Materiały źródłowe

• #1 Delayed ejaculation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/diagnosis-treatment/drc-20371363

  A physical exam and medical history might be all that are needed to suggest treatment for delayed ejaculation. But there might be a problem causing delayed ejaculation that needs treatment. Then you might need more tests, or you might need to see a specialist. […] Delayed ejaculation treatment depends on the cause. Treatment might include taking medicine or making changes to medicines you take. It might involve psychological counseling or addressing alcohol or illicit drug use. […] Counseling can help by dealing with mental health problems linked to delayed ejaculation, such as depression or anxiety. […] Ongoing delayed ejaculation can cause mental and emotional stress for you and your partner. If you have delayed ejaculation only sometimes, try not to assume that you have a lasting problem or to expect it to happen again the next time you have sex.

• #2 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  Delayed ejaculation is a condition in which it takes a long period of sexual arousal to reach climax and release semen from the penis, called ejaculate. Some people with delayed ejaculation can’t ejaculate at all. […] Treatment for delayed ejaculation depends on the cause. […] Your main healthcare professional is a good place to start when you have delayed ejaculation. See your healthcare professional if: Delayed ejaculation is an issue for you or your partner. […] Some medicines, certain ongoing health conditions and surgeries can cause delayed ejaculation. Other causes include substance misuse or a mental health concern, such as depression, anxiety or stress. […] The following can increase the risk of having delayed ejaculation: Older age. With aging, ejaculation takes longer. […] Complications of delayed ejaculation can include: Less sexual pleasure for you and your partner.

• #3 Delayed Ejaculation in Adults

  https://www.mindyra.com/solutions/adults/delayedejaculation

  Delayed ejaculation is a psychiatric disorder that affects less than 1% of males. Delayed ejaculation is defined by a delay or absence of ejaculation in almost all or all occasions of partnered sexual activity. Delayed ejaculation is characterized by prolonged sexual activity to achieve orgasm to the point of frustration or fatigue, or genital discomfort. […] Delayed ejaculation can cause anxiety, dissatisfaction and frustration around sex. Delayed ejaculation can both contribute to and be caused by interpersonal conflicts with a partner. […] Delayed ejaculation is treatable. However, the disorder is under researched and under reported as it is the least common male sexual complaint. Clinical treatment recommendations for delayed ejaculation are outlined in the International Journal of Impotence Research.

• #4 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  Delayed ejaculation (DE) occurs when a man needs more than 30 minutes of sexual stimulation to reach orgasm and ejaculate. […] DE has multiple causes, including anxiety, depression, neuropathy, and reactions to medications. […] While this condition does not pose any serious medical risks, it can be a source of stress and may create problems in your sex life and personal relationships. However, treatments are available. […] Treatment will depend on the underlying cause. If you’ve had lifelong problems or you’ve never ejaculated, a urologist can determine if you have a structural birth defect. […] Psychological counseling can help treat depression, anxiety, and fears that trigger or perpetuate DE. Sex therapy may also be useful in addressing the underlying cause of sexual dysfunction.

• #5 How Long Is Considered Delayed Ejaculation? – ISSM

  https://www.issm.info/sexual-health-qa/how-long-is-considered-delayed-ejaculation

  Delayed ejaculation occurs when a man requires an extended period of sexual stimulation (22 minutes or more) to orgasm and ejaculate. […] While some men may need 30 minutes or more of sexual stimulation to reach orgasm, the median intravaginal ejaculatory latency time (IELT) is 5.4 minutes. This means that men who reach orgasm after 22 minutes of sexual activity fall just below the 98th percentile of ejaculation times, which may qualify them to be diagnosed with delayed ejaculation. […] Nevertheless, these numbers do not represent a hard and fast rule for a delayed ejaculation diagnosis. In fact, ejaculation that occurs within a shorter period of time may still be considered delayed if it is distressing to a man or his partner, or if it requires significantly more time than a man’s previous normal.

• #6 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] You may have delayed ejaculation if you’re unable to ejaculate more than half the times you have sex. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression. […] Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis.

• #7 Disorders of Ejaculation: An AUA/SMSNA Guideline (2020) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/disorders-of-ejaculation

  Lifelong delayed ejaculation is defined as lifelong, consistent, bothersome inability to achieve ejaculation, or excessive latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. (Expert Opinion) […] Acquired delayed ejaculation is defined as an acquired, consistent, bothersome inability to achieve ejaculation, or an increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. (Expert Opinion) […] Clinicians should assess medical, relationship, and sexual history and perform a focused physical exam to evaluate a patient with delayed ejaculation. (Clinical Principle) […] Clinicians may utilize additional testing as clinically indicated for the evaluation of delayed ejaculation. (Conditional Recommendation; Evidence Level: Grade C)

• #8 Ejaculatory Dysfunction | Urology Associates | Denver Metro

  https://www.denverurology.com/mens-fertility-sexual-health/ejaculatory-dysfunction/

  Delayed ejaculation is when ejaculation is retarded beyond a reasonable period after sexual stimulation. This happens from time to time with many men as a normal occurrence but can be problematic if it occurs over a long period or frustrates either sex partner. […] Delayed ejaculation can be a permanent problem present from the beginning of sexual activity. Or it can be an acquired problem occurring after a history of normal ejaculation. It may be general or situational, in which it may occur only with certain partners or situations. […] Causes of delayed ejaculation can be physical, psychological or the side effects of certain medications. Causes also include alcohol abuse, diuretics (drugs or food and beverage ingredients that accelerate the body’s loss of water), high blood pressure, or the use of antidepressant, anti-seizure or antipsychotic medications.

• #9 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  Defining firm recommendations to approach the treatment of DE/AE is difficult for a condition that is less common and heterogeneous, for which the literature is confined to case reports, case series, and small studies. […] Paying special attention to psychogenic factors may additionally reinforce the therapeutic success of some patients. […] Attempts have been made to treat DE/AE using off-label medications based on pharmacological and physiologic considerations. However, an approved drug does not exist. […] Here again, a number of approaches can be employed. The simplest approach is to collect nocturnal emissions in a spermicide-free condom for assisted reproduction. […] The literature suggests that the pathophysiology of DE/AE is multifactorial, including both organic and psychosocial factors that are neither independent nor mutually exclusive.

• #10 Premature or Delayed Ejaculation | Urology | Kelsey-Seybold Clinic

  https://www.kelsey-seybold.com/medical-services-and-specialties/urology/male-sexual-dysfunction/premature-delayed-ejaculation

  Delayed ejaculation is a condition in which it takes an extended period of sexual stimulation for a man to reach sexual climax and ejaculate. […] Delayed ejaculation can be temporary or a lifelong problem. It’s normal for men to experience delayed ejaculation from time to time, but an ongoing problem may require treatment. […] Typically, men with delayed ejaculation need 30 minutes or more of sexual stimulation to have an orgasm and ejaculate, or they may not be able to ejaculate at all. The time it takes isn’t as much of a determining factor as the stress, frustration, or fatigue the condition causes. […] In many cases, delayed ejaculation can be caused by a combination of physical and psychological factors. Use of certain substances can also contribute. […] Physical causes may include: Certain birth defects, Injury to the pelvic nerves that control orgasm, Certain infections, such as a urinary tract infection, Prostate surgery or prostate removal, Neurological diseases, Hormone-related conditions, Retrograde ejaculation, a condition in which the semen goes backward into the bladder rather than out of the penis.

• #11 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  Delayed ejaculation is a condition in which it takes a long period of sexual arousal to reach climax and release semen from the penis, called ejaculate. Some people with delayed ejaculation can’t ejaculate at all. […] Treatment for delayed ejaculation depends on the cause. […] Your main healthcare professional is a good place to start when you have delayed ejaculation. See your healthcare professional if: Delayed ejaculation is an issue for you or your partner. […] Some medicines, certain ongoing health conditions and surgeries can cause delayed ejaculation. Other causes include substance misuse or a mental health concern, such as depression, anxiety or stress. […] The following can increase the risk of having delayed ejaculation: Older age. With aging, ejaculation takes longer. […] Complications of delayed ejaculation can include: Less sexual pleasure for you and your partner.

• #12 Premature or Delayed Ejaculation | Urology | Kelsey-Seybold Clinic

  https://www.kelsey-seybold.com/medical-services-and-specialties/urology/male-sexual-dysfunction/premature-delayed-ejaculation

  Psychological causes may include: Depression, anxiety, or other mental health conditions, Relationship problems, Anxiety about performance, Poor body image, Cultural or religious taboos, Unrealistic sexual expectations. […] Substances that can contribute to delayed ejaculation include: Some antidepressants, Certain high blood pressure medications, Certain diuretics, Some antipsychotic medications, Some anti-seizure medications, Alcohol abuse. […] If medication is a factor in delayed ejaculation, your doctor may reduce your dosage or switch medications. […] While there aren’t any medications specifically approved for the treatment of delayed ejaculation, the following are sometimes used to help treat the causes and symptoms of delayed ejaculation: Amantadine (Parkinson’s medication), Buspirone (anti-anxiety medication), Cyproheptadine (allergy medication), Psychological counseling. […] If you’re experiencing the symptoms of premature ejaculation or delayed ejaculation, the Urology specialists at Kelsey-Seybold Clinic in Houston can pinpoint the cause and help you return to a more satisfying sexual experience.

• #13 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Delayed ejaculation can suddenly start to happen after previously having no problems, or (less commonly) the man may have always experienced it. […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. […] Some integrated care boards (ICBs) provide a sex therapy service on the NHS. […] You can also pay privately. […] During sex therapy, you’ll have the opportunity to discuss any emotional or psychological issues related to your sexuality and relationship, in a non-judgemental way. […] Activities may also be recommended for you to try at home while you’re having sex with your partner. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”.

• #14 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. […] Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. […] There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist. The history is the key to the diagnosis. […] A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction.

• #15 The office management of ejaculatory disorders – Jiann – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10685/html

  DE is also called retarded ejaculation or inhibited ejaculation. According to the DSM-5, the major feature of DE is a marked delay in or inability to achieve ejaculation, despite the presence of adequate sexual stimulation and the desire to ejaculate. Approximately 25% of patients have lifelong DE, whereas the majority (75%) acquired it after a period of normal ejaculatory function. Most DE cases are caused by spinal cord injury (SCI; 68.9%); other common causes include retroperitoneal lymph node dissection (RPLND; 20.7%), idiopathy (7.1%), and DM (2.1%). Furthermore, neurological diseases and serotonergic drugs are associated with severe DE. […] Thus far, no evidence-based or specific criteria for accurately diagnosing a man with DE have been reported. According to a median IELT of 5.4 min, DE can be diagnosed in a man with an IELT more than 2530 minutes (approximately two standard deviations above the median) and distress associated with this condition.

• #16 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  If you have delayed ejaculation, you or your partner may find sexual intercourse frustrating instead of pleasurable because of the time it takes you to ejaculate. […] Treatment may include therapy or changes to your medications. […] Delayed ejaculation can be frustrating or unfulfilling, for you or a sexual partner. […] If it causes stress and its a long-lasting (chronic) issue, a healthcare provider can help. […] If you or your partner is upset by the time it takes to ejaculate, talk to a healthcare provider. […] A healthcare provider may suggest that you don’t have a physical cause of delayed ejaculation if you’re able to easily orgasm by yourself but have difficulty with your partner. […] A healthcare provider may offer several different delayed ejaculation treatments. […] A provider may also recommend that you speak with a therapist (psychotherapy) or sex therapist.

• #17 Disorders of Ejaculation: An AUA/SMSNA Guideline (2020) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/disorders-of-ejaculation

  Clinicians should consider referring men diagnosed with lifelong or acquired delayed ejaculation to a mental health professional with expertise in sexual health. (Expert Opinion) […] Clinicians should advise men with delayed ejaculation that modifying sexual positions or practices to increase arousal may be of benefit. (Expert Opinion) […] Clinicians should suggest replacement, dose adjustment, or staged cessation of medications that may contribute to delayed ejaculation. (Clinical Principle) […] Clinicians should inform patients that there is insufficient evidence to assess the risk-benefit ratio of oral pharmacotherapy for the management of delayed ejaculation. (Expert Opinion) […] Clinicians may offer treatment to normalize serum testosterone levels in patients with delayed ejaculation and testosterone deficiency. (Expert Opinion)

• #18 Delayed ejaculation Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/delayed-ejaculation

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. It may occur either during intercourse or by manual stimulation with or without a partner. Ejaculation is when semen is released from the penis. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. (Examples of stimulation may include wet dreams, masturbation, or intercourse.) Your provider may refer you to a urologist for additional evaluation and advice. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. Sex therapy most often includes both partners. In most cases, the therapist will teach you about the sexual response. You also will learn how to communicate and guide your partner to provide the right stimulation. […] Therapy often involves a series of „homework” assignments. In the privacy of your home, you and your partner

• #19 Delayed ejaculation – UF Health

  https://ufhealth.org/conditions-and-treatments/delayed-ejaculation

  Delayed ejaculation is a medical condition in which a male cannot ejaculate. It may occur either during intercourse or by manual stimulation with or without a partner. Ejaculation is when semen is released from the penis. […] If you have never ejaculated through any form of stimulation, see a urologist to determine if the problem has a physical cause. (Examples of stimulation may include wet dreams, masturbation, or intercourse.) […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. Sex therapy most often includes both partners. In most cases, the therapist will teach you about the sexual response. You also will learn how to communicate and guide your partner to provide the right stimulation. […] Therapy often involves a series of „homework” assignments. In the privacy of your home, you and your partner engage in sexual activities that reduce performance pressure and focus on pleasure.

• #20 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  If delayed ejaculation happens primarily with your partner, they may suggest counseling for both of you. […] A sex therapist may suggest that you and/or your partner use erotic or masturbatory aids. […] If delayed ejaculation affects your ability to have a biological child, a provider may suggest procedures to retrieve sperm from your testicles that they can use for insemination. […] Kegel exercises help strengthen the muscles in your pelvic floor. […] It’s also important to have an open, honest relationship with your partner. […] Talk to a healthcare provider when you first notice an inability to ejaculate, especially if it’s frustrating or troubling for you or your partner. […] If your partner has delayed ejaculation, be supportive. […] If delayed ejaculation is a problem for you and/or your partner, then it’s important to take that first step and reach out to a provider.

• #21 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  Traditional behavioral sex therapy for delayed ejaculation is as follows: the man begins by masturbating, then starts intercourse when he is almost ready to ejaculate; the procedure continues with the man beginning intercourse earlier and earlier. […] Delayed ejaculation carries with it issues of inability to achieve orgasm and infertility. […] A common cause is pudendal neuropathy, caused by a crush to the perineum such as from bike riding with a narrow saddle. […] If the delayed ejaculation is situational is is probably psychologic; if it is generalized the problem is probably biologic.

• #22 The drug treatment of delayed ejaculation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001980/

  Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. […] The clinicians need to be aware of the pathogenesis of DE and the pharmacological basis underlying the use of different drugs to extend better care for these patients. […] Successful drug treatment of DE is still in its infancy. […] Various drugs are available to address such problem, however their evidence of efficacy is still limited and their choice needs to be individualized to each specific case.

• #23 The office management of ejaculatory disorders – Jiann – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10685/html

  No specific medication has been approved for the treatment of lifelong or acquired DE. However, if DE is suspected to be a side effect of a medication, reducing the dosage or resorting to another medication with fewer side effects can facilitate to reversing DE. Amantadine, buproprion, buspirone, cyproheptadine, and yohimbine are recommended by the British Association of Sexual Health and HIV (BASHH) special interest group in sexual dysfunction for managing SSRI-induced DE. These drugs facilitate ejaculation through either a central dopaminergic or anti-serotonergic mechanism of action, or a peripheral adrenergic mechanism of action. When organic or pharmacological causes are excluded, patients with DE can benefit from psychological therapy. Numerous psychotherapeutic strategies, such as cognitive behavioral therapy, couples sex therapy, masturbatory retraining, and sexual tipping point, have been suggested for managing DE to reduce anxiety, enhance penile stimulation, or maximize arousal.

• #24 Ejaculatory Dysfunction | Patient Care

  https://weillcornell.org/services/urology/male-infertility-and-sexual-medicine/conditions-we-treat/ejaculatory-dysfunction

  Delayed ejaculation and anorgasmia involve the inability of the patient to achieve orgasm (ejaculation) in a timely manner, and in severe cases men fail to achieve orgasm on any occasion. […] Delayed ejaculation or anorgasmia involves the inability of the patient to achieve orgasm (ejaculation) in a timely manner, and in severe cases, involves failure to achieve orgasm on any occasion. As men age, there is an increase in the time it takes to achieve ejaculation. However, in some men, this increase may lead to the inability to ejaculate within a 30-minute time period from the initiation of sexual stimulation. […] Delayed ejaculation and anorgasmia are very difficult sexual dysfunctions to treat. There does not exist any FDA approved pharmacologic strategy for these patients. The use of penile vibratory therapy is used as a first line therapy in order to increase penile stimulation and has the ability to help patients achieve orgasm. The results are better in patients in whom there is a delay in orgasm, as opposed to those who have a consistent complete failure to achieve orgasm. Cabergoline, a dopamine receptor agonist used in patients with hyperprolactinemia and Parkinsons disease, has been shown in preliminary studies to decrease ejaculatory latency time and may be useful in the treatment of delayed ejaculation or anorgasmia. Buproprion is another drug that has had some anecdotal success in these patients.

• #25 Is delayed ejaculation normal? | Nebraska Medicine Omaha, NE

  https://www.nebraskamed.com/health/conditions-and-services/mens-health/is-delayed-ejaculation-normal

  While there are medications to treat delayed ejaculation, each one is off-label when you take an FDA-approved drug for an unapproved use. […] Another treatment for delayed ejaculation, especially if its a new issue (acquired), is going to a certified sex therapist. […] Modifying sex positions can also be helpful to address delayed ejaculation. […] Finally, checking and normalizing testosterone can also help with delayed ejaculation. […] Its really about whether it causes personal distress or not and whether its a change or its been a lifelong issue, says Dr. Deibert.

• #26 Disorders of Ejaculation: An AUA/SMSNA Guideline (2020) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/disorders-of-ejaculation

  Clinicians should treat men who have delayed ejaculation and comorbid erectile dysfunction according to the AUA Guidelines on Erectile Dysfunction. (Expert Opinion) […] Clinicians should counsel patients with delayed ejaculation that no currently available data indicates that invasive non-pharmacological strategies are of benefit. (Expert Opinion)

• #27

  https://uihealthcare.adam.com/content.aspx?productid=117&pid=1&gid=001954

  If medicines are causing the problem, your provider may recommend switching or stopping the medicine, if possible. […] Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. […] Openly discuss any fears or anxieties, such as fear of pregnancy or disease, with your partner.

• #28 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Delayed ejaculation is when you have trouble reaching orgasm and ejaculating. […] Delayed ejaculation can be a temporary or lifelong condition. […] Treatment depends on the cause. […] You should talk to your doctor if you have delayed ejaculation and it is bothering you. […] It’s important to communicate openly and honestly with your partner about your condition. Treatment is often more successful if couples work together as a team. […] Your doctor can: provide reassurance, assess you to identify the cause, recommend treatments. […] Your doctor will be able to give specific advice and treatment options. They may refer you to a specialist if needed. […] Delayed ejaculation might make it more difficult to conceive a baby. But there are treatments available. […] Talk with your doctor if you are worried about the effects of delayed ejaculation.

• #29 Delayed ejaculation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/diagnosis-treatment/drc-20371363

  Talk openly with your partner about your condition. Treatment often is more successful if couples work together as a team. You might want to see a counselor with your partner. This can help you address concerns you both might have about delayed ejaculation. […] If you’ve been having trouble having orgasm, talk with your main healthcare professional. Your care professional might send you to a specialist. This might be a specialist in male genital problems, called a urologist; a specialist in the hormonal systems, called an endocrinologist; or a mental health specialist, called a psychiatrist, psychologist or social worker.

• #30 Delayed ejaculation – UF Health

  https://ufhealth.org/conditions-and-treatments/delayed-ejaculation

  In cases where there is a problem with the relationship or a lack of sexual desire, you may need therapy to improve your relationship and emotional intimacy. […] Sometimes, hypnosis may be a helpful addition to therapy. This may be useful if one partner is not willing to participate in therapy. Trying to self-treat this problem is often not successful. […] Treatment commonly requires about 12 to 18 sessions. The average success rate is 70% to 80%. […] If the problem is not treated, the following may occur: Avoidance of sexual contact, Inhibited sexual desire, Stress within the relationship, Sexual dissatisfaction, Difficulty with conception and getting pregnant. […] Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. Realize that you cannot force yourself to have a sexual response, just as you cannot force yourself to go to sleep or to perspire. The harder you try to have a certain sexual response, the harder it becomes to respond.

• #31 Ejaculatory Disorder Treatments | University of Utah Health

  https://healthcare.utah.edu/fertility/conditions/ejaculatory-disorders/treatment

  The way we treat delayed ejaculation can vary widely based on the underlying cause. Consult with a urologist if you have never ejaculated with any stimulation. A urologist can evaluate whether there are underlying physical causes. […] You may find that other treatments work for you: […] Participating in sex/couples therapy […] Switching or stopping certain kinds of medications […] Using devices like high-speed vibrators […] You may experience several problems over time if you don’t treat your delayed ejaculation or inability to ejaculate: […] Avoiding sexual contact […] Difficulty conceiving […] Inhibited sexual desire […] Sexual dissatisfaction […] Stress in your romantic relationships.

• #32 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  The psychological definition of delayed ejaculation refers to the inability to have an ejaculation during sexual intercourse. […] Problems of delayed ejaculation tend to be somewhat rare and not well understood by psychologists and sex therapists. […] In many cases, the man himself may tend to delay treatment or to minimize the distress of the situation. […] In spite of the lack of information regarding delayed ejaculation, the most successful approach, for sex therapists, is to engage both members of the couple into addressing the problem. […] Ejaculatory problems can have a devastating affect on self-esteem. […] Ejaculation problems may also contribute to a low libido and lack of interest in sexual activity. […] For some men, there may be additional psychological issues that underlie an ejaculatory dysfunction.

• #33 Delayed or Absent Ejaculation | Department of Urology | UPMC

  https://www.upmc.com/services/urology/conditions/delayed-or-absent-ejaculation

  A delayed or absent ejaculation happens when a man takes an especially long time to ejaculate or can’t come at all. […] Treatment depends on the cause of the problem and how long it’s been going on. […] DE isn’t a life-threatening condition. And by itself, it doesn’t lead to any serious illness. […] If it causes distress or physical discomfort to you or your partner, you should see your doctor. […] Treatment for delayed ejaculation (DE) depends on what caused the problem. Once doctors find the cause, they’re often able to resolve the issue. […] Your doctor might suggest counseling if depression or other mental health issues are the root cause. Your doctor might also refer a sex therapist. Either going alone or with your partner can also help if sexual dysfunction is the cause. […] Your doctor might suggest surgery to treat delayed ejaculation.

• #34 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  DE can generally be resolved by treating the mental or physical causes. Identifying and seeking treatment for DE sometimes exposes an underlying medical condition. Once this is treated, DE often resolves. […] Treatment or counseling can help resolve these issues. By facilitating open, honest communication, understanding can often be reached. […] There are many possible causes of DE. Regardless of the cause, treatments are available. Don’t be embarrassed or afraid to speak up. The condition is very common. […] By asking for help, you can get the psychological and physical support needed to address the issue and enjoy a more fulfilling sex life.

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