Delayed Ejaculation (also known as retarded ejaculation)A reasonable definition of delayed ejaculation (DE) is that either (1) a man is completely unable to ejaculate during sex with a partner, or (2) he has great difficulty doing so, even though in both cases he wishes to achieve both climax and ejaculation, and he has had sufficient sexual stimulation with an erection perfectly adequate for lovemaking to take place normally. Usually, a man with delayed ejaculation can climax during masturbation, even though it may take him a long time. So this is, primarily, a problem that involves sex with a partner.
The majority of men who have this condition do not find it a pleasant experience in any way: in fact, it can be extremely frustrating. Men with delayed ejaculation (also known as retarded ejaculation) are unable to ejaculate during sex and usually develop feelings of frustration, anxiety, and low sexual self-confidence, if not low self-esteem in general. Their female partners often become depressed or irritable, since they are deprived of sexual fulfillment, and they may see their man's problem, his inability to ejaculate, as a reflection on their sexual attractiveness. Since this can be a long term problem within a relationship, the potential for mutual recrimination is considerable, and this will obviously be worse when a couple wish to conceive. In fact, it is often the woman's threat that the relationship will be at an end unless the man does something about his sexual dysfunction that prompts the man to seek treatment, and I have come across several couples who have actually broken up because of the issue. Finding a treatment for retarded ejaculation (or RE for short - the terms "delayed" and "retarded" are used interchangeably) is often thought to be difficult, but the reality is that we have so little information on the condition that we don't really know how many men have it, how many men seek treatment, and how many men are cured by the various treatments available. However, we have worked extensively with men who have had a greater or lesser degree of difficulty with their ejaculation reflex, and we believe that as many as 12% of men are experiencing ejaculatory difficulty at any one time; this is a far higher figure than most experts have recognized. The good news, however, is that with the right approach, and with support, a man who is sufficiently motivated to overcome the challenges associated with the treatment of retarded ejaculation has a good chance of being restored to normal sexual function (or acquiring it in the first place, in the case of a man who has experienced delayed ejaculation - which can be abbreviated to DE - as a lifelong condition). We know that most sexual therapists see delayed ejaculation as one of the less important dysfunctions that can affect a man, but it is our experience that it causes far more problems than, say, rapid or early ejaculation. Whether or not DE is more difficult to deal with - from the point of view of both client and therapist - than erectile dysfunction is difficult to say, but it is certainly at least as troubling, albeit in a very different way. Once again, imagine if you were a young couple, healthy in every way, and wishing to have a child, but the man could not climax during sex. The whole concept is rather strange, is it not? It goes against everything we assume about the nature of male-female sexual relationships, and so the primary question has to be: what causes it? We think that that both psychogenic (i.e. psychological) and physical (i.e. neurobiological) issues contribute to delayed ejaculation, but the actual way it develops is not at all clear. Happily, treatment can be effective despite our lack of understanding of the condition, and so if you happen to be one of the men who knows all too well the frustration it invokes, do not despair! Delayed ejaculation or retarded ejaculation, call it what you will, is often regarded as somehow related to anorgasmia in women. But another group of experts - including us - believe it is actually a completely different condition. It's certainly not a lack of sexual desire disorder, at least not in the sense that a man with DE usually has a normal libido. Whether or not he wants sex with the particular partner he is in bed with is, of course, another question. That is in fact closely related to the diagnosis and subsequent treatment of this condition - is it partner-specific, or does it occur with every partner? Some psychodynamic theories of DE suggest it is caused by fear of loss of control, hostility and anger, or too much reliance on fantasy during sex for arousal. Another suggestion is that it is caused by a man learning to masturbate in a particularly forceful way which inhibits his ability to reach orgasm through normal stimulation such as gentler masturbation or sexual intercourse - the theory being that he just does not get enough stimulation from these techniques to reach orgasm. Sexual therapist Bernard Apfelbaum believes that delayed ejaculation involves a low level of arousal - in other words, he thinks a man who thrusts for hours during sex without reaching orgasm and ejaculation is simply not sexually aroused, even though he has a hard and long-lasting erection. Much of the treatment for DE has centered on psychodynamic psychotherapy, simply because there are no drugs available which can be used. Psychotherapy tends to look for explanations of current conditions in a man or woman's emotional and psychological history. And it's not hard to understand how a man's inability to ejaculate with a specific partner might represent a "withholding" attitude towards her. His lack of ejaculation becomes the external symbol of his internal hostility, resentment, or anger towards her. Non-partner-specific delayed ejaculation might be the result of more generalized shame, anxiety or guilt around sex in general. I believe that some of our clients with delayed ejaculation have indeed held a great deal of hostility to women in general or their partner specifically, or feel a lot of shame and guilt around sex in general. But there's still an interesting question to be addressed, and that is why these emotions manifest in this way in only some men who have ejaculation issues. There is no doubt that many men have feelings of anger and hostility towards women, and/or shame and guilt around sex, but they have no difficulty engaging in intercourse and ejaculating normally. So is there another factor at work? The answer, as you may have expected, is probably "yes". It seems that men with delayed ejaculation - click here - generally have a very low level of sexual arousal, despite having a hard and often prolonged erection. This emotional state appears to come from a position where a man is, at a very deep emotional and psychological level, trying hard to please his partner, to fulfill her needs, and to satisfy her in a way that probably goes beyond sex alone. Indeed, it's hard not to see this as going back to a distorted relationship between mother and infant, where a boy was required to fulfill his mother's needs, presumably because she was lacking in any other source of emotional support and didn't see him as a separate entity with his own needs. That's not an uncommon situation in psychotherapy, but it's fascinating to see it manifesting as a sexual dysfunction later in life. But there are other explanations of delayed ejaculation too, the primary one being that a man learned to masturbate in a very idiosyncratic way which involved extreme pressure and force on his penis. Having conditioned himself only to ejaculate in response to very vigorous stimulation, it becomes impossible in later life to get the necessary stimulation he needs to ejaculate from the act of intercourse. A third explanation is even more prosaic: it is that a man simply prefers the feeling of his own hand to that of his current partner's, or any partner's, vagina.... although once again, it seems probable that this is the result of unhealthy relationships with women during childhood. And so of course the most important question is: what treatment methods are available? The answer is that there are many ways of treating DE, and which one of them will be successful depends on the individual circumstances in each case. For example, where there are clear issues of blurred boundaries, or, worse, childhood sexual abuse, then deep psychotherapy is probably the answer, so that a man can re-establish a sense of trust towards women, and an ability to maintain his own boundaries in the face of his partner's needs, wishes, and demands. One clue to this approach being the appropriate one is when a man seems to have a compulsion to "serve" his partner, or when it appears that his main aim during sex is to pleasure his partner, or when he seems unable to take any time or pleasure for himself. A man like this can be encouraged, through a gradual process of psychotherapy, to let go and take time and space for himself so that he can enjoy sex to the full. When he can let go of his emotional constraints, he will probably also be able to release physically during the act of intercourse. "Release" is a good word here, since it implies equally to the release of semen and the release of psychological inhibition. |
Having trouble ejaculating during intercourse?
Don't feel too bad about this....we have some answers for you. If you're a healthy man who can't climax in the normal way during lovemaking, you're most probably feeling pretty bad about it - and your partner may feel worse. And, whether you're still enjoying intercourse, or avoiding it because it's all too disturbing, we know the consequences can be severe - both for you and your relationship. This is an important and significant problem which needs attention. Over the years we've been dealing with delayed ejaculation, we've seen hundreds of men who were in despair, hundreds who had given up sex, and hundreds whose relationship was threatened because of it. And the good news? In about 96% of those cases, the right therapy made a massive difference to a man's ability to ejaculate normally....and that completely changed the lives of those men and their partners. And it's nobody's fault. That's what makes it seem so hard to deal with - why should such a problem even exist? Women tend to think they are somehow responsible, and men often try and carry on, "being strong", while not knowing how to solve the problem. So, as well as showing you how to cure delayed ejaculation, we offer a simple guide to getting your relationship back on track, and show you how to talk to your partner openly and honestly about the problems. What a relief for all concerned! You can cure your problems with ejaculation NOW! And you're not alone: as many as one man in ten finds it difficult to ejaculate during sex. But the simple, powerful and above all, effective, techniques described in this treatment program will give you the power to achieve a normal orgasm and release during intercourse - and you can explore the whole system in the privacy of your own home!
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