Delayed Ejaculation: The Psychological and Physical Causes

Delayed ejaculation is a common but often misunderstood condition where a man requires a prolonged period of sexual stimulation to reach orgasm and ejaculate.

For some, ejaculation may not be possible at all. This issue can stem from a complex interplay of physical and psychological factors, causing significant distress for both the individual and their partner.

A 2023 study estimates that delayed ejaculation affects at least 5% to 10% of males, though the actual prevalence may be higher due to underreporting.

This comprehensive guide will delve into the intricate causes, from the neurobiology of orgasm to the impact of medications and mental health.

You will learn to identify symptoms, understand the diagnostic process, and explore the full spectrum of available treatments, empowering you to take control of your sexual health.

What is Delayed Ejaculation? A Clear Definition

Delayed ejaculation (DE), also known as male orgasmic disorder or impaired ejaculation, is medically defined as a marked delay in, or inability to achieve, ejaculation despite adequate sexual desire, arousal, and stimulation.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnosis requires these symptoms to be present on 75-100% of partnered sexual occasions for at least six months and cause clinically significant distress.

Beyond the Clock: Why Time Isn’t the Only Factor

While some sources suggest a timeframe, such as needing more than 30 minutes of stimulation, there is no universally accepted time limit that defines delayed ejaculation. The key diagnostic component is the distress it causes.

If the time it takes to ejaculate is a source of frustration, anxiety, physical exhaustion, or relationship problems for you or your partner, it is considered a clinical issue, regardless of the exact duration.

As the Mayo Clinic notes, the problem isn’t the number on a stopwatch but the ongoing stress and worry it creates.

The experience can lead to stopping sex due to fatigue, physical irritation, loss of erection, or a partner’s request.

Differentiating Lifelong vs. Acquired Delayed Ejaculation

Delayed ejaculation is categorized based on its onset:

• Lifelong (Primary) DE: This type is present from the very beginning of sexual maturity. The individual has always experienced significant difficulty with ejaculation.
• Acquired (Secondary) DE: This type develops after a period of normal ejaculatory function. Its onset can often be traced to a specific physical or psychological trigger, such as starting a new medication, a medical procedure, or a significant life stressor.

Understanding Generalized vs. Situational Delayed Ejaculation

The condition is also classified by the context in which it occurs:

• Generalized DE: The difficulty occurs in all or nearly all sexual situations, including intercourse with a partner and masturbation.
• Situational DE: The difficulty occurs only under specific circumstances. A common example is being able to ejaculate easily during masturbation but finding it difficult or impossible during partnered sex. This often points toward psychological or relational factors.

How Common is Delayed Ejaculation?

Estimating the true prevalence of delayed ejaculation is challenging due to varying definitions and underreporting.

However, available data suggests it is a significant issue. A 2023 study cited by the Cleveland Clinic estimates that DE affects at least 5% to 10% of males.

Other research, such as a large-scale Japanese survey published in 2025, found a prevalence of 5.16% among sexually active men.

The study also highlighted a major gap: while over 58% of affected men desired treatment, only about 12% actually sought medical help, often due to embarrassment or lack of awareness.

How Do Ejaculation and Orgasm Work? The Underlying Biology

To understand what causes delayed ejaculation, it’s crucial to first understand the complex biological process of normal ejaculation.

It is not a single event but a coordinated reflex involving the brain, spinal cord, and a host of nerves and muscles.

The Two Phases of Ejaculation: Emission and Expulsion

As described by sources like the Cleveland Clinic, ejaculation occurs in two distinct phases controlled by the autonomic nervous system:

1. Emission Phase: This is the “loading” phase. The sympathetic nervous system (originating from the T10-L2 spinal segments) triggers contractions in the vas deferens, seminal vesicles, and prostate gland. This action moves sperm from the epididymis and mixes it with fluids from the glands to form semen, which is then deposited into the posterior urethra at the base of the penis. Crucially, during this phase, the bladder neck contracts tightly to prevent semen from flowing backward into the bladder (retrograde ejaculation).
2. Expulsion Phase: This is the “firing” phase. Once the urethra is filled with semen, a signal is sent to the spinal cord. This triggers a series of rapid, rhythmic contractions of the bulbocavernosus and other pelvic floor muscles, controlled by the somatic nervous system (S2-S4 spinal segments). These contractions forcefully propel the semen out through the urethral opening.

The Brain’s Role: Neurotransmitters in Control

Orgasm is a cerebral experience—a sensation of intense pleasure processed in the brain that typically coincides with ejaculation.

This process is heavily modulated by neurotransmitters, chemical messengers that transmit signals between nerve cells.

The balance of these chemicals is critical for normal ejaculatory function.

• Dopamine: Often called the “pleasure chemical”, dopamine is a key pro-ejaculatory neurotransmitter. As detailed in a review in *Current Neuropharmacology*, dopamine systems in the brain are crucial for sexual motivation, arousal, and facilitating the ejaculatory reflex. Drugs that increase dopamine activity can sometimes help treat delayed ejaculation.
• Serotonin (5-HT): Serotonin generally has an inhibitory, or delaying, effect on ejaculation. This is the primary reason why Selective Serotonin Reuptake Inhibitors (SSRIs), a common class of antidepressants, are a leading cause of medication-induced delayed ejaculation. By increasing serotonin levels in the brain, these drugs raise the threshold for ejaculation to occur.
• Norepinephrine: This neurotransmitter is involved in the sympathetic nervous system’s control of the emission phase. A proper balance is needed for the smooth muscle contractions that move semen into the urethra.

Any disruption in this delicate neurochemical balance can lead to ejaculatory dysfunction, including delayed ejaculation.

What Are the Primary Physical Causes of Delayed Ejaculation?

A wide range of physical factors can interfere with the nerves, hormones, and muscles responsible for ejaculation.

These organic causes are often the first area a healthcare provider will investigate, especially in cases of acquired delayed ejaculation.

Medical Conditions and Chronic Illnesses

Several ongoing health conditions can damage the nerves that control orgasm and ejaculation:

• Neurological Diseases: Conditions like multiple sclerosis (MS), stroke, spinal cord injury, and diabetic neuropathy can directly impair the nerve signals between the brain, spinal cord, and pelvic region.
• Diabetes: Over time, high blood sugar can cause widespread nerve damage (autonomic neuropathy), affecting the sympathetic nerves essential for the emission phase of ejaculation.
• Thyroid Disorders: An underactive thyroid (hypothyroidism) is strongly linked to delayed ejaculation. Research has shown that normalizing thyroid hormone levels can resolve DE in many affected men.
• Infections: Certain infections, such as a urinary tract infection (UTI) or prostatitis (inflammation of the prostate), can cause pain and interfere with normal function.

The Impact of Medications

Medication is one of the most common and reversible causes of delayed ejaculation. If your symptoms started after beginning a new prescription, it is a likely culprit.

The Cleveland Clinic and NHS highlight several classes of drugs known to cause this side effect.

Medication Class	Examples	Mechanism of Action
Antidepressants (SSRIs)	Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Escitalopram (Lexapro)	Increases serotonin levels, which has a strong inhibitory effect on the ejaculatory reflex. This is the most frequent cause of drug-induced DE.
Antipsychotics	Haloperidol, Thioridazine, Risperidone	Can interfere with dopamine pathways and other neurotransmitter systems involved in sexual function.
Antihypertensives (Blood Pressure Meds)	Beta-blockers (e.g., Propranolol), Alpha-blockers (e.g., Tamsulosin), Diuretics (e.g., Thiazides)	Can affect the sympathetic nervous system, which is crucial for the emission phase of ejaculation.
Antiseizure Medications	Phenytoin, Carbamazepine	Can alter nerve signaling throughout the body, including the pathways for sexual response.
Opioids	Morphine, Oxycodone, Heroin	Suppress the central nervous system and can lower testosterone levels, impacting both libido and ejaculatory function.

Excessive alcohol consumption and the use of recreational drugs can also significantly impair ejaculatory function.

Surgical and Anatomical Factors

Damage to the pelvic region can have a direct impact on the ability to ejaculate.

• Prostate Surgery: Procedures like transurethral resection of the prostate (TURP) for an enlarged prostate or a radical prostatectomy for cancer can damage the nerves and muscles around the bladder neck.
• Pelvic Surgery or Trauma: Any surgery or injury in the pelvic area (e.g., for bladder, colon, or rectal issues) risks damaging the delicate network of nerves controlling ejaculation.
• Birth Defects: In rare cases, congenital abnormalities of the reproductive system can be a cause of lifelong delayed ejaculation.
• Ejaculatory Duct Obstruction: A blockage in the tubes that carry semen can physically prevent or impair ejaculation.

Hormonal Imbalances

Hormones are the master regulators of sexual function. An imbalance can disrupt desire, arousal, and orgasm.

• Low Testosterone (Hypogonadism): Testosterone is essential for libido (sex drive) and plays a role in the ejaculatory process. Low levels can reduce sexual motivation and sensation.
• Hyperprolactinemia: High levels of the hormone prolactin (often caused by a benign pituitary tumor) can suppress testosterone production and directly interfere with sexual function.

The Natural Process of Aging

As men age, natural physiological changes occur. Penile sensitivity may decrease, testosterone levels can gradually decline, and the nerve reflexes may slow down.

These factors can contribute to a longer time needed to reach orgasm, making acquired delayed ejaculation more common in older men.

What Are the Key Psychological Causes of Delayed Ejaculation?

For many men, especially those with situational delayed ejaculation (e.g., can ejaculate with masturbation but not with a partner), the root causes are psychological, relational, or behavioral.

These factors can create a powerful mental block that inhibits the body’s natural reflexes.

Mental Health Conditions: Anxiety, Depression, and Stress

The mind and body are deeply connected in sexual response. General mental health plays a profound role.

• Depression: A core symptom of depression is anhedonia, the inability to feel pleasure. This can blunt sexual arousal and make orgasm feel distant or impossible.
• Anxiety: Generalized anxiety or specific anxiety disorders can put the body in a state of “fight or flight”, activating the sympathetic nervous system in a way that conflicts with the relaxed focus needed for sexual arousal to build to a climax.
• Chronic Stress: High levels of the stress hormone cortisol can suppress testosterone and interfere with the neurotransmitters needed for a healthy sexual response.

Performance Anxiety and the Pressure to Climax

Once a man experiences delayed ejaculation a few times, a vicious cycle of performance anxiety can begin.

The focus shifts from pleasure to performance. This creates a “spectatoring” effect, where the man is mentally watching and judging himself rather than being immersed in the sexual experience.

This pressure to “get it over with” is counterproductive and often makes the problem worse.

“The fear of not being able to ejaculate becomes a self-fulfilling prophecy. The more you worry about it, the more you inhibit the very reflexes you’re trying to trigger.”

Relationship Dynamics and Communication Issues

Unresolved issues with a partner can manifest as sexual problems. These can include:

• Unexpressed anger or resentment.
• Lack of emotional intimacy or connection.
• Poor communication about sexual needs and desires.
• Fear of impregnating a partner or fear of intimacy itself.

In these cases, the delayed ejaculation is a symptom of a deeper relational problem that needs to be addressed.

Cultural, Religious, and Personal Beliefs About Sex

A strict or repressive upbringing can instill deep-seated guilt, shame, or anxiety about sex.

If sex is subconsciously viewed as “dirty”, “sinful”, or purely for procreation, it can be difficult to let go and fully embrace the pleasure required for orgasm.

These cultural or religious taboos can create a powerful psychological barrier to climax.

The “Masturbation-Intercourse Disconnect”

This is a very common cause of situational delayed ejaculation. It occurs when a man becomes conditioned to a very specific type of stimulation during masturbation that cannot be easily replicated by a partner.

This often involves a tight grip, a specific rhythm, or the use of pornography.

Over time, the brain becomes “hard-wired” to this intense and specific stimulus.

The stimulation provided during partnered sex may then feel insufficient to reach the orgasmic threshold.

This is not a reflection on the partner’s skill but rather a result of a learned conditioning pattern.

It can also be related to a disconnect between sexual fantasies used during masturbation and the reality of sex with a partner.

How is Delayed Ejaculation Diagnosed?

Diagnosing delayed ejaculation is a comprehensive process that relies heavily on a detailed history.

A healthcare provider’s goal is to understand the full context of the problem to identify the underlying causes, whether they are physical, psychological, or a combination of both.

Preparing for Your Doctor’s Appointment

The first conversation with a provider can feel awkward, but being prepared can make it much more productive. Before your appointment, consider the following:

• Document Your Symptoms: When did the problem start? Does it happen every time, or only in certain situations? How long does it typically take to ejaculate?
• List Your Medications: Include all prescription drugs, over-the-counter medicines, and any herbal supplements you take.
• Review Your Medical History: Be ready to discuss any past or current health conditions, surgeries, or injuries.
• Consider Your Lifestyle: Be honest about your alcohol consumption and any recreational drug use.
• Involve Your Partner: If you are in a relationship, consider asking your partner to come with you. They can offer a valuable perspective and be part of the solution.

The Importance of a Thorough Medical and Sexual History

Your doctor will ask a series of specific questions to build a complete picture of the issue. According to the Cleveland Clinic, you can expect questions like:

• When did you first notice you had problems ejaculating?
• Are you able to ejaculate when you masturbate? What about with a partner?
• Does it happen with all partners or just one?
• What is your relationship with your partner like?
• Have you had any recent major life stressors or changes in your mood?
• What medications are you currently taking?

Answering these questions honestly, even if you feel embarrassed, is the most important part of the diagnostic process.

Physical Examinations and What to Expect

A physical exam is necessary to check for any underlying physical causes. This will typically include:

• An examination of the penis and testicles to check for any anatomical abnormalities.
• A check of your reflexes and sensation to assess for potential nerve damage.
• A general physical exam to look for signs of hormonal or other systemic health problems.

Diagnostic Tests: Blood Work, Urinalysis, and More

Based on your history and physical exam, your provider may order tests to rule out or confirm specific causes. As outlined by the Mayo Clinic, these may include:

• Blood Tests: To check hormone levels (testosterone, prolactin, thyroid hormones), blood sugar (for diabetes), and other markers of general health.
• Urinalysis (Urine Test): To check for signs of infection, diabetes, or the presence of sperm after orgasm (which would indicate retrograde ejaculation).
• Semen Analysis: This may be ordered if infertility is a concern, to check sperm count and quality.

What Are the Most Effective Treatments for Delayed Ejaculation?

There is no single “magic bullet” for delayed ejaculation treatment.

The most effective approach is highly individualized and depends on the underlying cause.

Often, a combination of strategies is required. It’s important to note that the U.S. Food and Drug Administration (FDA) has not approved any specific drug for treating delayed ejaculation, so many pharmacological treatments are used “off-label”.

A Multidisciplinary Approach: Why One Size Doesn’t Fit All

Effective treatment often involves a team approach. Your primary care provider may refer you to specialists such as:

• A Urologist for physical and anatomical issues.
• An Endocrinologist for hormonal problems.
• A Psychologist or Sex Therapist for psychological and relational factors.

Psychological and Behavioral Therapies

For DE caused by psychological factors, therapy is the cornerstone of treatment.

These approaches aim to reduce anxiety and change the behavioral patterns that maintain the problem.

• Sex Therapy: A trained sex therapist can help you and your partner explore emotional issues, improve communication, and learn new sexual techniques. This may involve sensate focus exercises to reduce performance pressure and increase pleasure.
• Cognitive-Behavioral Therapy (CBT): CBT helps identify and challenge the negative thought patterns (e.g., “I’ll never be able to finish”) that fuel performance anxiety.
• Masturbation Re-training: For situational DE caused by idiosyncratic masturbation, a therapist can guide you in gradually changing your technique to be more similar to partnered stimulation and reducing reliance on pornography.
• Using Sexual Aids: Therapists may recommend incorporating vibrators or other sex toys to increase stimulation during partnered sex.

Pharmacological Options: A Look at Off-Label Medications

While no drugs are FDA-approved specifically for delayed ejaculation, several have been used off-label with some success.

It is critical to discuss the potential benefits and side effects with your doctor before starting any medication.

Medication	Class	How It May Help	Common Side Effects
Bupropion (Wellbutrin)	Atypical Antidepressant	Increases dopamine and norepinephrine activity, which can counteract the inhibitory effects of serotonin. Often used to treat SSRI-induced sexual dysfunction.	Dry mouth, insomnia, headache, nausea.
Buspirone (Buspar)	Anxiolytic	Reduces anxiety and may have a pro-ejaculatory effect by acting on certain serotonin receptors.	Dizziness, nausea, headache, nervousness.
Cyproheptadine (Periactin)	Antihistamine	Blocks serotonin receptors, which can reverse the delaying effects of SSRIs.	Drowsiness, increased appetite, weight gain.
Amantadine	Dopamine Agonist	Increases dopamine levels in the brain, which is a key neurotransmitter for promoting ejaculation.	Dizziness, lightheadedness, insomnia.
Cabergoline	Dopamine Agonist	Primarily used to lower high prolactin levels, but its dopamine-promoting effects can also aid ejaculation.	Nausea, headache, dizziness, fatigue.
Oxytocin	Hormone	Administered as a nasal spray, it’s involved in orgasm and may help facilitate the ejaculatory reflex.	Nasal irritation, headache.

Lifestyle Modifications and At-Home Strategies

• Adjusting Medications: If a medication is the cause, your doctor may be able to lower the dose, switch you to an alternative (like bupropion instead of an SSRI), or schedule a “drug holiday”. Never stop or change a prescribed medication without consulting your doctor.
• Reducing Alcohol and Drug Use: Limiting alcohol intake and stopping recreational drug use can have a significant positive impact.
• Kegel Exercises: Strengthening the pelvic floor muscles with Kegel exercises may give you greater awareness and control over the muscles involved in ejaculation.
• Open Communication: Talking openly with your partner about what feels good and what doesn’t can reduce pressure and enhance stimulation.

Addressing Fertility Concerns: Sperm Retrieval Techniques

For men with severe delayed ejaculation or anejaculation (the complete inability to ejaculate) who wish to have biological children, several medical procedures can retrieve sperm for use in assisted reproductive technologies like IUI or IVF:

• Penile Vibratory Stimulation (PVS): A special high-amplitude vibrator is applied to the penis to trigger a reflex ejaculation. This is often a first-line approach, especially for men with spinal cord injuries.
• Electroejaculation (EEJ): An electrical probe is inserted into the rectum to stimulate the nerves that control ejaculation. This is typically done under anesthesia.
• Sperm Aspiration: If the above methods fail, sperm can be retrieved directly from the testicles (Testicular Sperm Aspiration – TESA) or epididymis (Microsurgical Epididymal Sperm Aspiration – MESA) with a fine needle.

How Does Delayed Ejaculation Affect Relationships and Mental Health?

The impact of delayed ejaculation extends far beyond the bedroom.

It can take a significant toll on an individual’s self-esteem and the health of a romantic relationship.

The Impact on the Individual: Frustration, Anxiety, and Self-Esteem

Men with DE often experience a cascade of negative emotions.

The inability to climax can lead to intense frustration and feelings of inadequacy.

Many begin to question their masculinity and sexual prowess. This can erode self-confidence, leading to performance anxiety, which only exacerbates the problem.

The stress of the condition can also contribute to a decreased desire for sex, as intimacy becomes associated with pressure and failure rather than pleasure.

The Partner’s Perspective: Misunderstanding and Support

The partner of a man with delayed ejaculation can also experience distress. They may feel:

• Unattractive or Unskilled: They might mistakenly believe they are not “good enough” to bring their partner to orgasm.
• Rejected or Unloved: The lack of a climax can be misinterpreted as a lack of arousal or emotional connection.
• Physically Uncomfortable: Prolonged intercourse can lead to vaginal dryness, soreness, and fatigue.
• Frustrated: Especially if the couple is trying to conceive, the inability to ejaculate can be a major source of stress and disappointment.

It is vital for the partner to understand that DE is a medical condition, not a reflection of their attractiveness or the health of the relationship.

Strategies for Couples to Navigate DE Together

Open communication and teamwork are essential for overcoming the challenges of delayed ejaculation.

1. Educate Yourselves: Learn about the condition together. Understanding that it has real physical and psychological causes can remove blame and foster empathy.
2. Talk Openly and Honestly: Share your feelings without judgment. The man can express his frustration and anxiety, and the partner can share their concerns and feelings of confusion or self-doubt.
3. Shift the Focus from Climax to Pleasure: Redefine what a “successful” sexual encounter is. Focus on mutual pleasure, intimacy, and different forms of sexual expression rather than making ejaculation the sole goal.
4. Seek Professional Help Together: Attending sex therapy or couples counseling can provide a safe space to work through these issues with the guidance of an expert.

Distinguishing Delayed Ejaculation from Other Conditions

Delayed ejaculation is one of several types of ejaculatory dysfunction.

It’s important to differentiate it from related conditions, as the causes and treatments can differ significantly.

Condition	Definition	Key Feature
Delayed Ejaculation (DE)	A marked delay in reaching orgasm and ejaculation despite adequate stimulation.	Orgasm/ejaculation is possible, but takes a very long and distressing amount of time.
Anejaculation	The complete inability to ejaculate semen, either during intercourse or masturbation. An orgasm (a “dry orgasm”) may or may not be felt.	No semen is expelled, despite reaching the point of climax.
Anorgasmia	The inability to achieve orgasm (the sensation of climax), even with ample stimulation. Ejaculation may or may not occur separately.	The primary issue is the absence of the pleasurable sensation of orgasm, not necessarily the expulsion of semen.
Retrograde Ejaculation	Semen travels backward into the bladder instead of forward out of the penis during orgasm.	The sensation of orgasm occurs, but little to no semen is expelled. The first urination after sex will appear cloudy due to the presence of semen.

Frequently Asked Questions (FAQ)

1. Can stress cause delayed ejaculation?

Yes, absolutely. High levels of stress and anxiety activate the body’s “fight or flight” response, which can interfere with the relaxed focus needed for sexual arousal to build to orgasm. Performance anxiety is a major psychological cause of delayed ejaculation.

2. Is delayed ejaculation a sign of low testosterone?

It can be. Low testosterone (hypogonadism) can reduce libido and contribute to ejaculatory problems. A simple blood test ordered by your doctor can check your hormone levels to see if this is a contributing factor to your delayed ejaculation.

3. Will Viagra help with delayed ejaculation?

Not directly. Sildenafil (Viagra) and similar drugs treat erectile dysfunction by increasing blood flow to the penis to help achieve and maintain an erection. They do not directly affect the nerves or brain chemicals that control ejaculation.

4. Is it normal for ejaculation to take longer as I get older?

Yes, it is a normal part of aging for many men. Penile sensitivity can decrease and nerve reflexes can slow down, leading to a longer time needed to reach climax. It only becomes a medical issue if the delay causes significant distress.

5. Can I have a biological child if I have delayed ejaculation?

Yes. If you are unable to ejaculate during intercourse, medical procedures like penile vibratory stimulation (PVS) or sperm aspiration can be used to retrieve sperm for assisted reproductive techniques, such as in-vitro fertilization (IVF).

6. What is the difference between anejaculation and delayed ejaculation?

Delayed ejaculation means climax is possible but takes a very long time. Anejaculation is the complete inability to ejaculate semen at all, even though you might still feel the sensation of an orgasm (a “dry orgasm”).

7. Can masturbation habits cause delayed ejaculation?

Yes. Becoming conditioned to a very specific, high-intensity masturbation style (often with a tight grip or specific pornography) can make the stimulation from a partner feel insufficient to reach orgasm, leading to situational delayed ejaculation.

8. When should I see a doctor for delayed ejaculation?

You should see a doctor if the condition is ongoing and causes distress for you or your partner, if you have other health problems that might be linked, or if you started a new medication around the time the symptoms began.

Conclusion

Delayed ejaculation is a complex and often distressing condition, but it is treatable.

The journey to improvement begins with understanding that its causes are multifaceted, spanning a wide spectrum of physical, pharmacological, and psychological factors.

From nerve damage and hormonal imbalances to performance anxiety and relationship stress, the root of the problem is unique to each individual.

The key takeaway is that you are not alone, and help is available. The most crucial step is to break the silence and have an open conversation with a healthcare provider.

A thorough diagnosis can pinpoint the underlying causes, paving the way for a tailored treatment plan that may include medication adjustments, sex therapy, lifestyle changes, or a combination of approaches.

By arming yourself with knowledge and seeking expert guidance, you can navigate the challenges of delayed ejaculation, reduce the associated stress, and work toward a more satisfying and fulfilling sexual life.

We encourage you to take that first step and schedule an appointment with a healthcare professional to begin your path to recovery.

Medical Disclaimer

The information provided in this article is for educational and informational purposes only and is not intended as medical advice. It should not be used to diagnose or treat any health problem or disease. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.