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What are psychological causes of delayed ejaculation?

Madeleine M. Castellanos, MD
Psychiatry
Some men with delayed ejaculation (DE) may get physiologically aroused when they're with a partner but are mentally disconnected and cannot focus enough to climax. A man may have worries that are related to sex, such as getting you pregnant. He might also be worried about his performance, which can be very intrusive. These negative thoughts -- "I wonder if she is enjoying this?", "I wonder if I am going to have difficulty coming?" or even, "I don't think that she is that attracted to me" -- pull a man's attention away from the action and make it difficult for him to reach the heights of orgasm. A man may also be preoccupied with concerns outside the bedroom, such as the economy, work, or finances.

Psychosocial and cultural factors can also play a significant role in DE. For example, religions that are extremely structured and strict in their views related to sexuality (those in which masturbation and/or sex outside of marriage is forbidden or discouraged) generally prevent men from learning about and experiencing sexual pleasure. Ultimately, this can hinder a guy's sexual self-expression when he becomes sexually active. Or, his shame and guilt can inhibit him from truly immersing himself mentally and emotionally in the experience of sex.

Guys with DE may also be dealing with control issues: They have trouble letting go and experiencing pleasure in various aspects of their life -- including their sex life. Or, they have sex to be able to brag about the number of partners they have had, but in the end are not really immersed in the sensuality of the sexual experience.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.