When sex lasts too long

By Madeleine Castellanos, M.D.

When it comes to sex and the male member, the laws of physics don't always apply. What goes up sometimes comes down all too quickly, or sometimes stays up all too long. Never-ending stamina (and an always-hard penis) may sound great on paper, but in reality, it can be awkward and exhausting for both of you. 

This condition, delayed ejaculation (DE), used to be relatively rare compared to other male sexual issues like erectile disorder (ED) and premature ejaculation (PE), but as I discuss in my new book Penis Problems: A Men's Guide, DE is rapidly becoming a major issue.

One of the major reasons is the rapid proliferation of Internet porn. These days, all you have to do is log on to your laptop to be a few clicks away from everything from the Sports Illustrated Swimsuit Issue to hardcore video clips. Easy access to porn has made frequent masturbation among men more common, which turn can increase the time it takes to reach orgasm and ejaculate during real sex. With so many varieties of porn at your fingertips, you may get in the habit of having a steady flow of sexual novelty and intense visual stimulation and therefore have a more difficult time reaching peak levels of sexual arousal with your real-world partner.

But unlike PE, DE generally isn't a condition you're born with. Instead it can be triggered or influenced by a number of different factors:

• Medications: A number of medications can have DE as a side effect. Tops on the list are antidepressants. One study published in the May 2009 issue of the Journal of Sexual Medicine found than men who took SSRIs were seven times more likely to have DE than those who didn't take these drugs. Certain types of medications used to treat high blood pressure, anxiety, pain, cold symptoms, or insomnia can also cause DE.
• Alcohol: A small amount of alcohol may put you in the mood, but larger quantities can impair not only your ability to achieve and maintain an erection, but your ability to ejaculate as well. This is because alcohol is a central nervous system depressant and slows down brain activity that is needed to achieve orgasm.
• Emotional issues: Some men with DE may get physiologically aroused when they're with a partner but are mentally disconnected and cannot focus enough to climax. You might be worried about your performance, which can be very intrusive. Or you may also be preoccupied with concerns outside the bedroom, such as the economy, work, or finances.

If you're dealing with DE, what can you do?

• Cut back on alcohol. Although some people feel that alcohol adds to their sexual experience because it helps them lose their inhibitions, one or two drinks can significantly delay your orgasm. Try reducing the amount to see if this improves your DE.
• Put away the porn. If you think too much porn could be crimping your sex-style, it may be time to take a break from porn and focus on real sex. I'm not saying you have to turn off the porn forever, but a taking break for several weeks can help you determine if it's triggering your DE, and can give you a chance to get your mojo back.
• Take a masturbation break. In the past, you may have been able to masturbate regularly and have sex regularly, but if you're masturbating more than you're having sex, it's time to go "hands off" for a while. 

DE can be challenging, but in many cases, it can be managed fairly easily. Communication is half the battle: You can discuss which positions work better for your excitement and avoid those which are not as helpful. Most importantly, it helps your partner understand that it is not her fault.

Women may think that they are not attractive or sexy enough, or they may wonder if you have lost interest in her. Reassure her of the way you feel and that you are going to explore why this is happening at this time.