A long and overlasting love

Dear Dr G,

I am a 27-year-old-man who is in an active sexual relationship.

Prior to this relationship, I was not very sexually experienced.

However, I am now having difficulty achieving climax during sex and it takes more than half an hour to achieve it.

Occasionally, I am unable to reach climax but it takes me around 10 minutes when I masturbate.

Admittedly, I used to masturbate a lot and that could be the cause of my problems.

Don't get me wrong, I am very proud of the prolonged sex and my girlfriend is mostly happy. However, it is exhausting for both of us and brings about frustration, even occasional pain.

Sometimes, I even lose my stamina and the erection if the sex goes beyond 30 minutes.

How long does normal sex last and when it is considered abnormal?

Am I suffering from delayed ejaculation and is there a treatment for this?

Please Help.

Dallying David

Delayed ejaculation is also known as retarded or impaired ejaculation. This is a well-documented condition characterised by extended sexual stimulation before a man ejaculates. This can also involve the reduction volume, force, and intensity of ejaculation.

On average, a man will last four to eight minutes from the time of penetration till the point of ejaculation. Men with delayed ejaculation often need more than 30 minutes of sexual stimulation to reach climax. Occasionally some may even encounter anejaculation due to exhaustion or a complete inability to do so.

It is natural for men to experience occasional delayed ejaculation due to stress and anxiety. This presents itself as a form of sexual dysfunction when it bothers the sufferers or affects sexual partners adversely.

Delayed ejaculation can be classified as diminished ejaculatory disorder (DED), which is a subset of male orgasmic disorder (MOD). This condition can be lifelong or acquired, according to its time of onset. Some sexual health specialists will further categorise the disorder into generalised or situational – with the latter only occurring with certain sexual partners, positions, or circumstances.

In one survey, 3% of men reported being unable to achieve orgasm over two months of regular sexual encounters.

The causes of delayed ejaculation are predominantly unknown but can be associated with biogenic and psychogenic origins. Depression, anxiety and stress can often be linked to the condition, as well as other medical conditions such as diabetic neuropathy, low testosterone or strokes.

Psychological causes of sexual dysfunction such as cultural and religious taboos, poor body image and differences between reality of sex with a partner and sexual fantasies have also been recognised to be associated with this.

The famous sexologists Masters and Johnson were the first to suggest association between delayed ejaculation and religious orthodoxy. Recent clinical studies also showed that delayed ejaculation is associated with religiously orthodox men with limited sexual knowledge who masturbated minimally.

On the other hand, another study revealed "auto-sexual" men may also be involved in frequent idiosyncratic and vigorous masturbation that renders impairment in ejaculation.

The treatment of delayed ejaculation depends on the underlying causes. Stopping medication such as antidepressants, certain anti-epileptics and the reduction of alcohol consumption can often normalise ejaculatory functions.

On the other hand, psychotherapy can usually help by addressing the underlying mental problems leading to the delay in ejaculation. The intervention usually involves counselling by a sex therapist.