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Delayed ejaculation

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of delayed ejaculation are prepared by our editorial team based on guidelines from the American Urological Association (AUA/SMSNA 2022). ...
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Screening and diagnosis

Definitions
As per AUA/SMSNA 2022 guidelines:
Recognize that lifelong DE is defined as lifelong, consistent, bothersome inability to achieve ejaculation, or excessive latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate.
E
Recognize that acquired DE is defined as an acquired, consistent, bothersome inability to achieve ejaculation, or an increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate.
E
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Diagnostic investigations

Initial assessment
As per AUA/SMSNA 2022 guidelines:
Elicit a medical, relationship, and sexual history and perform a focused physical examination for the evaluation of patients with DE.
B
Consider obtaining additional testing as clinically indicated for the evaluation of patients with DE.
C

Medical management

Modification in precipitating medications: as per AUA/SMSNA 2022 guidelines, consider offering replacement, dose adjustment, or staged cessation of medications likely to contribute to DE in patients with DE.
C

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Patient education

General counseling: as per AUA/SMSNA 2022 guidelines, consider advising patients with DE to modify sexual positions or practices to increase arousal.
E

Follow-up and surveillance

Indications for referral: as per AUA/SMSNA 2022 guidelines, consider referring patients with lifelong or acquired DE to a mental health professional with expertise in sexual health.
E