Delayed Ejaculation (also known as retarded ejaculation)
A simple definition of delayed ejaculation is that a man finds it difficult or impossible to ejaculate during sex with a partner, despite wanting to achieve both orgasm and ejaculation, having enough sexual stimulation and a firm erection. In general, a man can ejaculate without difficulty when he is alone but finds it difficult to come with his partner during sex. Most men who have this problem do not generally find it to be a pleasant experience, and end up feeling frustrated, anxious, and incompetent in bed. Their partners tend to feel deprived of sexual pleasure, anxious, distressed, and frustrated if they wish to conceive. And it's often a problem which lasts for years, if not decades, and a couple may only seek treatment when tension in the relationship has got to such a point that there is serious emotional distress or danger of breaking up. Dealing with how to stop retarded ejaculation is often thought to be difficult, though in fact this is only because there is so little research on the condition. In fact no-one really knows how many men are affected by delayed ejaculation, nor how effective treatment actually is. Except, perhaps, us....we have counseled many men over the years and we have found that with the right approach, and dedication on the part of the man concerned - and his partner - the success rate of treatment can be very high. The problem is regarded as the least important sexual problem for men, and yet it causes a lot more distress than premature ejaculation and erectile dysfunction - especially if a couple wish to conceive. We believe that neurobiological and psychological factors are involved in causing delayed ejaculation, but the actual mechanism that lies behind it remains unclear. However, we should not allow this to cause us despair - the condition can still be treated effectively, and if you are one of the men who who experiences delayed ejaculation, hope is at hand! Retarded ejaculation or delayed ejaculation is widely thought of as being related to the same condition in women. But in fact we believe it is a completely different condition. Most men who can't come during sex have sexual desire and can easily get an erection, but they simply cannot orgasm during intercourse, or they can only do so after great effort. In the past, the psychodynamic theories of delayed ejaculation suggested it was caused by fear of loss of control, hostility and anger, or too much reliance on fantasy during sex to get aroused. Another group of experts suggest that the problem is caused by a man learning to masturbate in a particular way which cripples his ability to reach orgasm through normal stimulation such as manual masturbation or sexual intercourse - the theory is that he just does not get enough stimulation from these techniques to reach orgasm. One man who has studied this condition, Bernard Apfelbaum, suggests that delayed ejaculation involves a low level of arousal - in other words, that the man who thrusts for hours during sex without reaching an orgasm and ejaculation is simply not sexually aroused, even though he has an erection. Apfelbaum thinks of this man as a "sexual workhorse" who is trying too hard to please his partner and yet is neither sexually aroused not getting much pleasure from sex with his partner. Treatment of the boyfriend who can't come during sex, designed to help a man "learn" how to ejaculate during sex, takes many forms, including the exploration of a man's childhood experiences and beliefs around sex and sexuality. Often men who have problems in this area have issues from childhood - issues such as sexual abuse, shame, poor personal boundaries due to inappropriate parental behavior (sexual or otherwise), and these problems have left the men with trust issues or a compulsion to "serve" their partner sexually. It's often said that these men are very giving during sex, but ironically the one thing they do not give to their partner is their semen - which in fact means that they are withholding their sexual pleasure. The implication of this is that a man doesn't know how to let go (or can't let go) and enjoy sex to the full. One helpful treatment approach is a series of behavioral exercises which involve the man ejaculating first in the presence of his partner, and then gradually nearer and nearer, then having the man's partner stimulating him, until the couple are finally ready to enjoy intercourse. One part of the system is to educate the man in some simple facts: for example, having an erection does not, in itself, mean that a man is ready for intercourse, and that he must learn how to communicate his sexual desires and feelings to his partner. As you might expect, any approach to treatment is most successful when it involves both the man and his partner, co-operating in a flexible treatment approach, communicating clearly, and dealing with any relationship issues which come up. The man (and his partner where appropriate) must take responsibility for dealing with any underlying conflicts, understanding any fear he has around sex, and resolving destructive relationship interactions that might be reinforcing his problem. There aren't - at least at the moment - any drugs which will help a man to ejaculate. This means that the qualities which man and his partner seeking to deal with this problem need to call upon include patience, mutual support, and dedication. Sensate focus is a great starting point and you can find information on that here. Keeping your erection during sex for an excessive length of time can be very unsettling; if you thrust in your partner's vagina for extended periods of time without ejaculating, it can be quite disturbing; and even if the goal of ejaculation is eventually achieved, the whole process is unsatisfactory for both partners. An inability to time ejaculation to ensure both partners' pleasure, and a wife's inability to help speed things up, can put a strain on even the best relationship. Fortunately there are treatment methods for retarded ejaculation which work, and in upwards of 80% of men, treatment (which involves reducing anxiety, having a clear focus on what you wish In most of the cases which I have treated, the partner who is unable to achieve orgasm during sexual intercourse can actually achieve orgasm during masturbation - but not during sexual intercourse. Like other sexual dysfunctions, it can be either lifelong or acquired and is either generalized (i.e. it occurs with all partners) or situational (i.e. it occurs with just one partner). The lifelong form of retarded ejaculation is rather less common than the acquired-later-in-life type; both are usually the result of emotional or psychological issues like a very strict religious background, resentment against women, poor childhood boundaries, sexual shame imposed during childhood, a lack of trust, or a high need to be in control. The treatment usually adopted is to gradually desensitize the man with delayed ejaculation to the factors that keep him from experiencing ejaculation - and this is actually easy enough to do. Men with this issue may have long-lasting erections and be sexually aroused, and they may enjoy sex, but reaching orgasm can take for ever (well, at least 45 minutes to an hour). Retarded ejaculation - an old fashioned term, now generally replaced by the expression "delayed ejaculation" - can be a very distressing condition. Men who cannot come during sex may feel embarrassed, resentful, angry, isolated, confused and very frustrated. Sex becomes a chore rather than a pleasure, and a man's partner may well blame herself and feel inadequate - unfortunately, this can place even more pressure on the man with delayed ejaculation. This compounds the issues even more. Possible emotional / psychological issues behind the problem include the following personality traits: perfectionism, over control, anxiety about sexuality or low sexual self-confidence, fears and conflicts about sex, distraction, lack of connection with sex, one's body or one's partner, disassociating during sex, worry or unhappiness. Delayed ejaculation is often approached by helping a man to reduce his anxiety and showing him how to control the timing of his ejaculation. This may involve sensate focus exercises, which are described in great detail on this website. By the way, delayed ejaculation is often caused by side effects from various medications, the most common being antidepressant medications such as the SSRIs. Basic things you can try at home! Try the Sensate Focus method outlined on this website. Although what follows is only an outline summary of how you can deal with retarded ejaculation, it will give you a brief flavor of how to approach the problem. First of all, reduce the frequency with which you have sex. Try Sensate-Focus Exercises. When you do get round to sex, lengthen the time intervals between sex, especially if you find that the length of time for which you can go before ejaculation is beginning to lengthen. Withhold penetration until the moment when ejaculation is inevitable - you can probably get better control by having your partner on top, astride you. When you sense that ejaculation is near, switch into the missionary position. Sensate focus exercises, developed by famous sexologists Masters and Johnson some years ago, work well and may prove to be all that you need to solve the problem. Sensate focus exercises take you through a series of levels of sexual exposure by helping you to stop focusing on orgasm and showing you how to focus more on the sensory / sensual / sexual pleasures of the moment (that's what "Sensate Focus" means, of course). In brief, you progress from level one (where you keep your clothes on), through more advanced touching and communication, to enjoying having your penis inside your partner without moving, and finally progressing right through to full-on thrusting. You move one step at a time in this therapy, which is often used to treat sexual problems such as anorgasmia, sexual desire disorder, and erection problems. In other words, it can help both men and women who have difficulty in getting sexually aroused and reaching orgasm. It works by reducing anxiety about sex and orgasm through placing attention on what feels good to you and your partner. The reason it works is that men with delayed ejaculation often think that the goal of sex is orgasm, while in fact it is sensual pleasure. If you focus on the attainment of orgasm, then you lose sight of your physical arousal and your sensual pleasure, and you may also find that you get anxious - and when you are anxious, you miss out on the joy of sex and physical contact, so that you lose out on the pleasure of being with your partner and taking your time to enjoy exploring many parts of your partner’s body. |