Treatments for Delayed Ejaculation: A Narrative Review

Delayed ejaculation has a prevalence of approximately 1–3%. The condition may be alarming for individuals and potentially complicates conception. As far as the authors are aware the literature on non-pharmacological and pharmacological treatments for delayed ejaculation has not been collated or summarised. This narrative review of the academic literature aims to address this knowledge gap.

Delayed ejaculation, also called retarded ejaculation, inhibited ejaculation, inadequate ejaculation, idiopathic anejaculation, primary impotentia ejaculationis or psychogenic anejaculation, is an ejaculatory dysfunction with a prevalence of 1–3%,1 and has multiple definitions. For example, Munjack and Kanno, first defined delayed ejaculation as ‘the persistent difficulty or inability to ejaculate despite the presence of adequate sexual desire, erection, and stimulation’.2 A more recent definition is provided by the American Psychiatric Association, which describes delayed ejaculation as a condition that requires one of two symptoms: marked delay in frequency or absence of ejaculation on 75–100% of occasions that persists for at least six months and causes personal distress.3

It is important to emphasise that despite this definition, in a recent study, Rowland et al. found that distress did not emerge as a significant factor when delayed ejaculation disorder was present as a symptom.4 However, delayed ejaculation is also likely to be concerning to patients and their partners and can sometimes frustrate a couple's attempt to conceive. Delayed ejaculation is also polyaetiological, and can be classified as lifelong, acquired and/or situational.5

Treatments for delayed ejaculation vary, sometimes according to the potential cause. For example, some medications may cause delayed ejaculation, so modifying these causal medications may be an option for some patients. Psychotherapy may also address any psychological issues that may cause delayed ejaculation in some patients. However, to date, no attempt has been made to collate and evaluate the academic literature on treatments for delayed ejaculation. Such a review is of utmost importance to guide clinical practice and patients. Given this background the aim of this review is to assess the treatment options for delayed ejaculation and their effectiveness.