A very common problem among young men is premature ejaculation or reaching orgasm too soon. In older men, delayed ejaculation becomes an issue of major concern where men find it difficult or impossible to ejaculate and experience orgasm during sexual encounters.
This causes relationship distress and anxiety for the man but also impacts the partner as well. While some partners may enjoy the extended intercourse, especially if they experience premature ejaculation when the man was younger, it is common for the partner to blame themselves that they are no longer attractive or may even be suspicious that that the man is having another partner or an affair.
The causes of delayed ejaculation includes anything that disrupts the nervous system path to the genitals such as might occur with multiple sclerosis, spinal cord injury, diabetes mellitus, alcoholism. One of the most common causes is older men is a surgical procedure in the pelvis such as prostate gland surgery for prostate cancer, bladder cancer, or colon cancer. In these surgical procedures there can be injury to the nerves that supply the penis and result in decreased sensation of penis. There are numerous medications that can contribute to delayed ejaculation. Some of the culprits are medications for treating high blood pressure, antidepressants, antipsychotic drugs, some drugs used to treat enlarged prostate gland. Finally, aging results in decreased sensation to the penis and as a result more genital stimulation is required to achieve an orgasm.
The diagnosis is made with a careful sexual history. The doctor will ask about the man’s attractiveness of his partner, whether the man uses fantasy during intimacy, and also the masturbation patterns such as the frequency and technique of masturbation.
At the present time there is no FDA approved drug used to treat delayed ejaculation. Effective techniques include behavioral therapy such as temporarily suspend masturbation and by limit orgasm to sexual encounters. In men who have had previous pelvic surgery, increased sexual stimulation such as using vibrators, or erotic videos have often proved helpful. For most men with delayed ejaculation, treatment is usually successful.
Bottom Line: Delayed ejaculation is a common problem affecting millions of older men. The diagnosis is easily made and most men can be helped with behavioral therapy or with added genital stimulation
