Delayed ejaculation (DE) is a condition in which it takes an individual an unusually long period of time to ejaculate during partnered sexual activity. Some people with DE may find that they are unable to ejaculate at all during partnered sexual activity.

As the data on DE continues to evolve, there will likely be more clarity around its definition. However, currently, there are several definitions of DE proposed by multiple professional and medical groups, which can make the process of identifying and diagnosing DE difficult.

For example, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition defines DE as “a marked delay in ejaculation” or “marked infrequency or absence of ejaculation…present in 75% or more of partnered sexual encounters and persistent over at least the last 6 months…(and the experience of) personal distress.”

On the other hand, the Eleventh Revision of the International Classification of Diseases describes 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.”

Lastly, the American Urological Association defines DE as “consistent, bothersome inability to achieve ejaculation, or excessive (lifelong DE) or increased (acquired DE) latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate.”

Given the general nature of these three definitions of DE, patients and health care providers alike might struggle to accurately identify and diagnose this condition. The authors of a recent study aimed to determine how best to diagnose DE by evaluating the reported symptoms and estimated ejaculation latencies of 1,660 men. (Ejaculation latency is the period of time from initial penetration to ejaculation).

They found that the strongest relationship between ejaculation latency and orgasmic difficulty occurred when the men who were experiencing orgasmic difficulty also reported having trouble reaching orgasm and had a low percentage of times successfully ejaculating during sex.

The researchers tested ejaculation latency cutoffs of >10, >15, and >20 minutes to see which would be the most accurate for a DE diagnosis. Each threshold had benefits and drawbacks, but an ejaculation latency of >15 minutes was found to be the most balanced cutoff in terms of sensitivity and specificity. An ejaculation latency threshold of >10 minutes is less specific but more sensitive when it comes to diagnosing DE, and an ejaculation latency threshold of >20 minutes is less sensitive but more specific.

With these findings in mind, the authors suggest that the best way to diagnose DE is to begin with an individual’s self-assessment of their ability to ejaculate, then collect information on the percentage of times when they ejaculate during partnered sexual activity. According to the authors, ejaculation latency could be used as a supplemental measure when diagnosing DE, because it may be less accurate when it is used as the only measure.

References:

• Horvath, Z., Hevesi, K., Kövi, Z., & Rowland, D. L. (2023). Identifying an optimal ejaculation latency for the diagnosis of men reporting orgasmic/ejaculation difficulty. The Journal of Sexual Medicine, 20(6), 821-832. https://doi.org/10.1093/jsxmed/qdad058