Delayed ejaculation

Delayed ejaculation is the term used when a man is unable to achieve ejaculation.

Many men have this problem at least once in their lives, but are not affected long-term by it. Unfortunately, however, some men have chronic delayed ejaculation (DE) which is complete and permanent….at least, that’s what conventional wisdom suggests.

But the common effects of delayed ejaculation, which include damage to a man’s relationship, emotional stress, and lowered sexual self-esteem, are not inevitable, nor are they untreatable. Delayed ejaculation is multi-factorial, and is neither inevitable nor a sentence to a life without sexual pleasure.

Video – delayed ejaculation

Because the definition is so vague – it can mean permanent impotence, or occasional loss of erection, or anything in between – it is hard to know how many men it affects.

But the chronic form probably affects about 10% or more of the male population. It is more common in older age groups: delayed ejaculation affects about 5% of men in their 40s, and three times as many by the age of 65. Almost all men will have some experience of it by the age of 50. But it is hard to separate the psychological and the physical factors, since any event of DE causes stress and anxiety which makes the physical problems worse.

Hormone Levels and Delayed Ejaculation

Low testosterone levels cause loss of libido and erection. An excess level of prolactin, caused by pituitary gland tumor, can be a factor in reduced testosterone, but usually it is due to age.

Neurologic Conditions

Spinal cord and brain injuries cause impotence when they affect nerve impulses going from the brain to the penis. Multiple sclerosis (MS), Parkinson’s disease, and Alzheimer’s, for example.

Psychological Conditions Causing Delayed Ejaculation

All emotional problems such as depression, worry, stress, anxiety, and guilt, may all contribute to loss of sexual drive and delayed ejaculation. The classic situation is that a man experiences temporary loss of erection, but then worries that it occur once again.

This can produce sexual performance anxiety which leads to a negative spiral which leads to chronic ejaculation problems during sex. Psychological factors often reinforce physical problems.

Effects of Delayed Ejaculation

Whether the cause of delayed ejaculation is physiological or psychological, both the man and his partner will undergo intense feelings and emotions. This may include a sense of despair, hopelessness and lowered self-esteem. Sexual insecurity caused by DE can reinforce any sexual performance anxiety a man happens to be experiencing and create a further cycle of repeated failures and increasingly negative self-esteem.

To get over this, it’s necessary to accept the problem and communicate openly and honestly with one’s partner.

Sexual performance is a big part of a man’s sexual self-esteem, so delayed ejaculation (DE) can be devastating to a man’s entire sense of being.

Men with DE may well be uncertain of their masculinity and avoid sexually intimate situations with their partners; this causes more anxiety and is unnecessary because DE is often treatable. Men with DE may also withdraw emotionally and psychologically.

The psychological effects of DE can be widespread – it affects a man’s social life, his work life, and his relationship. He needs to feel secure and safe to talk about it with his partner, doctor, and therapist so he can fid the right treatment.

But of course delayed ejaculation can be hard to discuss with both health care providers and partners: women may think that initiating a discussion about the DE will induce embarrassment or even humiliation. And although you want a treatment for this challenging problem, you may not want to see a therapist. Fortunately there is a good book which may help you deal with the difficulties of not being able to ejaculate. You can find it here. And the UK verison of this self help delayed ejaculation treatment is here.

And women themselves may develop a sense of personal inadequacy, possibly believing that their man’s DE is somehow their fault (for example, they may conclude they are not sexually attractive to their partner).

It’s said that DE is usually a result of physical causes, made worse by psychological factors, but this is untrue in many cases. Such complex etiology means that treating DE may not be so simple as it first appears. And any anxiety around the situation will always make DE worse.

Treatment of delayed ejaculation

Sexual Psychotherapy

DE rooted in psychological causes can usually be overcome. And even when a physiological cause has been addressed, self-esteem problems or anxiety can impair the restoration of normal function and adequate sexual performance.

Qualified sex counselors, or sexual psychotherapists, can reduce emotional tension, increase communication, and provide realistic expectations for sex, all of which can improve a man’s sexual performance.

Psychological therapy can emphasize how men and their partners can find the motivation to change psychological expectations and modify sexual behavior.

Delayed Ejaculation

One of the problems that men may face in their sexual relationships is delayed ejaculation. And in fact it’s interesting to see that a failure to ejaculate during sexual intercourse is something that actually happens to most men at some point in their sexual life.

Sometimes delayed ejaculation is the result of tiredness or stress, but it may also be the result of sexual boredom, the lack of attraction to a partner, or ill-health that affects a man’s libido.

Now, of course some of these problems are temporary, and a man’s sexual response will improve when the stress is removed, but delayed ejaculation can be more persistent, and men often wonder whether it is caused by psychological, emotional, or physical problems.

The answer is that actually is usually caused by combination of the two, although the emotional component is usually much more significant.

Even in cases of clear physical problems this is such an emotionally charged event that it produces a level of anxiety that acts against the likelihood of ejaculation in the future. This means that any case of delayed ejaculation needs to be examined both from a medical point of view and from a psychological point of view.

The point is that for many men it’s simply the fear and anxiety about some aspect of sex which lies at the root of consistent delayed ejaculation. In this context it’s also important to emphasize that a single man who has anxieties around sex would be well advised to avoid casual sexual encounters – these can simply confirm his anxiety and insecurity around his problems.

A much better process is to develop a full-time sexual relationship which builds intimacy slowly and gradually, so that his sexual confidence is supported and developed, rather than challenged. As in all sexual activities, good health is also important to successful sex.

Men put themselves under pressure to achieve an outstanding sexual performance. They may wish to satisfy their partner sexually before they satisfy themselves, particularly if the partner is demanding and unsympathetic, perhaps making comments on his sexual performance or physical attributes. Then, delayed ejaculation is much more likely.

A man’s experience of anxiety is likely to become a self-fulfilling prophecy, in particular if he does not have a secure relationship in which he can establish a level of emotional security about his sexual ability.

The first thing to do in all cases of delayed ejaculation is for a man to take the pressure off the situation: this may actually include temporary abstinence from sex, which can give the man space and time to control his anxiety from his sexual performance.

Sensate focus exercises are extremely beneficial for men with delayed ejaculation, and also in establishing intimacy with a partner.

When working through sensate focus exercises, it’s important that intercourse is not attempted until the man is completely able to relax into sensual touching. The object of this is to achieve pleasure for its own sake rather than to achieve orgasm and ejaculation.

Furthermore, it is also important when the woman gets to the final stage of sensate focus where genital touch is involved, that she does not focus too much on stimulation of her partner’s genitals, but maintains the experience of whole body sensitivity and sensuality.

At the point where a man has relaxed into the experience of whole-body sensuality, his partner should be able to stimulate him to ejaculation either with masturbation or oral sex. This enables the man to develop a clear belief that he does indeed have full sexual  capacity.

It is also necessary for the man to maintain a clear involvement with touching and caressing his partner’s body, rather than focusing on whether or not he can ejaculate. A man’s expectation around his sexual performance is key here (i.e. not necessarily expecting to come every time): his partner also needs to be able to touch his body and genitals without expecting anything in particular to happen. You can see how different this is from the normal expectations that we hold of sex.

However, as a man becomes less focused on his penis, and more involved with pleasure of simply touching his partner, his level of relaxation will increase and he will be able to gain a new confidence which enables him to fully explore his sensuality and sexuality.