A Review of Delayed Ejaculation

A review of delayed ejaculation

This has been described as one of the most challenging male sexual disorders: and it’s certainly true that men who have a problem ejaculating, whether they are alone, or with a partner, will likely feel anxious, frustrated, and possibly consider themselves a failure in the arena of sexual relationships. Often, the woman who partners a man like this also feels stressed, partly because she’s deprived of sexual pleasure, but also because she feels she cannot arouse him sufficiently to bring him to climax.

The majority of men who need some kind of treatment or therapy for retarded ejaculation have a normal level of sexual desire, and get apparently normal erections, but they simply cannot reach climax during intercourse. As you can imagine, this condition has produced a whole host of theories and a lot of speculation about what might possibly cause it: opinions differ widely on the subject, but in broad terms there are two main explanations.

The first is that the man who is unable to reach his own climax is simply too focused on the pleasure of his partner, probably insufficiently aroused, possibly unaware of his feelings and level of arousal, and basically trying too hard to please his partner.

The second is that the man with delayed ejaculation is basically either demonstrating his psychological “withholding” from the relationship, or is highly resentful and/or angry against women. 

Another reason that this condition has received comparatively little attention is that it’s been regarded as the least frequent male sexual dysfunction, a supposition which is not true, since its occurrence in the population is around 10% of all men. And it’s also been assumed that treatment for delayed ejaculation is significantly less likely to succeed than it is for other sexual dysfunctions, but this too is a falsehood. Treatment can be very successful, although it may involve more psychological work than a condition like premature ejaculation.

In the case of men who aren’t able to reach the point of ejaculation, it’s clear that there is some inhibition of the normal reflex reaction which provokes ejaculation. There’s some kind of dissociation between the emission of semen into the base of the urethra prior to ejaculation, and the experience of orgasm.

Classifying Men’s Inability To Ejaculate

Delayed ejaculation may be something that a man has had for his entire sexual life, or it can be acquired later in life; equally, it can occur with every sexual encounter, or it can be an intermittent condition that only occurs with certain partners.

Finally, some men with delayed ejaculation can masturbate successfully, whilst others are unable to do so. It certainly true that the most common form of delayed ejaculation is coital anorgasmia. Every degree of difficulty from complete anorgasmia to a limited ability to reach climax with a partner can be found in this spectrum of dysfunction.

None of the degrees of difficulty that a man may have with his ejaculation responses have noticeably less impact on the relationship than any other: in all cases, achieving orgasm is hard work, and there is little room for intimacy or a satisfying sense of pleasure.

For the woman, the experience of extended intercourse is often uncomfortable or painful, and will probably require additional lubricant to be acceptable. Partners may miss the shared experience of intimate intercourse, and clearly cannot experience a mutual exchange of pleasure in response to the other partner’s climax.

And the inability of the male partner to “let go” can be seen as symptomatic of his withholding in more general terms in the relationship; a woman who, as most women do, relies on her ability to give sexual pleasure to her partner to maintain her own sexual self-esteem and confidence is likely to feel negated and devalued.

It seems from research that men with delayed ejaculation have difficulty connecting with their own inner world of arousal: although they may have a long-lasting and rigid erection, this in itself does not indicate a high level of sexual arousal. There may also be some physiological mechanism at work which prevents men from responding to the stimulation applied to their penis, so that they are unable to move through the sexual response cycle, unable to reach the plateau phase or the point of ejaculatory inevitability.

Our own experience in dealing with this condition suggests that there may be two main antecedents: the first is when a man has simply conditioned himself through extremely harsh and vigorous masturbation during puberty, so that he can only respond to physical sexual stimulation of an extremely forceful kind. This “traumatic masturbatory syndrome” is a comparatively common condition, and it certainly causes a great deal of difficulty for men in future life, as they struggle to reach climax.

It can be seen as a lack of arousal even during adolescent sexuality; but whether that’s so or not, this conditioning process leaves men with a real problem — fortunately, one that can be overcome, by a process of retraining the body to achieve orgasm with lower stimulation thresholds. The other main cause of delayed ejaculation appears to be related to a man’s psychological orientation: in its simplest form, DE may express a lack of trust, an inability to fully release into his partner’s body, that inability being, perhaps, a  metaphor for not being able to open up and trust her fully.

It’s certainly observable that many men with delayed ejaculation have traumatic sexual histories, although it’s not entirely clear why they would develop this condition rather than premature ejaculation. If we rely on psychological interpretations, we might see PE is a means of quickly “getting out of here” – which can be a different manifestation of a desire not to invest fully in a relationship.

In the case of delayed ejaculation, the psychological mechanism seems to be more about appearing to cooperate, but secretly withholding a sense of self in a private inner psychological world. Clearly, this delayed ejaculation isn’t going to be amenable to treatment if the man concerned isn’t willing to explore the psychological issues that may be preventing him from investing himself fully in his partner or his relationship with her.

In some cases, men will deny any knowledge of such issues: but, in the hands of a skilful therapist, they’re not hard to tease out, and generally speaking at some level most men are aware of how they really feel towards a partner — it just requires appropriate and skilful questioning by a competent therapist to draw this out, and then to establish the connection between these insights and a man’s lack of responsivity during intercourse.

It’s been said that if a woman stimulates her man vigorously so that he nears the point of orgasm and then rapidly transfers his penis into her vagina, it’s possible for him to ejaculate intravaginally, and that this will somehow break down the inhibitions which currently prevent him from ejaculating inside her, thereby allowing him to establish greater and greater levels of sexual responsivity.

The significance of ejaculating intravaginally should not be underestimated: it signifies many fundamental psychological tenets of human existence on many levels. Superficially, it’s about the possibility of creating new life. On a deeper level, it’s about possession and ownership. It’s also about the psychology of giving (here, giving the essence of life and vitality to a woman), and also about rendering oneself completely powerless in the throes of orgasm, subject to a woman’s protectiveness and, for want of a better word love, at the moment when one is most vulnerable and where one’s psychological masks are most likely to be weakened, if not torn off completely.

No wonder that a man who has had traumatic relationships with women may find it difficult to express himself in this most vulnerable of sexual experiencesThe treatment, or training, takes a period of weeks but it seems to be effective and certainly allows a man to extend the time for which he is able to enjoy intercourse.