What Causes a Man To Not be Able To Climax

Delayed ejaculation can be caused by medications, certain chronic illnesses, and surgeries. Or it can be caused by substance abuse or a mental health problem, such as depression, anxiety, or stress. In many cases, it is due to a combination of physical and psychological problems.

Psychological causes of delayed ejaculation include:

• Depression, anxiety, or other mental illnesses
• Relationship problems due to stress, poor communication, or other concerns
• performance anxiety
• negative body image
• Cultural or religious taboos
• Differences between real sex with a partner and sexual fantasies

Medications and other substances that can cause delayed ejaculation include:

• some antidepressants
• Certain medications for high blood pressure
• certain diuretics
• Some antipsychotic medications
• Some anti-seizure medications
• Alcohol, particularly drinking too much alcohol (alcohol abuse or alcoholism)

Physical causes of delayed ejaculation include:

• Certain congenital abnormalities arising in the male reproductive system
• Injury to the pelvic nerves that control orgasm
• Certain infections, such as a urinary tract infection
• Prostate surgery, such as transurethral resection of the prostate or removal of the prostate
• Neurological diseases, such as diabetic neuropathy, stroke, or injury to the nerves of the spinal cord
• Hormone-related disorders, such as low levels of thyroid hormone (hypothyroidism) or low levels of testosterone (hypogonadism)
• Retrograde ejaculation, a disorder in which semen backs up into the bladder instead of out of the penis

For some men, a minor physical problem causing delayed ejaculation could cause anxiety to ejaculate during a sexual encounter. Anxiety can make delayed ejaculation worse.