Delayed ejaculation disorder (DE) is a sexual dysfunction in which an individual struggles to achieve orgasm or ejaculation even with sufficient stimulation.

Each person has different sexual needs, and the time needed to ejaculate can vary because of that. Situational delayed ejaculation can be normal on occasion, but that is often caused by problems with arousal or communication.

Delayed ejaculation disorder, however, is a recurrent or persistent struggle with ejaculation.

Individuals with this condition may have reduced sensation during orgasm or may be unable to ejaculate at all. This condition may create feelings of frustration, embarrassment, or anxiety for individuals who experience it.

It can create problems with an individual’s relationships or sexual experiences, as those with delayed ejaculation may become fatigued while trying to achieve orgasm, or may experience loss of arousal, penile irritation, or distress during sex.

This condition may occur only during masturbation, only during intercourse, or both. It can be a condition that occurs from the start of a person’s sex life, or later in life after no previous problems with ejaculation.

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Delayed ejaculation disorder can be caused by a mixture of factors. Medications, alcohol, mental health, anxiety, body image, past surgeries, and many other aspects can contribute to delayed ejaculation.

Infections or neurological diseases can affect your ability to ejaculate, as can hormonal issues or pelvic floor dysfunction.

The pelvic floor plays a large role in ejaculation, as it affects sexual functions such as sensation, arousal, erection, and the physical ejaculation response. However, the pelvic floor must be in good condition to allow for these sexual functions.

When the pelvic floor is weak, tight, inflexible, or poorly coordinated, this is known as pelvic floor dysfunction.

Pelvic floor dysfunction can affect sexual functions by:

• Preventing arousal responses such as erection through reduced blood flow.
• Irritating or compressing important nerves needed for sexual sensation.
• Disrupting orgasm and ejaculation because of weak, poorly coordinated pelvic floor muscles.
• Delaying ejaculation due to overactive and tight muscles.
• Causing pelvic pain that may disrupt sexual pleasure and function.

All of these aspects can affect your sexual function and ability to ejaculate. Most often in the case of delayed ejaculation, the pelvic floor muscles are too tight and cannot relax (overactive).

When you ejaculate, the pelvic floor expels semen through a series of short, rhythmic contractions and relaxations.

However, when your muscles are too tight and unable to relax, this rhythm is disrupted and cannot be performed properly—making it painful or difficult to ejaculate, even if you feel the need to.

To restore function to the pelvic floor and reverse these effects, pelvic floor physical therapy looks to reduce muscle tension, improve function, and educate patients on their pelvic floor muscles. We’ll discuss this in further detail next!

Treating delayed ejaculation requires addressing both psychological and physical factors. Pelvic floor physical therapy looks to restore sexual function and sensation by improving pelvic floor health.

Additionally, Hive’s physical therapists are always open to collaboration with other health professionals, such as sex therapists, urologists, or mental health professionals.

That being said, pelvic floor therapy may also help indirectly address some aspects of anxiety, stress, or confidence by restoring function, promoting relaxation, and improving the patient’s understanding of their body’s function.

Let’s take a closer look at how pelvic floor treatments are utilized for delayed ejaculation:

Manual Therapy

As mentioned before, your pelvic floor muscles need to be able to relax in order to support proper blood flow for arousal and erection, as well as the ability to perform ejaculation.

Manual therapy can help reduce tension in the pelvic floor in two ways:

• By addressing muscle tension in the surrounding areas, such as the lower back, abdominals, and hips.
• By directly addressing tightness and trigger points in the pelvic floor itself, through internal tissue manipulation via the rectum. This may be performed with tools such as pelvic wands.

These manual therapies can improve nerve function necessary for sexual sensation, reduce pelvic pain, relieve trigger points, and address restrictive scar tissue, too.

Pelvic Floor Training

Some other important aspects for sexual function include the strength, coordination, and control of your pelvic floor muscles. Therefore, your pelvic floor therapist will teach you about your pelvic floor anatomy and how it relates to sexual function.

They will guide you through pelvic floor exercises that will allow you to better feel and understand the contractions and relaxations of these important muscles.

This can include treatments such as neuromuscular re-education and biofeedback, which will allow you to better understand the functions of the pelvic floor as you contract and relax them in real time.

As you improve your control of your pelvic floor, you can begin to practice relaxation and strengthening exercises that will support better sexual function, including your ability to ejaculate.

Behavioral Modifications

Pelvic floor dysfunction can be caused by many different things, even things that you do every day. Your posture, body alignment, restroom habits, and other lifestyle choices can create tension in the pelvic floor.

Your physical therapist will help you correct any of these aspects, and will also teach you relaxation techniques to practice at home. Learning methods of relaxation can help you actively relax the pelvic floor muscles and manage anxiety associated with sexual dysfunction.

Exercise Prescription

While under the care of Hive Therapy and Wellness, you can expect a curated exercise and stretching routine—even for conditions like delayed ejaculation. This is because proper exercise and regular stretching can provide the following benefits:

• Reduce any muscle imbalances that can cause tension in the pelvic floor.
• Improve blood flow and general health needed to support sexual function through better mobility and flexibility.
• Support proper nerve function and mobility, which allows for better sensation and arousal.

Pain Management

Hive Therapy and Wellness can provide many pain-relieving modalities to address pelvic pain that is often associated with pelvic floor dysfunction.

This is also useful for individuals who live with chronic conditions such as chronic pelvic pain syndrome, which further exacerbates symptoms of delayed ejaculation.

Some examples of pain-relieving treatments used at Hive include tissue scraping, cupping, and dry needling.

There are many different treatments that Hive’s pelvic floor therapists can use to treat your symptoms and address delayed ejaculation.

While we didn’t go into extreme detail for every possible treatment, you can expect any of the following treatments to be included in your comprehensive care plan:

• Neuromuscular re-education 
• Manual therapy
• Exercise prescription 
• Dry needling 
• Cupping 
• Tissue scraping 
• Behavioral modifications 
• Therapeutic activities 
• Electrical muscle stimulation
• Spinal manipulation 
• Therapeutic modalities 
• Biofeedback