Delayed ejaculation is often an age-related phenomenon in men over the age of 50. Possible causes may be decreased sensitivity related to a decrease in blood flow to the genital area, which may be related to long-term diabetes or low bio-available testosterone levels. However, there are psychogenic causes for delayed ejaculation and a detailed sexual and medical history is required before treatment is commenced.
Dry ejaculation or non-ejaculation can occur after the operation for BPH, in long-term diabetics and sometimes following surgery in the pelvic area and after spinal cord injuries. Medication may also cause delayed ejaculation, as can some neurological diseases such as MS, alcoholism and heroin addiction. Anti-depressants account for about 28% of all cases of delayed or absent ejaculation, hypertensive medication for about 18%, psychogenic for 10% and beta blockers 5%.