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Delayed Ejaculation: Medical and Psychological Treatments and Algorithm

  • Male Sexual Dysfunction and Disorders (SE Althof and AW Pastuszak, Section Editors)
  • Published:
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Abstract

Delayed ejaculation (DE) is a challenging disorder to treat. Many clinicians are not comfortable dealing with DE due to a lack of treatment approaches supported by evidence-based medicine. In this review, we discuss the most common treatments and the latest studies that support each DE treatment. The goal of our review is to help clinicians identify and treat patients who present with this disorder. An integrative approach using medications, penile vibratory stimulation, and sexual counseling is important for successful treatment of DE. We propose an algorithm for DE treatment to help guide clinicians. However, an individualized treatment plan should be developed for each unique case due to the multifactorial etiology of DE.

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Conflict of Interest

Daniel J. Sadowski and Michael J. Butcher declare no conflicts of interest.

Tobias S. Köhler declares the receipt of grants and personal fees from AMS and Coloplast and personal fees from Auxilium, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. The Pavilion at St. John’s Hospital, 301 North Eighth Street, Springfield, IL, 62701, USA

    Daniel J. Sadowski, Michael J. Butcher & Tobias S. Köhler

  2. Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA

    Daniel J. Sadowski, Michael J. Butcher & Tobias S. Köhler

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  1. Daniel J. Sadowski
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  2. Michael J. Butcher
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  3. Tobias S. Köhler
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Correspondence to Michael J. Butcher.

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This article is part of the Topical Collection on Male Sexual Dysfunction and Disorders

Appendices

Appendix 1: Treatment Algorithm for Ejaculatory Disorders

ψ = See collaboration of clinician and sexual therapist (Appendix 2).

* = Medications in Table 1 can be tried in treatment of retrograde ejaculation (see Table 1).

^ = If patient on SSRI consider use of SSRI antidote types of medications (see Table 1).

† = Medications in Table 1 can be used for prolactin abnormalities (see Table 1).

Graphic based off of Rowland et al. Please see [3].

Appendix 2: Clinician and Sexual Therapist Integrative Therapy for Delayed Ejaculation

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Sadowski, D.J., Butcher, M.J. & Köhler, T.S. Delayed Ejaculation: Medical and Psychological Treatments and Algorithm. Curr Sex Health Rep 7, 170–179 (2015). https://doi.org/10.1007/s11930-015-0054-x

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