In this ISSM Podcast episode, Estela Cirtin interviews Alan Shindel about the causes, consequences, and treatment of delayed ejaculation. Dr. Shindel explains how biological factors, relationship dynamics, cultural beliefs, pornography use, and performance anxiety can all contribute to difficulties reaching climax, and discusses how this can affect partners emotionally and physically. He emphasizes open communication, behavioral strategies, and carefully selected medical options, while reassuring listeners that sexual patterns can be relearned and that compassionate, individualized care can significantly improve sexual wellbeing.