such as low thyroid hormone (hypothyroidism) or low testosterone
Psychological causes of delayed ejaculation include:
- Depression, anxiety or other mental health conditions
- Relationship problems due to stress, poor communication or other concerns
- Anxiety about performance
- Cultural or religious taboos
- Differences between the reality of sex with a partner and sexual fantasies
Medications and other substances that can cause delayed ejaculation include:
- Most types of antidepressants
- Certain high blood pressure medications
- Certain diuretics
- Some antipsychotic medications
- Alcohol — particularly drinking too much (alcohol abuse or alcoholism)
For some men, a minor physical problem that causes a delay in ejaculation may cause anxiety about ejaculating during a sexual encounter. The resulting anxiety can worsen delayed ejaculation.
May. 24, 2012
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- Cunningham GR, et al. Overview of male sexual dysfunction. http://www.uptodate.com/index. Accessed April 5, 2012.
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- Althof SE. Psychological factors associated with male sexual dysfunction: Screening and treatment for the urologist. Urological Clinics of North America. 2011;38:141.
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