Significant progress has been made in recent years in breaking the taboo on male sexual health problems.
But while most people are aware of premature ejaculation and erectile dysfunction, doctors say there is another common problem that millions of men suffer in silence.
Delayed ejaculation (DE) – commonly defined as taking at least 30 minutes to achieve orgasm, either through masturbation or sex with a partner – affects an estimated four percent of the male population.
According to Dr. Juza Chena urologist from Tel-Aviv University: ‘Men with DE report less coital activity, higher levels of relationship problems, sexual dissatisfaction, lower arousal, anxiety about their sexual performance and general health problems compared to sexually functional men.’
An estimated four percent of men experience delayed ejaculation, which can put a significant strain on their relationships
Delayed ejaculation has been called the least studied of all male sexual dysfunctions by sexual health experts.
Estimates of the number of men suffering from the poorly understood condition range from around four percent to as much as 10 percent worldwide.
There are no set criteria for judging a man complaining of DE, because everyone’s idea of a “normal” amount of time to ejaculation is different. But trying to reach orgasm for 25 to 30 minutes is typically the threshold psychiatrists use to measure and diagnose DE.
Despite the minimal research attention the condition receives, it can cause significant damage to a man’s self-esteem and the health of his relationship with a partner.
Dr. Chen wrote in 2016, “The psychological and relationship impact of DE is often significant because it typically results in a lack of sexual satisfaction for both the man and his partner.”
In the meantime, researchers in the US and the Netherlands reported that same year: ‘Like men with other sexual dysfunctions, men with (delayed ejaculation) showed lower relationship satisfaction than controls and increased levels of performance anxiety in sexual situations, indicating a significant amount of distress or anxiety from their condition.’
Based on relatively little scientific research into the causes of the condition, sexual health experts believe this may have roots in childhood trauma and attitudes of shame and fear around sex.
Reaching orgasm is typically the end goal for men during a sexual encounter, BUT men with signs of a delayed ejaculation problem may struggle to reach the finish line.
Erectile dysfunction (ED) is much more common in the realm of sexual dysfunction, with approximately 18 percent of men aged 20 and older reporting persistent inability to achieve an erection.
Some men are born with DE, but in some cases it develops at some point in a man’s life, and the condition can last for years.
The risk of DE increases with age, similar to erectile dysfunction, due to the many age-related changes the body undergoes as we age, such as naturally declining testosterone levels, as well as weakened pelvic muscles and deterioration of the nerve function that helps the brain. communicate with other systems in the body that lead to an erection.
Testosterone levels typically peak around age 20 and slowly decline throughout adulthood.
At their highest, testosterone levels should be between 300 and 1,200 ng/dL. Once men reach their mid-30s, testosterone levels begin to decline by at least one percent per year.
There is also increasing evidence that having type 1 diabetes increases the risk of ejaculation problems in men.
Mental problems, especially anxiety, are a major cause of delayed ejaculation. In a 2023 study published in the Journal of Sexual Medicine, more than 3,000 men were asked what they thought was the cause of their DE.
Was at the top of the list general anxiety in 45 percent of men claiming this as the cause, followed by 34 percent who attributed it to anxiety specifically about sexual performance, followed closely by 30 percent of men who blamed it on inadequate penile stimulation.
The report’s authors said their results confirmed previous assumptions about possible causes of DE, but expected anxiety to play such a large role.
Northeastern states such as Maine, Vermont and New Hampshire have relatively high average ages. ED tends to be more common in older men
They said: ‘Specifically, fear and negative emotions – whether gender-specific or more general distress – received the strongest support from respondents.
‘The link between anxiety and sexual performance problems has long been known, but we were surprised that it took such precedence in the list of reasons for DE symptoms.’
Often, treating delayed ejaculation requires the help of a mental health professional to address the cause.
This could result in a prescription for a selective serotonin reuptake inhibitor, SSRI, the gold standard treatment for depression and anxiety.
However, in something that seems like a chicken-and-egg scenario, men take antidepressant medications It also seems more likely that you are living with DE.
A 2009 report in the Journal of Sexual Medicine estimated SSRI users had a seven times higher risk of delayed ejaculation compared to non-users.
There are also numerous possible physical causes, such as injury to the pelvic nerves that control orgasm, hormone-related conditions such as hypothyroidism, previous prostate surgery, or a phenomenon called retrograde ejaculation, in which semen travels backward into the bladder instead of out. of the penis.
In cases where doctors suspect low T levels, they do so may choose to administer testosterone to address declining T levels as a possible cause for the condition.
Doctors can also administer oxytocin, a hormone released when a pregnant woman goes into labor.
Oxytocin is abundant during sexual arousal and can enhance an already pleasurable experience.
It is also known as the ‘love hormone’, which plays a crucial role in connecting and feeling close to another person.
The taboo surrounding the issue of men’s sexual health has led to relatively little public awareness about issues of sexual dysfunction.
But in recent years the stigma has been disappearing as more and more men feel empowered to raise the subject with their GPs.
This has coincided with the rapid rise of virtual prescribing services that allow men to get prescriptions for medications to treat erectile dysfunction, such as Viagra and Cialis, as well as male pattern baldness remedies that can arrive on their doorstep in just a few days. only $10 per month.