What factors (age, health, medication) affect time to ejaculation in men?
Executive summary
Age, health and medications all influence time to ejaculation: intravaginal ejaculation latency averages about 5–7 minutes in healthy men (stopwatch studies) and both premature and delayed ejaculation have biological and psychological contributors [1]. Research identifies endocrine (testosterone, prolactin), neurologic (sympathetic tone, serotonin genetics), urological (prostatitis, erectile function) and psychosocial (anxiety, depression, relationship factors) drivers, while medications—especially SSRIs—commonly lengthen latency and alcohol or recreational drugs can delay ejaculation [1] [2] [3].
1. Age and the clock: how time since puberty shapes ejaculation
Age affects both how quickly men ejaculate and how fast they recover afterwards. Young men tend to have shorter refractory periods and report higher ejaculation frequency; average intravaginal latency in studies is around 5–7 minutes (stopwatch measures) and can shift with age and relationship context [1] [4]. Older men are more likely to present with acquired forms of ejaculatory dysfunction and may experience longer latencies tied to comorbid erectile problems or general declines in sexual stamina [2] [5].
2. Biology under the skin: hormones, nerves and genetics
Endocrine and neurobiological systems are core determinants. Low testosterone (hypogonadism) and hyperprolactinemia are linked to delayed orgasm or reduced orgasmic response [3]. Neurotransmitter systems—particularly serotonin pathways—are implicated in rapid versus delayed ejaculation; genetic variants in 5‑HT receptors and transporters have been associated with premature ejaculation in some studies [2]. The sympathetic nervous system’s activity raises anxiety and tends to speed ejaculation, while lower sympathetic tone can delay it [2].
3. Health of the genitourinary system: prostate, erection and semen factors
Urological conditions change timing. Prostatitis and other prostate disorders are noted risk factors for earlier ejaculation or ejaculatory complaints; clinicians often investigate and treat prostate inflammation before addressing sexual dysfunction [1]. Erectile dysfunction lengthens the time and effort needed to reach orgasm—so poor erection quality may indirectly produce delayed ejaculation even if it’s not the primary cause [5]. Studies of ejaculation frequency focus more on semen quality than latency, but they underline how reproductive-system health and ejaculation patterns interact [6] [7].
4. Mental health and situational influences: anxiety, depression and relationships
Psychological factors drive large, sometimes dominant, effects. Anxiety—performance worry or relationship stress—frequently causes premature ejaculation, while depression is associated with decreased orgasmic function or delayed ejaculation in clinical samples [2] [8]. The literature treats psychological and biological causes as interacting: lifelong versus acquired premature ejaculation categories reflect that some men have stable biologic predispositions while others develop timing changes after stressful life events or medical comorbidity [2] [1].
5. Medications and substances: what speeds and what slows
Prescription drugs and recreational substances change latency predictably. Selective serotonin reuptake inhibitors (SSRIs) are the best‑documented medication class to prolong ejaculation time and can cause delayed ejaculation as an adverse effect; some SSRIs are also used off‑label therapeutically for premature ejaculation [2] [9]. Alcohol and certain recreational drugs commonly delay orgasm and ejaculation; clinicians consider substance use when evaluating delayed ejaculation [3]. Blood‑pressure drugs and other medications may also affect timing—available sources mention blood‑pressure drugs in passing but do not detail mechanisms [10].
6. Measurement problems and why “normal” is slippery
Research measurements vary and many studies warn against simple norms. Stopwatch‑based intravaginal latency finds averages in minutes, but self‑reports overestimate time by 25–50% and prevalence estimates of premature ejaculation range widely depending on definitions [1]. Reviews and bibliometric analyses stress that PE is multifactorial—genetic, neurobiological, hormonal, and psychosexual factors all feature in contemporary research—so single‑cause explanations are misleading [9].
7. Practical implications and where the evidence is thin
Clinically, assessment should include age, endocrine tests (testosterone, prolactin when indicated), urologic exam (prostate, ED evaluation), medication review (notably SSRIs), and mental‑health screening for anxiety/depression [5] [3] [2]. Available sources do not mention detailed guidance on every common antihypertensive or non‑SSRI psychotropic drug class—those specifics are not found in current reporting. Researchers and guidelines (e.g., EAU 2025 overview) emphasize multidisciplinary evaluation and that treatments include behavioral, pharmacologic and psychotherapeutic options [11] [9].
Limitations: this summary uses the supplied sources only; many clinical nuances (exact effect sizes by age or drug dose) are not provided in these extracts and thus are not claimed here.