Premature ejaculation (PE) is the most common type of sexual dysfunction in males, affecting up to 30 percent of the male population. It occurs when a man reaches orgasm, but ejaculates too quickly with little or no control. PE can come with negative thoughts such as, “I’m an inadequate lover,” or “I’m coming too fast!” It can lead to feelings of distress, shame and frustration for both partners involved, which can lead to secondary symptoms, such as anxiety and depression. This can create a vicious cycle where the fear of not lasting long enough contributes to the problem. Other possible factors include: lack of sexual experience, sexual abuse, poor body image, depression, or sex-related shame that could subconsciously cause someone to rush through the process.
Delayed ejaculation, also called impaired ejaculation, affects about 8 percent of men. It’s not commonly recognized by many in the medical field, as it’s the least studied and least understood of male sexual dysfunctions. If a man takes longer than 30 minutes to ejaculate while performing penetrative sex, it is considered to be impaired ejaculation. Impaired ejaculation can be a source of infertility, blocked sexual pleasure, and can disrupt relationship intimacy. Most men are unaware of impaired ejaculation and other normal changes associated with aging. Erections may be less firm, and it may take longer to ejaculate. Testosterone levels may also decrease, which can affect energy, strength and sexual function.
The causes of PE and impaired ejaculation can be psychological, physical, or both. Medication for premature ejaculation can be the most effective when paired with a psychosexual skills program. This method is beneficial when integrated with the couple’s sexual style of intimacy. If PE is not addressed, it can set unrealistic expectations in the bedroom for both partners.
In the case of delayed ejaculation, there are several psychological causes that can be explored in couple’s therapy, but being unable to climax can become a more common problem with age, and it is often misdiagnosed as an erection problem. Generally speaking, the psychological issues related to PE and impaired ejaculation most often fall under the anxiety category. Anxiety is usually a physical manifestation of fears or emotions that are avoided and unresolved. Therapy is the perfect place to resolve them, and if the cause turns out to be physical, a referral to a specialist can be given.