Male Sexual Dysfunction
Delayed ejaculation is a surprisingly common sexual dysfunction affecting many men, perhaps as many as one man in 20 in the general population.
It consists of the inability to ejaculate in a timely way during intercourse, and sometimes even during partnered masturbation or solo masturbation.
The causes remain somewhat unclear even now, after years of research and development of new treatment methods. However, it’s fair to say that in general men experience either an inadequate level of sexual stimulation, or they have some emotional factors at work which inhibit their ability to reach the point of ejaculation.
It’s been suggested many times in the past that inhibition of sexual desire can be caused by emotional factors at work in the subconscious.
These include anger and hostility towards women, shame and guilt around sex, and anxiety about sexual performance.
A qualified sex therapist can assist a man in examining these issues and considering how his beliefs about sex and his own performance during intercourse with a partner can be improved or adapted so that he sees himself as sexually more competent.
But if he is suffering from an inhibition of sexual arousal and desire, it’s essential to address this as well: this might be done, for example, by helping the man to identify orgasm triggers that increase his sexual arousal dramatically.
These might include using a particular fantasy during intercourse, nipple stimulation, anal stimulation or some other individual stimulus that takes a man towards the point of ejaculatory inevitability more rapidly.
Other factors that cause delayed ejaculation include traumatic masturbatory syndrome.
This arises when a man has habitually masturbated using a hard and fast technique that desensitizes the penile nerves to physical stimulation.
However it’s important to understand that it has also been suggested that this form of masturbation is actually a way of dealing with low sexual arousal in the first place.
In other words, the cause of delayed ejaculation is not the harsh penile stimulation, but the man’s lack of sexual arousal.
In this frame of reference, the harsh way of stimulating the penis becomes a method of overcoming low sexual arousal and actually achieving orgasm.
In either event, it’s obvious that sexual intercourse will never provide the same level of stimulation to the penis that this type of masturbation does.
For this reason it is important for a man who is seeking delayed ejaculation treatment to find treatment methodologies that will actually allow him to experience a much higher level of sexual desire, arousal, and excitement.
In general, orgasm triggers are a powerful way of doing this, as already mentioned, and the other is to explore the emotional and psychological factors which may be inhibiting the expression of his full sexuality.
Therapy for delayed ejaculation
Classic psychodynamic therapy is one way of approaching the emotional issues, and cognitive behavioural therapy is another.
It’s often been suggested that cognitive behavioural therapy is less effective than deep psychotherapy. This is because although it produces apparently dramatic changes in behaviour, the underlying factors that may be responsible for inhibiting a man’s sexual desire are not addressed. They will therefore always come into play during sex with a partner.
So any treatment approach must be eclectic and probably also individually designed for the man concerned.
Orgasm and ejaculation
Contrary to conventional notions, orgasm and ejaculation are 2 entirely different events!
Conversely, ejaculation is a reflex reaction that is induced by persistent pleasurable physical contact to the male organ and other pleasure points elsewhere in the body.
Science has not yet identified the exact location orgasmic pleasure occurs inside the brain, but we do know a significant lot about the synaptic mechanisms by which the physical function of ejaculation is triggered.
There are competing viewpoints. But one conclusion is that when erotic pleasure gets to a certain threshold, the flow of ejaculatory fluids into the farthest point of the the urethra concentrates the pressure at the base of the penis.
This consequently results in a whole set of physical responses including flexing of the pubococcygeal muscle.
Ejaculation is governed by the autonomic nervous system, while gradually heightening erotic pleasure during sex is confined to the sympathetic nervous system.
Delayed ejaculation has been known to the medical profession for years now.
The evolution of the terminology used to identify this peculiar sexual dysfunction most likely mirrors in some part, the medical profession’s evolving understanding (and I would hope compassion) of this dysfunction: ejaculatory incompetence, ejaculatory over-control, retarded ejaculation, and finally delayed ejaculation.
These are names that represent, from my point of view, a new and increasingly sympathetic attitude for the men whose sex lives are diminished by their inability to ejaculate in a timely way during sex.
The thing that’s particularly puzzling to researchers is that most of these men are able to ejaculate without any apparent difficulty when they are pleasuring themselves.
This fact has led many scientists to conclude that there might be some relationship issues associated with the inability to achieve orgasm and ejaculate in the course of engaging in sexual intercourse.
Naturally, one must exercise an ample dose of skepticism when seeking an explanation in the relationship between sexual partners.
You would expect that a man’s apparent inability to ejaculate during oral sex with a partner, intercourse with a partner, or even masturbation by a partner, suggests he is not aroused. Maybe this can only mean that there’s nothing in these activities to compare to the higher level of arousal and / or pleasure a man can produce while pleasuring himself.
Certainly, anyone can get physically accustomed to react to higher levels of stimulation. It’s inherently logical to establish whether or not the problem in ejaculating simply lies in the fact that the man on his own, can apply hard, firm, or high-frequency stroking during self stimulation, in a manner that is not mirrored during actual sex with a partner. See www.women-coming-first.com for more information.
If the problem is, in fact, triggered by a simple incompatibility in techniques, the remedy will be in the form of a physical retraining of the body, the sex organ and the mind, to react to much more gentle stimulation of the kind that can bring about a climax during sexual activity.
As is often the case, therapists and counsellors often take the view that the internal dynamics is the real cause of the problem.
And it might as well be. In my years of working as a therapist, I’ve come across sex partners who have become increasingly hostile to each other and have diminished intimacy. In some cases, this has developed to such a degree that the man no longer enjoys sex, but in fact resents it. And he may also simultaneously find himself powerless to communicate with his spouse to start a rational dialogue so as to find the resolution of these problems.
Moreover, even without hostility, anger, or any other emotion on the part of the male towards his partner, there is, as some studies show, a particular kind of individual who is often a natural sufferer of delayed ejaculation.
Based on the most current research journals, this individual type is quite likely a person who is in some way strangely unaware of his own process of sexual arousal.
He is often unable to realize just how aroused he is during sexual activity, and may regard sex with his partner as a duty that he needs to perform.
He may see his partner’s pleasure during sexual intercourse as his own responsibility, and who is convinced that the woman’s pleasure must come before his own and is the priority during sex.
These men often, whether intentionally or not, perceive themselves as the “workhorse of sex”, labouring away (often against all the odds) to steer the sexual intercourse to a successful climax.
It is also observable that most of the partners of men in this situation are often disinterested about sex, and have an expectation that the man is implicitly obligated to bring them sexual pleasure.
In fact, they should be without a doubt responsible for their own pleasure. In instances like this, it’s absolutely essential to help and re-educate the sex partners and give them some useful sexual information.
Approached in this manner, their ideas and beliefs around sex and sexual gratification can be brought closer to reality.
In a very real sense, there seems to be a certain disconnect, or a veritable vacuum, in their sexual experience. This means their own process of sexual pleasure gets confused with the dynamics of having sex with a partner.
What can be deduced from all these is that their own erotic world somehow doesn’t function as a source of sexual stimulus and pleasure: they are left in a sort of sexual limbo where they are trying to have sex with a partner without all the emotional and physical tools that are important for the sex act to be an enjoyable and intimate exercise.