Delayed ejaculation, also called impaired ejaculation, may be temporary or permanent, persist from the time a man reaches sexual maturity, or be acquired later on in life. It’s normal for a man to occasionally experience delayed ejaculation, but when it happens regularly or is causing issues in a relationship, it can be a problem.

“Premature ejaculation is very fast: ejaculating before you want it,” says Dr. Stacy Elliott, Chair of the Canadian Male Sexual Health Council and a Sexual Medicine Physician active in The Men’s Health Initiative of BC. “Delayed ejaculation is the opposite, where you can’t ejaculate when you want it. It’s defined by going on for quite a long time with your sexual activity, and you may or may not even reach orgasm.”

Delayed ejaculation is less common than premature ejaculation, and is more difficult to manage than premature ejaculation. “We usually see it in men who are older, or men who have had some sort of neurological injury,” says Dr. Elliott.

Physical causes of Delayed Ejaculation include:

• Thyroid problems
• Prostate infection
• Spinal cord injury
• Prostate surgery
• Injury to the pelvic nerves

Certain medications and substances can cause delayed ejaculation, such as anti-depressants, anti-psychotics, alcohol and illegal drugs.

Psychological causes of Delayed Ejaculation include:

• Depression or anxiety
• Stress
• Relationship problems
• Fatigue

One reason for delayed ejaculation may be sexual disinterest. “Is he in a relationship that he enjoys, is he attracted to his partner? A man may not have a sexual drive, and doesn’t see the world in a sexual way anymore,” says Dr. Elliott. “Delayed ejaculation can be a very complicated thing to assess, and a man needs someone who’s capable of looking at both the medical and psychological end of it.”

If medical reasons for delayed ejaculation are ruled out, a man may be referred to a sex therapist. Medical and psychological treatment for delayed ejaculation can be very effective, but a man must be willing to work with healthcare professionals and his partner to resolve the issue.