Materiały źródłowe

• #1 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  The International Classification of Diseases (ICD)-11 defines DE as an inability to achieve ejaculation or an excessive or increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. […] Treatment plans are often multidisciplinary, involving urologists, primary care providers and mental health professionals to adequately address biopsychosocial factors. […] Testosterone replacement is indicated for men with testosterone deficiency in accordance with available guidelines. […] Psychosocial evaluation with a sex therapist is recommended for all patients. […] Exact rates of success are difficult to determine based on existing literature due to variability of therapy methods and lack of large-scale studies. […] Though there are no drugs approved by the U.S. Food and Drug Administration (FDA) at this time due to the absence of conclusive data, several pharmacological therapies show promise in treatment of DO including cabergoline, bupropion, oxytocin, and recently amphetamine/dextroamphetamine (AdderallTM). […] The existing literature provides insufficient evidence to recommend the use of these drugs in treatment of DO at this time.

• #2 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)

• #3 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. […] Treatment for delayed ejaculation includes psychotherapy to deal with underlying mental health and psychological issues. Some mental health counselors are specially trained to deal with sexual issues. Counseling can involve just the male or he and his partner. […] A few medications are also used to treat delayed ejaculation. These are not specifically approved for treatment of delayed ejaculation but are approved for treatment of other conditions. This is referred to as off-label use.

• #4 Delayed Ejaculation & Delayed Ejaculation Treatment | DTAP ClinicFacebookInstagramLinkedInYouTubeFacebookInstagramLinkedInYouTube

  https://www.dtapclinic.com/mens-health/delayed-ejaculation-treatment/

  Ejaculatory disorders are probably the most common men’s health issues following erectile dysfunction. They fall primarily into two categories: premature ejaculation and delayed ejaculation. […] At this point you may be thinking, what is the problem, wouldn’t a man be lucky to have delayed ejaculation? The truth of the matter is, it is a legitimate issue and many men who struggle with this condition often feel ashamed and embarrassed. It can also result in significant mental and emotional stress to both partners in a relationship. […] Delayed ejaculation, also known as impaired ejaculation, is a condition in which a man has persistent difficulty or inability to achieve an orgasm and ejaculate, despite having sexual desire and stimulation. Delayed ejaculation affects approximately 4% of sexually active men, as compared to 20-30% for premature ejaculation.

• #5 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. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that successful drug treatment of DE is still in its infancy. 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. 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.

• #6 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)

• #7 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  The Sexual Tipping Point (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence. […] Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of friction and fantasy. […] Assessment requires a thorough sexual history including inquiry into masturbatory methods. […] The clinicians most valuable diagnostic tool is a focused sex history (sex status). […] Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. […] Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner.

• #8 Delayed Ejaculation: Informed Diagnosis and Treatment | Psychology Today

  https://www.psychologytoday.com/us/blog/sexual-tipping-point/201812/delayed-ejaculation-informed-diagnosis-and-treatment

  Men with DE find it difficult or impossible to ejaculate and/or experience orgasm. DE is a failure to ejaculate during masturbation and/or partner manual, oral, coital, or anal stimulation. […] Many physicians, for better and sometimes for worse, will begin treatment by first prescribing pharmaceuticals, lubricants, and devices (e.g. vibrators). Unfortunately, there are no FDA approved treatment for DE and the drugs that doctors typically use have only anecdotal (here and there reports) of success. […] The most important tool available to any healthcare professional for diagnosing any sexual disorder is a sex status exam. […] The difference between what a man experiences in coupled sex, versus self-stimulation, must be explored. […] Sex therapists have reported good success rates using cognitive-behavioral techniques.

• #9 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. […] Delayed ejaculation can have psychological or physical causes. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. […] Therapy often involves a series of „homework” assignments. […] 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. […] Treatment commonly requires about 12 to 18 sessions. […] 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. […] To reduce the pressure, focus on the pleasure of the moment.

• #10 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.

• #11 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.

• #12 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.

• #13 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  There is scarce literature on the psychological aspects relating to DE, as well as on empirical evidence regarding psychological treatment efficacy. Studies on psychological aspects have revealed that men with DE show a strong need to control their sexual experiences. Delayed ejaculation is associated with difficulties surrendering to sexual pleasure during sex – i.e., the sense of letting go – which denotes an underlying psychological mechanism influencing the reaching of orgasm.

• #14 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  There is scarce literature on the psychological aspects relating to DE, as well as on empirical evidence regarding psychological treatment efficacy. Studies on psychological aspects have revealed that men with DE show a strong need to control their sexual experiences. Delayed ejaculation is associated with difficulties surrendering to sexual pleasure during sex – i.e., the sense of letting go – which denotes an underlying psychological mechanism influencing the reaching of orgasm.

• #15 Delayed Ejaculation & Delayed Ejaculation Treatment | DTAP ClinicFacebookInstagramLinkedInYouTubeFacebookInstagramLinkedInYouTube

  https://www.dtapclinic.com/mens-health/delayed-ejaculation-treatment/

  Treatment of any underlying cause can in many cases resolve the delayed ejaculation. Any potential medications that can contribute to delayed ejaculation should be stopped or changed. There are certain medications which are supposedly able to help with delayed ejaculation, but they can be unreliable and have little effect, if any. As such, the mainstays of treatment are psychotherapy and sex counselling. […] Psychotherapy involves analysing past and current factors that can directly result in delayed ejaculation, including previous unpleasant sexual experiences, underlying psychological issues, performance anxiety, etc. […] Sex counselling is done either alone or with both partners, and involves sex education and goal-oriented tasks and exercises intended to help a man achieve orgasms earlier during sexual intercourse.

• #16 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.

• #17 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] Delayed ejaculation can also be caused by psychological and physical factors. […] Physical causes of delayed ejaculation include: diabetes (usually only type 1 diabetes), spinal cord injuries, multiple sclerosis (MS), surgery to the bladder or prostate gland, increasing age. […] Delayed ejaculation can suddenly start to happen after previously having no problems, or the man may have always experienced it. […] When ejaculation only occurs in certain situations, there’s usually a psychological cause. […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. […] There are a number of alternative medications that can be used if it’s thought medication you are currently taking is responsible for causing delayed ejaculation. […] Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.

• #18 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.

• #19 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] Delayed ejaculation can also be caused by psychological and physical factors. […] Physical causes of delayed ejaculation include: diabetes (usually only type 1 diabetes), spinal cord injuries, multiple sclerosis (MS), surgery to the bladder or prostate gland, increasing age. […] Delayed ejaculation can suddenly start to happen after previously having no problems, or the man may have always experienced it. […] When ejaculation only occurs in certain situations, there’s usually a psychological cause. […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. […] There are a number of alternative medications that can be used if it’s thought medication you are currently taking is responsible for causing delayed ejaculation. […] Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.

• #20 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.

• #21 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] Delayed ejaculation can also be caused by psychological and physical factors. […] Physical causes of delayed ejaculation include: diabetes (usually only type 1 diabetes), spinal cord injuries, multiple sclerosis (MS), surgery to the bladder or prostate gland, increasing age. […] Delayed ejaculation can suddenly start to happen after previously having no problems, or the man may have always experienced it. […] When ejaculation only occurs in certain situations, there’s usually a psychological cause. […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. […] There are a number of alternative medications that can be used if it’s thought medication you are currently taking is responsible for causing delayed ejaculation. […] Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.

• #22 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.

• #23 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] Delayed ejaculation can also be caused by psychological and physical factors. […] Physical causes of delayed ejaculation include: diabetes (usually only type 1 diabetes), spinal cord injuries, multiple sclerosis (MS), surgery to the bladder or prostate gland, increasing age. […] Delayed ejaculation can suddenly start to happen after previously having no problems, or the man may have always experienced it. […] When ejaculation only occurs in certain situations, there’s usually a psychological cause. […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. […] There are a number of alternative medications that can be used if it’s thought medication you are currently taking is responsible for causing delayed ejaculation. […] Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.

• #24 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/

  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. […] 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. […] 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.

• #25 Delayed Ejaculation – Men’s Clinic – The Men’s Clinic at UCLA | UCLA Health

  https://www.uclahealth.org/medical-services/urology/mens-clinic-ucla/sexual-health/delayed-ejaculation

  With our board-certified urologists at The Mens Clinic at UCLA, you can be assured you are getting an experienced physician performing your delayed ejaculation evaluation and treatment. […] The opposite of premature or rapid ejaculation is delayed ejaculation. This can be as, if not more, frustrating than its opposite. Delayed ejaculation is the inability of a man to achieve climax within a reasonable amount of time. […] Treatment for delayed ejaculation depends on its cause. For men with nerve injuries, sometimes they respond to medical vibrators placed at the tip of the penis to retrain the nerves to fire more rapidly. […] For men with hormone imbalances, the doctor needs to run some laboratory tests, specifically testosterone and prolactin levels to see if there’s an imbalance. […] If a man has diminished penile hardness, he may respond to oral impotence drugs like sildenafil or tadalafil to increase penile engorgement and sensitivity.

• #26 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.

• #27 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] Delayed ejaculation can also be caused by psychological and physical factors. […] Physical causes of delayed ejaculation include: diabetes (usually only type 1 diabetes), spinal cord injuries, multiple sclerosis (MS), surgery to the bladder or prostate gland, increasing age. […] Delayed ejaculation can suddenly start to happen after previously having no problems, or the man may have always experienced it. […] When ejaculation only occurs in certain situations, there’s usually a psychological cause. […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. […] There are a number of alternative medications that can be used if it’s thought medication you are currently taking is responsible for causing delayed ejaculation. […] Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help.

• #28 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.

• #29 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #30 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.

• #31 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #32 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.

• #33 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #34 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #35 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model – Perelman – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/11164/html

  The Sexual Tipping Point (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence. Assessment requires a thorough sexual history including inquiry into masturbatory methods. Many men with DE engage in an idiosyncratic masturbatory style, defined as a masturbation technique not easily duplicated by the partner’s hand, mouth, or vagina. Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patient’s narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #36 Delayed Ejaculation: Informed Diagnosis and Treatment | Psychology Today

  https://www.psychologytoday.com/us/blog/sexual-tipping-point/201812/delayed-ejaculation-informed-diagnosis-and-treatment

  In summary, high-frequency idiosyncratic masturbation, combined with fantasy-partner disparity, often predispose men to experience problems with arousal and ejaculation. […] Most urologists find treating DE to be difficult and challenging. However, for many men and couples, it is often possible to successfully overcome DE especially with the guidance of a well-trained sex therapist.

• #37 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. […] Treatment depends on the cause. […] You should talk to your doctor if you have delayed ejaculation and it is bothering you. […] The treatment for delayed ejaculation depends on the cause. […] Your doctor will be able to give specific advice and treatment options. […] Your doctor may recommend medicines, depending on the cause of your delayed ejaculation. […] Counselling or sexual health therapy may also help.

• #38 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. […] Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. […] Encourage a man who continues to masturbate to alter style (switch hands) and to approximate the stimulation likely to be experienced with his partner. […] Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. […] Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. […] This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patients narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #39 Ejaculation problems

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

  Treating delayed ejaculation […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live. […] You can also pay privately. The College of Sexual and Relationship Therapists website provides information about private sex therapists and how to find a therapist in your local area. […] The relationship counselling service Relate also offers sex therapy at a number of its centres. You’ll need to pay for each session. […] 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.

• #40 Ejaculation problems

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

  Treating delayed ejaculation […] Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live. […] You can also pay privately. The College of Sexual and Relationship Therapists website provides information about private sex therapists and how to find a therapist in your local area. […] The relationship counselling service Relate also offers sex therapy at a number of its centres. You’ll need to pay for each session. […] 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.

• #41 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  Any psychological intervention must address both historical factors and current factors that might contribute to the present dysfunction. […] A psychodynamic-oriented treatment aims to explore and understand such factors, decrease secondary feelings such as anxiety and guilt, and correct negative cognitions that can result in psychological inhibition and orgasmic dysfunction. […] A psychodynamic approach is recommended for persistent, treatment-resistant anorgasmia. […] Cognitive-behavioral interventions to decrease anxiety include sexual education (to dispel misconceptions about sexuality or relieve feelings of inadequacy or inappropriate guilt), guided imagery, and sensate focus. […] If anorgasmia appears to be secondary to relationship problems, couples or marital therapy might be indicated.

• #42 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  Any psychological intervention must address both historical factors and current factors that might contribute to the present dysfunction. […] A psychodynamic-oriented treatment aims to explore and understand such factors, decrease secondary feelings such as anxiety and guilt, and correct negative cognitions that can result in psychological inhibition and orgasmic dysfunction. […] A psychodynamic approach is recommended for persistent, treatment-resistant anorgasmia. […] Cognitive-behavioral interventions to decrease anxiety include sexual education (to dispel misconceptions about sexuality or relieve feelings of inadequacy or inappropriate guilt), guided imagery, and sensate focus. […] If anorgasmia appears to be secondary to relationship problems, couples or marital therapy might be indicated.

• #43 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  The Sexual Tipping Point (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence. […] Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of friction and fantasy. […] Assessment requires a thorough sexual history including inquiry into masturbatory methods. […] The clinicians most valuable diagnostic tool is a focused sex history (sex status). […] Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. […] Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner.

• #44 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model – Perelman – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/11164/html

  The STP can be easily used to explain etiology and highlight treatment targets for patients. It helps clinicians disabuse patients erroneous binary beliefs. Teaching the STP model to the patient and partner helps reduce despair and anger. A complaint of DE might evoke this dialogue: Your DE is not all in your head nor is it all a physical problem. […] Help the man identify behaviors that enhance his ability to be immersed in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner. Current treatments usually emphasize integrating behavioral masturbatory retraining, within a nuanced sex therapy. Masturbation can serve as rehearsal for partnered sex. By informing the patient how masturbation conditioned his response, stigma is minimized and partner cooperation can be evoked.

• #45 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  Any psychological intervention must address both historical factors and current factors that might contribute to the present dysfunction. […] A psychodynamic-oriented treatment aims to explore and understand such factors, decrease secondary feelings such as anxiety and guilt, and correct negative cognitions that can result in psychological inhibition and orgasmic dysfunction. […] A psychodynamic approach is recommended for persistent, treatment-resistant anorgasmia. […] Cognitive-behavioral interventions to decrease anxiety include sexual education (to dispel misconceptions about sexuality or relieve feelings of inadequacy or inappropriate guilt), guided imagery, and sensate focus. […] If anorgasmia appears to be secondary to relationship problems, couples or marital therapy might be indicated.

• #46 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. […] Delayed ejaculation can have psychological or physical causes. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. […] Therapy often involves a series of „homework” assignments. […] 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. […] Treatment commonly requires about 12 to 18 sessions. […] 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. […] To reduce the pressure, focus on the pleasure of the moment.

• #47 Delayed ejaculation – UF Health

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

  Delayed ejaculation can have psychological or physical causes. […] 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. […] 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 medicines are causing the problem, your provider may recommend switching or stopping the medicine, if possible. A full recovery is possible if this can be done.

• #48 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/

  For men, erectile dysfunction and ejaculatory problems are the most common sexual difficulties. […] Typically, ejaculatory disorders fall into two categories. These are: delayed ejaculation and early ejaculation. This column will explore some of the psychological factors and treatment options related to these two distinct male dysfunctions. […] In the vast majority of cases, the most effective therapeutic approach for ejaculatory dysfunction is a combination of biologic and psychologic therapy. […] Regardless of the psychological issues, a good medical or urologic work-up is always encouraged before embarking on a behavioral treatment program. […] 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.

• #49 Overcoming Ejaculation Problems: Delayed, Premature, and Retrograde Ejaculation

  https://www.webmd.com/men/features/overcoming-ejaculation-problems

  But while masturbation can cause delayed ejaculation, it can also aid in the cure. If a guy won’t agree to keep his hands off, Perelman will urge him at least to alter his masturbation style — to switch hands, for example — in order to break old habits. […] So instead of just masturbating efficiently to achieve orgasm, Perelman encourages men to fantasize about a sexual experience with their partner while they masturbate. […] For men who aren’t helped by any of these techniques, there’s a pharmaceutical option. Since some antidepressants — selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation, researchers tried them as a way to treat premature ejaculation. […] Instead of drugs, some men use a desensitizing cream to delay orgasm. There’s an even simpler solution: double up your condoms to reduce your stimulation. For some men, behavioral and psychological therapies also help. Combining therapy and medication seems to be more effective than just taking medication. […] Whatever your ejaculation problem, there are solutions. The key is to get help. And we don’t just mean from a doctor, although that’s important — ejaculation problems can be signs of more serious medical issues, after all.

• #50 Overcoming Ejaculation Problems: Delayed, Premature, and Retrograde Ejaculation

  https://www.webmd.com/men/features/overcoming-ejaculation-problems

  But while masturbation can cause delayed ejaculation, it can also aid in the cure. If a guy won’t agree to keep his hands off, Perelman will urge him at least to alter his masturbation style — to switch hands, for example — in order to break old habits. […] So instead of just masturbating efficiently to achieve orgasm, Perelman encourages men to fantasize about a sexual experience with their partner while they masturbate. […] For men who aren’t helped by any of these techniques, there’s a pharmaceutical option. Since some antidepressants — selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation, researchers tried them as a way to treat premature ejaculation. […] Instead of drugs, some men use a desensitizing cream to delay orgasm. There’s an even simpler solution: double up your condoms to reduce your stimulation. For some men, behavioral and psychological therapies also help. Combining therapy and medication seems to be more effective than just taking medication. […] Whatever your ejaculation problem, there are solutions. The key is to get help. And we don’t just mean from a doctor, although that’s important — ejaculation problems can be signs of more serious medical issues, after all.

• #51 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. […] Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. […] Encourage a man who continues to masturbate to alter style (switch hands) and to approximate the stimulation likely to be experienced with his partner. […] Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. […] Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. […] This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patients narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #52 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  The Sexual Tipping Point (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence. […] Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of friction and fantasy. […] Assessment requires a thorough sexual history including inquiry into masturbatory methods. […] The clinicians most valuable diagnostic tool is a focused sex history (sex status). […] Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. […] Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner.

• #53 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model – Perelman – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/11164/html

  The Sexual Tipping Point (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence. Assessment requires a thorough sexual history including inquiry into masturbatory methods. Many men with DE engage in an idiosyncratic masturbatory style, defined as a masturbation technique not easily duplicated by the partner’s hand, mouth, or vagina. Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patient’s narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #54 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  The Sexual Tipping Point (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence. […] Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of friction and fantasy. […] Assessment requires a thorough sexual history including inquiry into masturbatory methods. […] The clinicians most valuable diagnostic tool is a focused sex history (sex status). […] Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. […] Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner.

• #55 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model – Perelman – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/11164/html

  For both primary and secondary DE (as soon as therapeutically possible) obtain an agreement from the patient to temporarily refrain from ejaculating alone. If he won’t stop, negotiate a reduction in his masturbatory ejaculatory frequency with a minimum commitment of no orgasm within 72 hours of his next partnered experience. […] Temporary cessation of masturbation (and/or alteration of both masturbation style and frequency) required by most men is difficult to accomplish. Below are tips to manage resistance and facilitate success. Coach an answer if the patient appears to draw a blank stare when asked how he might think and move his body differently. […] The treatment approach recommended above is not merely for heterosexual men. This author recently provided a successful 4-month treatment with a homosexual man who never had been able to orgasm with a partner.

• #56 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model – Perelman – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/11164/html

  For both primary and secondary DE (as soon as therapeutically possible) obtain an agreement from the patient to temporarily refrain from ejaculating alone. If he won’t stop, negotiate a reduction in his masturbatory ejaculatory frequency with a minimum commitment of no orgasm within 72 hours of his next partnered experience. […] Temporary cessation of masturbation (and/or alteration of both masturbation style and frequency) required by most men is difficult to accomplish. Below are tips to manage resistance and facilitate success. Coach an answer if the patient appears to draw a blank stare when asked how he might think and move his body differently. […] The treatment approach recommended above is not merely for heterosexual men. This author recently provided a successful 4-month treatment with a homosexual man who never had been able to orgasm with a partner.

• #57 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. […] Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. […] Encourage a man who continues to masturbate to alter style (switch hands) and to approximate the stimulation likely to be experienced with his partner. […] Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. […] Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. […] This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patients narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #58 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. […] Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. […] Encourage a man who continues to masturbate to alter style (switch hands) and to approximate the stimulation likely to be experienced with his partner. […] Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. […] Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. […] This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patients narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #59 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. […] Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. […] Encourage a man who continues to masturbate to alter style (switch hands) and to approximate the stimulation likely to be experienced with his partner. […] Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. […] Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. […] This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patients narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

• #60 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. […] 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. […] 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.

• #61 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. […] 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. […] 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.

• #62 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. […] 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. […] 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.

• #63 Therapy for Premature & Delayed Ejaculation | Toronto, Ontario

  https://newmoonpsychotherapy.ca/premature-and-delayed-ejaculation/

  Psychotherapy, or talk therapy, can be a valuable component of treatment for premature or delayed ejaculation. Psychotherapy that focuses on premature or delayed ejaculation is referred to as sex therapy. Here are some ways that sex therapy can help: […] A trained therapist can help you explore the emotional and psychological factors contributing to premature or delayed ejaculation. This process can provide valuable insights into the causes of your condition. […] Therapy equips you with effective coping strategies to manage anxiety, performance pressure, and relationship issues. You’ll learn relaxation techniques and ways to reframe negative thoughts. […] These exercises, guided by a therapist, help improve sexual awareness and enhance intimacy between partners, which can be beneficial for both premature and delayed ejaculation. The activities can be performed alone or with a partner. Therapy will involve processing the exercise and any physical, emotional, or cognitive (thoughts) difficulties that came up during the process.

• #64 Therapy for Premature & Delayed Ejaculation | Toronto, Ontario

  https://newmoonpsychotherapy.ca/premature-and-delayed-ejaculation/

  Strong communication is the foundation of a satisfying and fulfilling sex life. It can reduce anxiety and enhance sexual satisfaction. Sex therapy often involves teaching communication skills and addressing difficulties within a relationship. For this reason, it can be beneficial to involve a partner (if available) in the therapy process eg. Couple’s therapy. […] Sex therapy is not a replacement for medical and pharmacological intervention. However, research consistently shows that treatment outcomes are enhanced when combined with sex therapy. […] Recovery from Premature Ejaculation or Delayed Ejaculation is possible, and seeking help is a courageous first step. With the right support, including psychotherapy, you can regain control of your sexual health and enjoy a fulfilling and satisfying sex life once again. […] If you’re specifically interested in therapy for premature or delayed ejaculation, please tell us at this time so that we can connect you with a therapist trained in it.

• #65 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. […] 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. If delayed ejaculation happens primarily with your partner, they may suggest counseling for both of you. […] The U.S. Food and Drug Administration (FDA) hasn’t approved a drug treatment for delayed ejaculation. But some healthcare providers may prescribe medications on an off-label basis with some success. […] Kegel exercises help strengthen the muscles in your pelvic floor. Strengthening your pelvic floor may give you greater control over when you ejaculate. […] Talk to a healthcare provider as soon as you have problems ejaculating. If you have difficulty ejaculating with a partner, talking to a therapist can help.

• #66 The drug treatment of delayed ejaculation

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

  Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment. Drug treatment of DE includes many agents with varying degrees of success. Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] Here, we reviewed how DE is treated pharmacologically. We also highlighted specific settings where drugs could be introduced to medical practice.

• #67 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. […] 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. If delayed ejaculation happens primarily with your partner, they may suggest counseling for both of you. […] The U.S. Food and Drug Administration (FDA) hasn’t approved a drug treatment for delayed ejaculation. But some healthcare providers may prescribe medications on an off-label basis with some success. […] Kegel exercises help strengthen the muscles in your pelvic floor. Strengthening your pelvic floor may give you greater control over when you ejaculate. […] Talk to a healthcare provider as soon as you have problems ejaculating. If you have difficulty ejaculating with a partner, talking to a therapist can help.

• #68 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. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that successful drug treatment of DE is still in its infancy. 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. 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.

• #69 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. […] Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that 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. […] Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment.

• #70 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  The International Classification of Diseases (ICD)-11 defines DE as an inability to achieve ejaculation or an excessive or increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. […] Treatment plans are often multidisciplinary, involving urologists, primary care providers and mental health professionals to adequately address biopsychosocial factors. […] Testosterone replacement is indicated for men with testosterone deficiency in accordance with available guidelines. […] Psychosocial evaluation with a sex therapist is recommended for all patients. […] Exact rates of success are difficult to determine based on existing literature due to variability of therapy methods and lack of large-scale studies. […] Though there are no drugs approved by the U.S. Food and Drug Administration (FDA) at this time due to the absence of conclusive data, several pharmacological therapies show promise in treatment of DO including cabergoline, bupropion, oxytocin, and recently amphetamine/dextroamphetamine (AdderallTM). […] The existing literature provides insufficient evidence to recommend the use of these drugs in treatment of DO at this time.

• #71 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)

• #72 Delayed Ejaculation Causes, Diagnosis, Treatment, and Coping

  https://www.verywellhealth.com/delayed-ejaculation-3300047

  Delayed ejaculation (DE) is a medical condition in which a man has difficulty reaching an orgasm. DE can be treated with medications or other medical interventions. […] The treatment of delayed ejaculation depends on the underlying cause or causes of the dysfunction. Some of the techniques take time but can often improve sexual function and increase the speed by which you climax and ejaculate. […] If DE is caused by medication side effects, it sometimes helps to lower the dose or substitute the drug with another agent. While there are no FDA-approved drugs used to treat DE, there are medications healthcare providers will sometimes prescribe off-label if the problem is moderate to severe. These include: Cabergoline (Dostinex), a dopamine agonist; Buspirone, an anti-anxiety drug; Periactin (Cyproheptadine), an allergy medication; Symmetrel (Amantadine), a Parkinson’s disease medication.

• #73 The drug treatment of delayed ejaculation

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

  Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment. Drug treatment of DE includes many agents with varying degrees of success. Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] Here, we reviewed how DE is treated pharmacologically. We also highlighted specific settings where drugs could be introduced to medical practice.

• #74 Delayed Ejaculation Causes, Diagnosis, Treatment, and Coping

  https://www.verywellhealth.com/delayed-ejaculation-3300047

  Delayed ejaculation (DE) is a medical condition in which a man has difficulty reaching an orgasm. DE can be treated with medications or other medical interventions. […] The treatment of delayed ejaculation depends on the underlying cause or causes of the dysfunction. Some of the techniques take time but can often improve sexual function and increase the speed by which you climax and ejaculate. […] If DE is caused by medication side effects, it sometimes helps to lower the dose or substitute the drug with another agent. While there are no FDA-approved drugs used to treat DE, there are medications healthcare providers will sometimes prescribe off-label if the problem is moderate to severe. These include: Cabergoline (Dostinex), a dopamine agonist; Buspirone, an anti-anxiety drug; Periactin (Cyproheptadine), an allergy medication; Symmetrel (Amantadine), a Parkinson’s disease medication.

• #75 The drug treatment of delayed ejaculation

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

  Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment. Drug treatment of DE includes many agents with varying degrees of success. Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] Here, we reviewed how DE is treated pharmacologically. We also highlighted specific settings where drugs could be introduced to medical practice.

• #76 Delayed Ejaculation Causes, Diagnosis, Treatment, and Coping

  https://www.verywellhealth.com/delayed-ejaculation-3300047

  Delayed ejaculation (DE) is a medical condition in which a man has difficulty reaching an orgasm. DE can be treated with medications or other medical interventions. […] The treatment of delayed ejaculation depends on the underlying cause or causes of the dysfunction. Some of the techniques take time but can often improve sexual function and increase the speed by which you climax and ejaculate. […] If DE is caused by medication side effects, it sometimes helps to lower the dose or substitute the drug with another agent. While there are no FDA-approved drugs used to treat DE, there are medications healthcare providers will sometimes prescribe off-label if the problem is moderate to severe. These include: Cabergoline (Dostinex), a dopamine agonist; Buspirone, an anti-anxiety drug; Periactin (Cyproheptadine), an allergy medication; Symmetrel (Amantadine), a Parkinson’s disease medication.

• #77 Delayed Ejaculation Causes, Diagnosis, Treatment, and Coping

  https://www.verywellhealth.com/delayed-ejaculation-3300047

  Delayed ejaculation (DE) is a medical condition in which a man has difficulty reaching an orgasm. DE can be treated with medications or other medical interventions. […] The treatment of delayed ejaculation depends on the underlying cause or causes of the dysfunction. Some of the techniques take time but can often improve sexual function and increase the speed by which you climax and ejaculate. […] If DE is caused by medication side effects, it sometimes helps to lower the dose or substitute the drug with another agent. While there are no FDA-approved drugs used to treat DE, there are medications healthcare providers will sometimes prescribe off-label if the problem is moderate to severe. These include: Cabergoline (Dostinex), a dopamine agonist; Buspirone, an anti-anxiety drug; Periactin (Cyproheptadine), an allergy medication; Symmetrel (Amantadine), a Parkinson’s disease medication.

• #78 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/disorders-of-ejaculation

  The American Psychiatric Association defines delayed ejaculation (DE) as requiring one of two symptoms: marked delay, infrequency or absence of ejaculation on 75-100% of occasions that persists for at least 6 months and causes personal distress. […] The aetiology of DE can be psychological, organic (e.g., incomplete spinal cord lesion or iatrogenic penile nerve damage), or pharmacological (e.g., SSRIs, antihypertensive drugs, or antipsychotics). […] Several pharmacological agents, including cabergoline, bupropion, alpha-1-adrenergic agonists (pseudoephedrine, midodrine, imipramine and ephedrine), buspirone, oxytocin, testosterone, bethanechol, yohimbine, amantadine, cyproheptadine and apomorphine have been used to treat DE with varied success. Unfortunately, there is no FDA or EMA-approved medications to treat DE, as most of the cited research is based on case-cohort studies that were not randomised, blinded, or placebo-controlled.

• #79 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment for delayed ejaculation is dependent on what is causing the condition. […] Research from 2016 indicates some limited efficacy of the following medications to treat delayed ejaculation: Testosterone, Cabergoline, Amantadine, Imipramine, Ephedrine, Buspirone, Oxytocin, Yohimbine, Pseudoephedrine, Cyproheptadine, Midodrine, Bupropion, Bethanechol. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation.

• #80 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment for delayed ejaculation is dependent on what is causing the condition. […] Research from 2016 indicates some limited efficacy of the following medications to treat delayed ejaculation: Testosterone, Cabergoline, Amantadine, Imipramine, Ephedrine, Buspirone, Oxytocin, Yohimbine, Pseudoephedrine, Cyproheptadine, Midodrine, Bupropion, Bethanechol. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation.

• #81 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #82 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment for delayed ejaculation is dependent on what is causing the condition. […] Research from 2016 indicates some limited efficacy of the following medications to treat delayed ejaculation: Testosterone, Cabergoline, Amantadine, Imipramine, Ephedrine, Buspirone, Oxytocin, Yohimbine, Pseudoephedrine, Cyproheptadine, Midodrine, Bupropion, Bethanechol. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation.

• #83 Delayed Ejaculation | San Diego,CA

  https://www.sdsm.info/male-issues/delayed-ejaculation

  A new report shows that yohimbine hydrochloride taken on an empty stomach at doses of 20 40 mg one to two hours prior to sexual activity has the ability to restore ejaculation capabilities in some men. […] For men with these symptoms, aids to facilitate maintenance of the erection allow the man the time necessary, despite fatigue, to achieve orgasm and satisfaction.

• #84 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment for delayed ejaculation is dependent on what is causing the condition. […] Research from 2016 indicates some limited efficacy of the following medications to treat delayed ejaculation: Testosterone, Cabergoline, Amantadine, Imipramine, Ephedrine, Buspirone, Oxytocin, Yohimbine, Pseudoephedrine, Cyproheptadine, Midodrine, Bupropion, Bethanechol. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation.

• #85 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment for delayed ejaculation is dependent on what is causing the condition. […] Research from 2016 indicates some limited efficacy of the following medications to treat delayed ejaculation: Testosterone, Cabergoline, Amantadine, Imipramine, Ephedrine, Buspirone, Oxytocin, Yohimbine, Pseudoephedrine, Cyproheptadine, Midodrine, Bupropion, Bethanechol. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation.

• #86 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment for delayed ejaculation is dependent on what is causing the condition. […] Research from 2016 indicates some limited efficacy of the following medications to treat delayed ejaculation: Testosterone, Cabergoline, Amantadine, Imipramine, Ephedrine, Buspirone, Oxytocin, Yohimbine, Pseudoephedrine, Cyproheptadine, Midodrine, Bupropion, Bethanechol. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation.

• #87 Delayed Ejaculation – Men’s Clinic – The Men’s Clinic at UCLA | UCLA Health

  https://www.uclahealth.org/medical-services/urology/mens-clinic-ucla/sexual-health/delayed-ejaculation

  With our board-certified urologists at The Mens Clinic at UCLA, you can be assured you are getting an experienced physician performing your delayed ejaculation evaluation and treatment. […] The opposite of premature or rapid ejaculation is delayed ejaculation. This can be as, if not more, frustrating than its opposite. Delayed ejaculation is the inability of a man to achieve climax within a reasonable amount of time. […] Treatment for delayed ejaculation depends on its cause. For men with nerve injuries, sometimes they respond to medical vibrators placed at the tip of the penis to retrain the nerves to fire more rapidly. […] For men with hormone imbalances, the doctor needs to run some laboratory tests, specifically testosterone and prolactin levels to see if there’s an imbalance. […] If a man has diminished penile hardness, he may respond to oral impotence drugs like sildenafil or tadalafil to increase penile engorgement and sensitivity.

• #88 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #89 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #90 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #91 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] In the case of antidepressant-induced inhibited male orgasm, consideration may be given to switching to bupropion (also used as adjunctive therapy), mirtazapine, nefazodone, or vilazodone, which have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) do. […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD).

• #92 Delayed Ejaculation | San Diego,CA

  https://www.sdsm.info/male-issues/delayed-ejaculation

  An orgasm is a pleasurable feeling (a cerebral event) usually associated with emission and/or ejaculation. In delayed ejaculation, there is an undue delay in reaching ejaculation during sexual activity. Delayed ejaculation is a particularly troublesome sexual problem. […] There are several strategies available for men with delayed ejaculation. The first step is to identify the cause of the ejaculatory problem in order to treat it. The next step is to aid in maintaining the erection until orgasm can be achieved. […] Should low androgens be identified as the problem, testosterone administration would be indicated, assuming there are no contraindications such as prostate cancer. […] If the delayed ejaculation is a result of surgery in the sympathetic nerve chain, studies have shown that administration of adrenaline-like drugs can facilitate ejaculation.

• #93 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. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that successful drug treatment of DE is still in its infancy. 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. 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.

• #94 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. […] Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that 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. […] Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment.

• #95 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. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that successful drug treatment of DE is still in its infancy. 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. 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.

• #96 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] 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 to the patients.

• #97 The drug treatment of delayed ejaculation

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

  Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment. Drug treatment of DE includes many agents with varying degrees of success. Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] Here, we reviewed how DE is treated pharmacologically. We also highlighted specific settings where drugs could be introduced to medical practice.

• #98 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] 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 to the patients.

• #99 Delayed Ejaculation – Men’s Clinic – The Men’s Clinic at UCLA | UCLA Health

  https://www.uclahealth.org/medical-services/urology/mens-clinic-ucla/sexual-health/delayed-ejaculation

  With our board-certified urologists at The Mens Clinic at UCLA, you can be assured you are getting an experienced physician performing your delayed ejaculation evaluation and treatment. […] The opposite of premature or rapid ejaculation is delayed ejaculation. This can be as, if not more, frustrating than its opposite. Delayed ejaculation is the inability of a man to achieve climax within a reasonable amount of time. […] Treatment for delayed ejaculation depends on its cause. For men with nerve injuries, sometimes they respond to medical vibrators placed at the tip of the penis to retrain the nerves to fire more rapidly. […] For men with hormone imbalances, the doctor needs to run some laboratory tests, specifically testosterone and prolactin levels to see if there’s an imbalance. […] If a man has diminished penile hardness, he may respond to oral impotence drugs like sildenafil or tadalafil to increase penile engorgement and sensitivity.

• #100 SMSNA – Delayed Orgasm and Delayed Ejaculation

  https://www.smsna.org/patients/conditions/delayed-ejaculation

  Men with low testosterone may find improvement with testosterone replacement. […] Penile vibratory stimulation (using a vibrator) may also be useful for some men. […] For heterosexual couples desiring pregnancy in which the man is unable to ejaculate inside the vagina, couples can achieve pregnancy through several measures.

• #101 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. […] 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. If delayed ejaculation happens primarily with your partner, they may suggest counseling for both of you. […] The U.S. Food and Drug Administration (FDA) hasn’t approved a drug treatment for delayed ejaculation. But some healthcare providers may prescribe medications on an off-label basis with some success. […] Kegel exercises help strengthen the muscles in your pelvic floor. Strengthening your pelvic floor may give you greater control over when you ejaculate. […] Talk to a healthcare provider as soon as you have problems ejaculating. If you have difficulty ejaculating with a partner, talking to a therapist can help.

• #102 Delayed Ejaculation Treatment Clinic Toronto

  https://precisionclinictoronto.ca/delayed-ejaculation/

  These categories help in diagnosing an underlying cause and determining what might be the most effective treatment. A better erection can help make the overall treatment for delayed ejaculation more effective. We can help. (416) 792-1007 Book a consult. […] DE treatment options include Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. […] Penile vacuum therapy and penile traction techniques may provide some benefit to treatment.

• #103 Kelowna Delayed Ejaculation Treatment – Precision Sexual Health Clinic

  https://precisionclinickelowna.ca/delayed-ejaculation/

  DE treatment options include Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. Sometimes, adding medication might help. There aren’t any drugs that have been specifically approved for the treatment of delayed ejaculation. […] Penile vacuum therapy and penile traction techniques may provide some benefit to treatment. We may employ the Restorex Traction Device and/or a vacuum erection device (VED).

• #104 Delayed Ejaculation Treatment – Buenafe Clinic – Winnipeg, MB

  https://buenafeclinic.com/mens-sexual-health/delayed-ejaculation/

  Treatment is important because delayed ejaculation can cause diminished sexual pleasure for you and your partner, stress or anxiety about sexual performance, marital or relationship problems due to an unsatisfactory sex life, and inability to get your partner pregnant (male infertility). […] DE treatment options at our Winnipeg clinic include: Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies such as Oral Medication and Penile Vacuum Therapy. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. […] Sometimes, adding medication might help. […] There aren’t any drugs that have been specifically approved for the treatment of delayed ejaculation.

• #105 Delayed Ejaculation Treatment – Precision Sexual Health Clinic for Men

  https://precisioncliniclondon.ca/delayed-ejaculation/

  These categories help in diagnosing an underlying cause and determining what might be the most effective treatment. A better erection can help make the overall treatment for delayed ejaculation more effective. […] DE treatment options include Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. […] Penile vacuum therapy and penile traction techniques may provide some benefit to treatment.

• #106 Delayed Ejaculation Treatment – Buenafe Clinic – Winnipeg, MB

  https://buenafeclinic.com/mens-sexual-health/delayed-ejaculation/

  Treatment is important because delayed ejaculation can cause diminished sexual pleasure for you and your partner, stress or anxiety about sexual performance, marital or relationship problems due to an unsatisfactory sex life, and inability to get your partner pregnant (male infertility). […] DE treatment options at our Winnipeg clinic include: Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies such as Oral Medication and Penile Vacuum Therapy. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. […] Sometimes, adding medication might help. […] There aren’t any drugs that have been specifically approved for the treatment of delayed ejaculation.

• #107 Delayed Ejaculation Treatment – Precision Sexual Health Clinic for Men

  https://precisioncliniclondon.ca/delayed-ejaculation/

  These categories help in diagnosing an underlying cause and determining what might be the most effective treatment. A better erection can help make the overall treatment for delayed ejaculation more effective. […] DE treatment options include Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. […] Penile vacuum therapy and penile traction techniques may provide some benefit to treatment.

• #108 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  The International Classification of Diseases (ICD)-11 defines DE as an inability to achieve ejaculation or an excessive or increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. […] Treatment plans are often multidisciplinary, involving urologists, primary care providers and mental health professionals to adequately address biopsychosocial factors. […] Testosterone replacement is indicated for men with testosterone deficiency in accordance with available guidelines. […] Psychosocial evaluation with a sex therapist is recommended for all patients. […] Exact rates of success are difficult to determine based on existing literature due to variability of therapy methods and lack of large-scale studies. […] Though there are no drugs approved by the U.S. Food and Drug Administration (FDA) at this time due to the absence of conclusive data, several pharmacological therapies show promise in treatment of DO including cabergoline, bupropion, oxytocin, and recently amphetamine/dextroamphetamine (AdderallTM). […] The existing literature provides insufficient evidence to recommend the use of these drugs in treatment of DO at this time.

• #109 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  A safe effective medication for DE does not yet exist. […] However, there are still numerous techniques, which can be combined to treat DE including and not limited to sex education, cognitive-behavioral therapy, mindfulness, psychodynamic exploration of underlying conflicts, and/or couples therapy. […] Help the man identify behaviors that enhance his ability to be immersed in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner. […] For both primary and secondary DE (as soon as therapeutically possible) obtain an agreement from the patient to temporarily refrain from ejaculating alone. […] Temporary cessation of masturbation (and/or alteration of both masturbation style and frequency) required by most men is difficult to accomplish. […] The treatment approach recommended above is not merely for heterosexual men.

• #110 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/

  For men, erectile dysfunction and ejaculatory problems are the most common sexual difficulties. […] Typically, ejaculatory disorders fall into two categories. These are: delayed ejaculation and early ejaculation. This column will explore some of the psychological factors and treatment options related to these two distinct male dysfunctions. […] In the vast majority of cases, the most effective therapeutic approach for ejaculatory dysfunction is a combination of biologic and psychologic therapy. […] Regardless of the psychological issues, a good medical or urologic work-up is always encouraged before embarking on a behavioral treatment program. […] 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.

• #111 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] 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 to the patients.

• #112 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. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that successful drug treatment of DE is still in its infancy. 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. 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.

• #113 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] 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 to the patients.

• #114 Delayed Ejaculation Treatment – Buenafe Clinic – Winnipeg, MB

  https://buenafeclinic.com/mens-sexual-health/delayed-ejaculation/

  Treatment is important because delayed ejaculation can cause diminished sexual pleasure for you and your partner, stress or anxiety about sexual performance, marital or relationship problems due to an unsatisfactory sex life, and inability to get your partner pregnant (male infertility). […] DE treatment options at our Winnipeg clinic include: Shockwave Therapy, Injection Therapy, Sex Therapy, and Additional Therapies such as Oral Medication and Penile Vacuum Therapy. […] If you’re taking medication that might be causing delayed ejaculation, reducing the dose of a medication or switching medications might fix the problem. […] Sometimes, adding medication might help. […] There aren’t any drugs that have been specifically approved for the treatment of delayed ejaculation.

• #115 Delayed Ejaculation Treatment – Precision Sexual Health Clinic for Men

  https://precisioncliniclondon.ca/delayed-ejaculation/

  Delayed ejaculation (DE) is a condition where it takes an extended period of sexual stimulation for men to reach sexual climax and ejaculate. Some men with DE are unable to ejaculate at all. […] Possible causes of DE include certain chronic health conditions, surgeries and medications, and treatment for it depends on the underlying cause. […] A physical exam and medical history are needed to be able to recommend treatment for delayed ejaculation, and Precision clinic is a good place to start. […] Delayed ejaculation is a potentially treatable condition at our London mens sexual health centre. […] Treatment is important because delayed ejaculation can cause diminished sexual pleasure for you and your partner, stress or anxiety about sexual performance, marital or relationship problems due to an unsatisfactory sex life, and inability to get your partner pregnant (male infertility).

• #116 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  The good success rates reported by sex therapists when treating DE should only be viewed as exploratory. […] There is no question that a drug treatment for men with severe DE would be beneficial (regardless of the degree of psychosocial-behavioral and cultural factor complications) although patients would benefit even more from medical treatment augmented by counseling.

• #117 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model – Perelman – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/11164/html

  Success rates for treatment are greater than 75%. Approximately 20% of these men will experience an intravaginal ejaculation in less than 6 weeks of employing these techniques. […] DE is an academic stepchild when compared to the vast number of PE studies in the sexual medicine literature. A major source of that disparity is related to no regulatory agency anywhere in the world having yet approved a drug for DE. There is no question that a drug treatment for men with severe DE would be beneficial.

• #118 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. […] Delayed ejaculation can have psychological or physical causes. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. […] Therapy often involves a series of „homework” assignments. […] 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. […] Treatment commonly requires about 12 to 18 sessions. […] 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. […] To reduce the pressure, focus on the pleasure of the moment.

• #119 Delayed ejaculation – UF Health

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

  Delayed ejaculation can have psychological or physical causes. […] 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. […] 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 medicines are causing the problem, your provider may recommend switching or stopping the medicine, if possible. A full recovery is possible if this can be done.

• #120 Delayed ejaculation | Lima Memorial Health System

  https://www.limamemorial.org/m/health-library/HIE%20Multimedia-TextOnly/1/001954

  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 medicines are causing the problem, your provider may recommend switching or stopping the medicine, if possible. A full recovery is possible if this can be done.

• #121 Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-023-00692-7

  The International Classification of Diseases (ICD)-11 defines DE as an inability to achieve ejaculation or an excessive or increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. […] Treatment plans are often multidisciplinary, involving urologists, primary care providers and mental health professionals to adequately address biopsychosocial factors. […] Testosterone replacement is indicated for men with testosterone deficiency in accordance with available guidelines. […] Psychosocial evaluation with a sex therapist is recommended for all patients. […] Exact rates of success are difficult to determine based on existing literature due to variability of therapy methods and lack of large-scale studies. […] Though there are no drugs approved by the U.S. Food and Drug Administration (FDA) at this time due to the absence of conclusive data, several pharmacological therapies show promise in treatment of DO including cabergoline, bupropion, oxytocin, and recently amphetamine/dextroamphetamine (AdderallTM). […] The existing literature provides insufficient evidence to recommend the use of these drugs in treatment of DO at this time.

• #122 Delayed ejaculation: Causes, treatment, and outlook

  https://www.medicalnewstoday.com/articles/284679

  Some medications may help improve the symptoms of delayed ejaculation when used off-label, but none have been specifically approved to treat it yet. […] Successful treatment of delayed ejaculation depends on the cause of the delayed ejaculation and the type of treatment. Each individual will have different needs and outcomes.

• #123 Delayed ejaculation: Causes, treatment, and outlook

  https://www.medicalnewstoday.com/articles/284679

  Some medications may help improve the symptoms of delayed ejaculation when used off-label, but none have been specifically approved to treat it yet. […] Successful treatment of delayed ejaculation depends on the cause of the delayed ejaculation and the type of treatment. Each individual will have different needs and outcomes.

• #124 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. […] Delayed ejaculation can have psychological or physical causes. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. […] Therapy often involves a series of „homework” assignments. […] 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. […] Treatment commonly requires about 12 to 18 sessions. […] 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. […] To reduce the pressure, focus on the pleasure of the moment.

• #125 Delayed ejaculation – UF Health

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

  Delayed ejaculation can have psychological or physical causes. […] 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. […] 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 medicines are causing the problem, your provider may recommend switching or stopping the medicine, if possible. A full recovery is possible if this can be done.

• #126 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. […] Delayed ejaculation can have psychological or physical causes. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. […] Therapy often involves a series of „homework” assignments. […] 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. […] Treatment commonly requires about 12 to 18 sessions. […] 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. […] To reduce the pressure, focus on the pleasure of the moment.

• #127 Delayed ejaculation – UF Health

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

  Delayed ejaculation can have psychological or physical causes. […] 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. […] 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 medicines are causing the problem, your provider may recommend switching or stopping the medicine, if possible. A full recovery is possible if this can be done.

• #128 Treatment of Delayed Ejaculation | Neupsy Key

  https://neupsykey.com/treatment-of-delayed-ejaculation/

  Based on the definition and etiology of DE; workup and treatment are geared towards the underlying issues. An example of this focused evaluation and treatment would be looking into a patients medications and evaluating the quality of his sexual relationship with his partner along with evaluation of the partners health especially if the patient presented with secondary DE. […] A recent study by Teloken and Mulhall shows the importance and relative success with goal directed medical therapy targeted towards etiologies of DE. Rates of men with secondary DE from SSRIs were 34%, of which 82% recovered normal ejaculations after cessation of the drug and 34% improved with medication adjustments. […] Of note, when a psychogenic cause is found, sexual therapy traditionally has had a much higher success rate than treatment of non-psychogenic causes.

• #129 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. […] 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. If delayed ejaculation happens primarily with your partner, they may suggest counseling for both of you. […] The U.S. Food and Drug Administration (FDA) hasn’t approved a drug treatment for delayed ejaculation. But some healthcare providers may prescribe medications on an off-label basis with some success. […] Kegel exercises help strengthen the muscles in your pelvic floor. Strengthening your pelvic floor may give you greater control over when you ejaculate. […] Talk to a healthcare provider as soon as you have problems ejaculating. If you have difficulty ejaculating with a partner, talking to a therapist can help.

• #130 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.

• #131 Delayed Ejaculation

  https://www.sexualhealthaustralia.com.au/delayed-ejaculation.html

  Delayed ejaculation is difficult to treat. […] Treatment may include: […] Sex Therapy/Counselling for delayed ejaculation […] We have experienced sex therapists and relationship counsellors who offer counselling and support for men with delayed ejaculation and their partners. […] Sex therapy for delayed ejaculation may include some of the following:

• #132 The drug treatment of delayed ejaculation

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

  Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment. Drug treatment of DE includes many agents with varying degrees of success. Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] Here, we reviewed how DE is treated pharmacologically. We also highlighted specific settings where drugs could be introduced to medical practice.

• #133 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. […] Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that 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. […] Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment.

• #134 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. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that successful drug treatment of DE is still in its infancy. 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. 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.

• #135 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. […] Here we reviewed how DE is treated pharmacologically. […] There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. […] Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. […] It is concluded that 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. […] Treatment should be etiology specific, and may include patient and their partner psychosexual therapy, drug therapy or integrated treatment.

• #136 Premature ejaculation treatment – ROC Clinic

  https://rocclinic.com/en/premature-ejaculation/treatment/

  It is essential to identify the point of orgasmic no return, a moment that if we go beyond, we will not be able to stop the triggering of orgasm and ejaculation. […] In our experience the best treatment is multimodal, associating different strategies in a unified treatment. […] Success depends largely on the commitment of the man with premature ejaculation and the involvement of the team of health professionals who are necessary to help the person (urologist, psychologist, physiotherapist). […] Finally, a brief mention should be made of surgical treatments. There is much debate about their usefulness. […] Other treatments, such as dorsal penile nerve neurotomy, are considered experimental. Recently, radiofrequency neuromodulation has achieved promising results.

• #137 Premature ejaculation treatment – ROC Clinic

  https://rocclinic.com/en/premature-ejaculation/treatment/

  It is essential to identify the point of orgasmic no return, a moment that if we go beyond, we will not be able to stop the triggering of orgasm and ejaculation. […] In our experience the best treatment is multimodal, associating different strategies in a unified treatment. […] Success depends largely on the commitment of the man with premature ejaculation and the involvement of the team of health professionals who are necessary to help the person (urologist, psychologist, physiotherapist). […] Finally, a brief mention should be made of surgical treatments. There is much debate about their usefulness. […] Other treatments, such as dorsal penile nerve neurotomy, are considered experimental. Recently, radiofrequency neuromodulation has achieved promising results.

• #138 Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5001992/

  The good success rates reported by sex therapists when treating DE should only be viewed as exploratory. […] There is no question that a drug treatment for men with severe DE would be beneficial (regardless of the degree of psychosocial-behavioral and cultural factor complications) although patients would benefit even more from medical treatment augmented by counseling.

• #139 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] 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 to the patients.

• #140 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  Currently, no drug has been approved by FDA for DE. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] 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 to the patients.

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