Delayed Ejaculation

Physical causes may account for DE, as any procedure or disease that disrupts the nervous systems path to the genitals (spinal cord injury, multiple sclerosis, pelvic‐region surgery, severe diabetes, alcoholism, etc.) has the potential to interfere with ejaculation and orgasm. It is frequently useful for a doctor to conduct a physical examination and medical history that may identify problems (such as reversible urethral, prostatic, epididymal, and testicular infections) as well as hormonal (androgen, etc.) contributory factors. A number of drugs may cause DE. Common culprits include drugs for high blood pressure, antidepressants, antipsychotic drugs, and some drugs that are used to treat prostate growth or baldness. Decreased sensation of the penis (often associated with aging) may also be a factor. Finally, there is increasing evidence that some men have natural variation in their ejaculation latency (how long they last during sex) and this may lead to DE‐like problems for some couples.