Delayed ejaculation (DE) is a sexual health condition in which a man takes a long time to ejaculate or is unable to ejaculate, particularly during partnered sex. It can also refer to a significant increase in the time it takes a man to ejaculate during sex compared to his previous “normal.” Often, ejaculation latency time is discussed with regard to DE, which is the time it takes a person to ejaculate during penetrative sex.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines DE as a marked delay, infrequency, or absence of ejaculation in ejaculation present in 75% or more of partnered sexual encounters and persistent over at least the last 6 months that causes clinically significant distress.

Similarly, the International Classification of Diseases, 11th Revision (ICD-11), defines DE as the inability to achieve ejaculation or an excessive or increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate which has occurred episodically or persistently over at least several months, and is associated with clinically significant distress.

Importantly, these definitions both involve: 1) a problem with the timing of ejaculation during sex (i.e., it taking too long), 2) a lack of self-efficacy in being able to achieve the desired ejaculatory response, and 3) bother or distress related to the situation.

Recently, a study was published in The Journal of Sexual Medicine that was aimed at identifying the differences between men with and without DE symptoms to work towards validating diagnostic criteria for the condition.

In total, 2,679 men participated in this internet-based study and were divided into groups of men with and without DE symptoms based on their self-reported difficulty reaching orgasm/ejaculation during partnered sex. The participants completed a 55-item survey that covered demographic and health information, sexual and relationship satisfaction, and histories of sexual dysfunctions, including DE.

Ultimately, 5 face-valid diagnostic variables emerged from the data:

1. The men with DE reported significantly longer estimated average ejaculatory latency times during partnered sex than the men without DE.
2. The men with DE reported a significantly longer estimated minimum ejaculatory latency time during partnered sex than the men without DE.
3. Regarding the percentage of sexual episodes ending in orgasm/ejaculation during partnered sex, the men with DE reported a significantly lower percentage of sexual events ending in orgasm than the men without DE.
4. In general, the men with DE reported less orgasmic pleasure/satisfaction during partnered sex than the men without DE.
5. Overall, the men with DE reported more bother and distress related to partnered sexual activity than the men without DE.

The results of this study affirmed the previously stated elements of the DE definition and diagnostic criteria. For example, the longer estimated average and estimated minimum ejaculatory latency times for men with DE indicate a problem with the timing of ejaculation during sex. The percentage of sexual episodes leading to orgasm showed a lack of self-efficacy in being able to achieve the desired ejaculatory outcome. Lastly, the lower levels of pleasure/satisfaction as well as the higher levels of bother/distress clearly indicate vexation related to sexual activity. These findings provide strong support for the 5 face-valid measures of DE and may help shed light on the experiences of men with this condition.

References:

• Rowland, D. L., Attinger, D. R., Morrow, A. L., Motofei, I., & Hevesi, K. (2023). Characteristics of men who report symptoms of delayed ejaculation: providing support for empirically derived diagnostic criteria. The Journal of Sexual Medicine, 20(4), 426-438. https://doi.org/10.1093/jsxmed/qdad008