Diagnosis

A physical exam and medical history may be all that's needed to recommend treatment for delayed ejaculation. However, if delayed ejaculation appears to be caused by an underlying problem that might need treatment, you may need further tests or you may need to see a specialist.

Tests for underlying problems can include:

  • Physical exam. This may include careful examination of your penis and testicles. The doctor will use light touch to make sure you have normal sensation in your genitals.
  • Blood tests. A sample of your blood may be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health problems.
  • Urine tests (urinalysis). Urine tests are used to look for signs of diabetes, infection and other underlying health conditions.

Treatment

Delayed ejaculation treatment depends on the underlying cause, but may include taking a medication or making changes to medications you currently take, undergoing psychological counseling, or addressing alcohol abuse or illegal drug use.

Medications

If you're taking medication that may be causing delayed ejaculation, reducing the dose of a medication or switching medications may fix the problem. Sometimes, adding a medication may help.

There aren't any drugs that have been specifically approved for the treatment of delayed ejaculation. Medications used to treat delayed ejaculation are used primarily to treat other conditions.

Medications sometimes used to treat delayed ejaculation include:

  • Amantadine (Parkinson's)
  • Buspirone (antianxiety)
  • Cyproheptadine (allergy)

Psychological counseling (psychotherapy)

Psychotherapy can help by addressing underlying mental health problems leading to delayed ejaculation, such as depression or anxiety. It's also used to address psychological issues that directly affect your ability to ejaculate.

Counseling may involve seeing a psychologist or mental health counselor on your own, or along with your partner. Depending on the underlying cause, you may benefit most from seeing a sex therapist — a mental health counselor who specializes in talk therapy for sexual problems. The type of counseling that's best for you will depend on your particular concerns.

Coping and support

If it's an ongoing concern, delayed ejaculation can cause mental and emotional stress for a man and his partner. If you have delayed ejaculation only on occasion, try not to assume that you have a permanent problem or to expect it to happen again during your next sexual encounter. Remember, occasional delayed ejaculation due to stress or other temporary factors may improve when the underlying cause gets better.

In addition, if you experience occasional or persistent delayed ejaculation, it's important to reassure your sexual partner. Your partner may think your inability to reach climax is a sign of diminished sexual interest.

Communicate openly and honestly with your partner about your condition. Treatment is often more successful if couples work together as a team. You may even want to see a counselor with your partner. This can help you address concerns you both may have about delayed ejaculation.

Preparing for your appointment

If you've been having trouble achieving orgasm, talk with your primary care doctor. Your doctor may refer you to a specialist — such as a doctor who specializes in male genital problems (urologist), a doctor who specializes in the hormonal systems (endocrinologist), a doctor who diagnoses and treats mental health problems (psychiatrist), or another type of specialist.

Here's some information to help you get ready for your appointment, as well as what to expect from your doctor.

What you can do

To prepare for your appointment:

  • Write down any symptoms you've had, including any that may seem unrelated to delayed ejaculation.
  • Write down key personal information, including any major stresses or recent life changes, illnesses, or changes in medications you take.
  • Make a list of all medications, vitamins, herbal remedies and supplements you take.
  • Take your partner along, if possible. Your partner may be able to provide information that will assist in diagnosing and treating the problem.
  • Write down questions to ask your doctor.

Questions to ask your doctor

For delayed ejaculation, some basic questions to ask your doctor include:

  • What's the most likely cause of my delayed ejaculation?
  • What kinds of tests do I need?
  • Is this problem temporary?
  • What treatments are available, and which one do you recommend for me?
  • I have other health conditions. How can I best manage these conditions together?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Should I see a specialist?
  • Where can I find more information about my condition?

What to expect from your doctor

Being ready to answer your doctor's questions may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • How long have you had trouble ejaculating? Does it happen only now and then, or is it an ongoing problem?
  • Are you able to ejaculate during sexual intercourse? Or are you able to ejaculate only when your partner directly touches your penis or when you masturbate?
  • If you're able to ejaculate, how long does it take after sexual activity starts?
  • Have you had any changes in sexual desire or any other sexual problems?
  • Are there any problems in your relationship with your sexual partner?
  • Have you had any recent surgeries? Or have you had surgery to the pelvic area, such as surgery to treat an enlarged prostate?
  • What health problems or chronic conditions do you have? Are you taking any medications for these conditions?
  • Have you had any other sexual problems, such as trouble getting or maintaining an erection (erectile dysfunction)?
  • Do you drink alcohol or use illegal drugs? If so, how much?
April 17, 2015
References
  1. Sexual dysfunctions. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed March 19, 2015.
  2. McMahon CG. Management of ejaculatory dysfunction. Internal Medicine Journal. 2014;44:124.
  3. Ferri FF. Ejaculation and orgasm disorders. In: Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. http://www.clinicalkey.com. Accessed March 18, 2015.
  4. Althof SE. Psychological interventions for delayed ejaculation/orgasm. International Journal of Impotence Research. 2012;24:131.
  5. Calabro RS. Pregabalin-induced severe delayed ejaculation. Epilepsy & Behavior. 2010;19:543.
  6. Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. March 28, 2015.