Delayed Ejaculation

THE thrill of the Summer Olympic Games will come to a close in Rio de Janeiro tonight. Many who were not interested in this sporting event were eventually drawn to the excitement.

For Malaysia, it is a tremendous achievement for winning three silver medals in three Olympic games in 2008, 2012 and 2016 in the men’s badminton singles.

After all, Lee Chong Wei is the sixth Malaysian to win an Olympic medal and the first Malaysian to reach the finals in the men’s single event, ending Malaysia’s Olympic medal drought since 1996.

With his repeated achievement, this makes him the most successful Olympian in Malaysia.

Lee once said: “If we dare to win, we should dare to lose!”

After having lost two consecutive gold medals to Lin Dang, Chong Wei beating his nemesis in the semi finals brought hope to the nation. But unfortunately, he lost the finals to China’s Chen Long in Brazil.

To mark the “non-climatic” end of this Summer Olympic Game, we address the issue of another “dampening climax” faced by a reader with his advancing age.

Dear Dr G,

My name is Peter and I am 57 years old.

I have a “strange” problem in recent years and I hope you are able to help me.

I have a very active sex life since I got married in my late 20s.

In the past two years, instead of having problems faces by many of your readers such as premature ejaculation and erectile dysfunction, I am facing the complete opposite problem of having difficulties in achieving sexual climax.

Initially, I thought I was just tired and the delay in climax is just temporary, however, I am increasingly concerned with the inability to “finish the business” even after 20 to 30 minutes.

This really bothers me and is affecting my relationship with my wife.

Can you tell me whether it is a common condition? Why is it affecting me now?

Can it be cured? Please help.

Peter.

The inability to achieve climatic ejaculation is a well-recognised sexual dysfunction in recent years. This is termed as delayed ejaculation, retard ejaculation or sometimes called impaired ejaculation.

It is often recognised in men who takes an extended period, commonly around 30 minutes of sexual stimulation to achieve climax and ejaculate.

Some men with this condition are also unable to ejaculate at all. Although some may wish they “last all night”, however, when it truly happens, it is very distressing and frustrating for couples.

The true prevalence of delayed ejaculation is largely unknown. It is normal for men having trouble ejaculation from time to time, depending on the sexual circumstances.

The condition only becomes problematic if it is ongoing, causing fatigue and loss of erection, resulting in distress in a relationship.

Delayed ejaculation can be lifelong or acquired, and generalised or situational.

With lifelong delayed ejaculation, the problem starts from the beginning of sexual maturity. The acquired delayed ejaculation is usually due to illnesses or chronic medical conditions.

Generalised delayed ejaculation affects men in all sexual experiences and situational delayed ejaculation is limited to certain partners or circumstances.

The causes of delayed ejaculation are thought to be mainly psychological in nature. These include cultural taboo, poor body image, relationship issues, depressions and anxiety.

Other causes of delayed ejaculation are due to alcohol and drug abuse, and neurological diseases such as diabetic neuropathy, stroke and spinal cord injury.

Hormonal imbalance such as low thyroid hormones (hypothyroidism) and diminished testosterone (hypogonadism) also cause delayed ejaculation.

There is usually no definitive treatment for delayed ejaculation in men unless it is caused by medications or underlying medical conditions.

There is no medication that is specifically designed to treat delayed ejaculation, however, medications such as buspirone for anti-anxiety, amantadine for Parkinson’s and cyproheptadine for the treatment of allergy are noted to have the effect of facilitating ejaculation.

Generally, psychotherapy and counselling from a sex therapist will address issues that affect timing of ejaculations.

The true etiology and the complexity of delayed ejaculation are not known, and this often results in frustrations for both the sufferers and health care providers.

George Orwell once said: “Happiness can exist only in acceptance”. My advice to Peter is, “sexual happiness can also exist without a climactic end.”