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Ejaculation

You Ask — We Answer

Dr. Fabio Castiglione Urologist London

How long should sex last?

There is no official rule on how long sex should last. The duration of sex varies from couple to couple and can depend on many factors, such as:
• Their preferences. Some couples want sex to be fast. Others like to take a slower pace.
• Their circumstances. Young, busy parents might have short sexual encounters when they have time. Couples relaxing on the weekend may spend the entire day in bed.
• Their age and health. As people get older, they sometimes need more time to become aroused and reach orgasm.
• Their definition of “sex.” If couples define sex as the time spent in penile-vaginal intercourse, then sex might last just a few minutes. But if they include foreplay and other sexual activities (massage, oral sex, etc.), it could be much longer.
Scientifically, duration of sex is often associated with the intravaginal ejaculation latency time (IELT). This measurement begins when the penis first enters the vagina and ends when the man ejaculates.
In 2005, a study of 500 couples in five different countries found that the median IELT is 5.4 minutes. But that assumes a definition of sex as heterosexual intercourse. Couples – both heterosexual and homosexual – may have different views.

What is delayed ejaculation?

Delayed ejaculation occurs when a man has difficulty ejaculating. It may take longer than he’d like to ejaculate, even if he has a full erection and is sufficiently aroused and stimulated. The situation can cause distress to both the man and his partner.

An estimated 1% – 4% of men experience delayed ejaculation.

Delayed ejaculation is classified as primary or secondary. Primary (lifelong) delayed ejaculation applies to men who have always had difficulty ejaculating. Men with secondary (acquired) delayed ejaculation have been able to ejaculate normally during intercourse in the past but have later developed a problem.

The disorder is considered “generalized” when it happens in any circumstance. When it happens only under certain conditions (such as with specific sex partners), it is called “situational.”

Causes

Delayed ejaculation can have physical and psychological causes. Sometimes, there are a combination of factors at play.

Possible physical causes include the following:

• Birth defects
• Side-effects from medications (especially antidepressants, blood pressure medications, and drugs for anxiety)
• Nerve damage
• Pelvic injury
• Hormone deficiencies, such as hypogonadism (low testosterone)
• Excessive alcohol or illicit drug use

Psychological factors can include:

• Depression
• Relationship problems
• Performance anxiety
• Cultural or religious beliefs that consider sex to be taboo

Men may also have delayed ejaculation when the method or intensity of stimulation changes. For example, a man who masturbates a certain way may not get the same degree of stimulation from intercourse.

Treatment

Treatment for delayed ejaculation usually involves treating the underlying issue. This may mean changing medication, changing masturbation habits, or getting help for alcohol or drug abuse.

Counseling and sexual therapy can help, too. Men can work through the psychological causes as well as the stress that results from delayed ejaculation. Often, partners attend sessions as well.

In addition, some men benefit from medications, such as cabergoline. The drug anandamide is currently being researched for treatment of delayed ejaculation.

Men who have trouble ejaculating should speak to their doctor, especially if they find the situation stressful.

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Urologist London 

Andrologist London

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