- With Mayo Clinic endocrinologist
Todd B. Nippoldt, M.D.
read biographyclose windowBiography of
Todd B. Nippoldt, M.D.
Todd B. Nippoldt, M.D.
Dr. Todd Nippoldt is a board-certified specialist in internal medicine and endocrinology and metabolism. He has special expertise in the area of hormone disorders affecting the pituitary and adrenal glands as well as the testes and ovaries. He has been a member of the Mayo Clinic staff since 1988.
Dr. Nippoldt is a consultant in the Division of Endocrinology, Metabolism and Nutrition and works with patients who have disorders of the hormone-producing glands. Common disorders include diabetes, thyroid problems, osteoporosis and elevated cholesterol levels.
He also is involved in andrology, the study of male hormonal disorders, male infertility and sexual dysfunction and is an assistant professor of medicine at Mayo Clinic College of Medicine.
Dr. Nippoldt, a St. Paul, Minn., native, has also contributed to "Mayo Clinic Health Letter," a Mayo Clinic CD-ROM and the "Mayo Clinic Family Health Book." He is a fellow in the American College of Physicians and a member of the American Society of Reproductive Medicine, the American Society of Andrology, The Endocrine Society, The Pituitary Society and the American Association of Clinical Endocrinologists.
"I have found that those patients who have gone to the Internet and obtained accurate medical information come to their appointment with me very well informed, and the discussions regarding the evaluation and management of their condition are very productive and satisfying," he says.
"The key, however, is obtaining accurate medical information. As a medical editor for MayoClinic.com, I hope to be able to ensure that accurate, relevant and up-to-date information is available for patients and their families."
Definition (1)
- Delayed ejaculation: What causes it?
Alternative medicine (2)
- 'Herbal viagra': Is it safe?
- Erectile dysfunction treatment: Can herbal remedies help?
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Question
Delayed ejaculation: What causes it?
It takes me a long time to reach orgasm, sometimes 45 minutes or longer, which is very frustrating. What causes delayed ejaculation, and is there anything I can do about it?
Answer
from Todd B. Nippoldt, M.D.
The difficulty in ejaculating that you describe is known as delayed ejaculation. Men with delayed ejaculation may be unable to ejaculate or may only be able to ejaculate after prolonged — 30 minutes or longer — intercourse or manual stimulation. This can be a frustrating problem for both partners.
Medical causes of delayed ejaculation include:
- Trauma to the pelvic nerves, which control orgasms, such as from injury or pelvic surgery
- A side effect of certain medications, including some antidepressants
- Excessive alcohol use or illicit drug use
- Neurological diseases, such as stroke or nerve damage to the spinal cord
However, the most common causes of delayed ejaculation are psychological. These may stem from concerns about performance or cultural or religious taboos. Another psychological cause is conditioning resulting from certain masturbation patterns. For example, a man who is used to masturbating with a very fast motion may find it difficult to climax with the slower process of intercourse.
A medical history and thorough physical or neurological exam can determine if delayed ejaculation is due to an underlying medical condition or a side effect of medication. Treatment of delayed ejaculation depends on the underlying cause but may include:
- Sex therapy with a therapist who specializes in this area, if the cause is psychological
- Changing medications, if the cause is thought to be a side effect of medication
- Discontinuing use of alcohol or illicit drugs
