The Diagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR), puts this disorder among the sexual dysfunctions, along with rapid ejaculation.

A man affected by retarded ejaculation is unable to attain orgasm following a normal level of sexual excitement. The man in question may regularly experience delays in orgasm, or may be unable to attain orgasm altogether.

Although we talk of orgasm and ejaculation as though they were identical, they are separate processes which almost always occur simultaneously.

What we know as orgasm is a peak emotional and physical sensation, whereas ejaculation is simply an unconscious reflex Which occurs when we are aroused enough to stimulate an unconscious reflex mediated in the lower part of the spinal cord. Some men have been able to recognize the individual elements of the two processes, enabling them to experience multiple orgasms without the occurrence of ejaculation. After you have ejaculated, a period of time to recover is required before another orgasm can happen.

The sensation of orgasm differs between individuals, and individual orgasms may differ in the same person. All orgasms include rhythmic body and pelvic contractions, a higher heart rate, increased muscle tension and a final phase of release of tension.

Our sexual responses are controlled by both the sympathetic and the parasympathetic nervous systems. The sympathetic nervous system causes action whereas the parasympathetic system causes recovery and relaxation. In order for a penis to become erect, its smooth muscle fibres are relaxed and allow blood to flow into the penis. This process is mediated by an intricate system of humoral, neurological and circulatory events controlled by the parasympathetic nervous system. Orgasm and ejaculation and subsequent relaxation of the sexual arousal are mostly mediated by the sympathetic nervous system.

Emission is a parasympathetic activity, but orgasm and ejaculation are predominantly under the control of the sympathetic nervous system. We know that orgasm has more to do with the brain than with the body. The fact that orgasm occurs during sleep is supportive of this concept. In any event, this may be blocked by various abnormalities.

If retarded ejaculation only occurs under a particular set of circumstances, for example with only one sexual partner, it is known as "situational" rather than "generalized" retarded ejaculation.

The cause of retarded ejaculation may be physical, but is more often psychological. The physical causes include hormonal problems such as hypogonadism, hyperthyroidism, hypothyroidism, and excessive production of the hormone prolactin. Other physical causes include some drugs, including drugs to treat high blood pressure, and antidepressants.

The most common causes of retarded ejaculation are psychological. Some likely candidates include depression, anxiety, and fear of getting the partner pregnant. Other possible psychological factors include traumatic sexual encounters during childhood such as abuse, rape or incest, and even the possibility of having been brought up in a household where sex was taboo.

A diagnosis of retarded ejaculation depends on the following factors being noticeable: a persistent or recurrent delay in, or absence of, orgasm following a level of normal sexual excitement that would be expected to produce orgasm. Most men who have delayed ejaculation also complain of a low sexual self-esteem. Although this particular sexual problem usually occurs during partner sex, it can happen during masturbation as well! If it occurs during masturbation, it's more likely to be about the man's body than any feelings associated with his partner. Male orgasmic disorder may be part of a complex of sexual malfunctioning that can range across erectile dysfunction, ejaculation problems such as premature ejaculation or retrograde ejaculation, and low sexual desire.

Retarded ejaculation is found in all races and ethnic groups. It may develop around puberty or it may start later in life.

If some obvious physical cause is linked to male orgasmic disorder, the cure may be easy; for example, cessation of excessive drinking or a change in medications. But in most cases, psychotherapy will be advisable. Since most men are too embarrassed to seek professional advice, the availability of self-help programs on the internet is a blessing. Treatment usually requires the partner's assistance for both the psychological and the physical aspects of the treatment. Behavioural programs can allow a man to recover the ability to ejaculate normally quite easily and quickly.