Delayed ejaculation
This is an ejaculatory dysfunction that occurs in a large number of men, resulting in them being unable to ejaculate during sexual intercourse and sometimes even during solo masturbation.
The cause of delayed ejaculation it is not exactly clear, but we know that men who have this problem fall into several broad categories.
The first category of men is those who have learned to masturbate using a hard and fast technique which desensitizes the penile nerves, so that ejaculation becomes impossible as the point of ejaculatory inevitability is never reached.
A second group of men appear to be experiencing delayed ejaculation because of emotional and psychological issues which prevent them achieving a sufficiently high level of sexual arousal to trigger the ejaculatory reflex.
Delayed ejaculation is not the opposite of premataure ejaculation!
Whether or not delayed ejaculation is due to physical insensitivity to sexual stimulation, or is due to internal emotional inhibitions on the levels of sexual desire that they can reach is not clear. However we do know that DE is not the opposite of premature ejaculation.
The fact that dictates treatment strategy is mediated by both physical resensitization strategies and emotional exploration using in depth psychology and psychodynamic therapy. Treatment can generally be successful, at least to the extent that a man becomes able to ejaculate much more readily than previously, even if his ejaculatory responses are not as labile as those amongst men in the general population.
Ironically, that may not in fact be much of a disadvantage, since many men in the general population experience premature ejaculation all too readily! However, we know is that the duration of intercourse that is common among most men with delayed ejaculation is far too long for the satisfaction of their female partners. As a general rule, we know that sex which goes on for more than 10 minutes is not satisfactory for the great majority of women.
In fact it’s not satisfactory to the great majority of men either, despite the illusion which seems to be widespread in society that men who can make love for a very long period of time are somehow very desirable as lovers. The truth is that both the man and his partner will experience high levels of frustration and distress, not to mention the possibility of physical soreness for the woman.
The fact is that a man will see himself as a sexual failure, unable to satisfy his partner, and the woman may see herself as an unattractive partner who cannot bring her man successfully to climax.
Now having said that, we do know that delayed ejaculation sometimes obscures other psychological or emotional issues, so in treating delayed ejaculation one has to be aware of the possibility that there may be some collusion between the couple at a subconscious level to maintain the sexual dysfunction.
For example, it may be that a woman is unable to reach orgasm, or perhaps doesn’t like sex particularly, a fact which she is able to disguise by the distress and emotional difficulties caused by delayed ejaculation. If her male partner was able to ejaculate in a timely fashion during intercourse, it may be that her own dissatisfaction with sex would be revealed.
Equally, for the man, it’s possible that delayed ejaculation serves a purpose, perhaps allowing the couple to focus on emotional distress of the delayed ejaculation rather on the fact that the man has a difficulty with being in a relationship with his partner in the first place.
Now clearly not all cases of delayed ejaculation will actually have such powerful and emotive underlying issues, but certainly many of them do.
Treatment is generally by means of sexual therapy and exploration of the deeper psychological issues underlying the condition, combined with behavioural adaptation techniques – in particular, cognitive behavioural therapy. The outcome can generally be expected to be very good, a man reaching ejaculation within five minutes of intercourse starting.
The main workers is in the field of delayed ejaculation have beenHelen Singer Kaplan, Marcel Waldinger, and Bernard Apfelbaum, all of whom have presented original, novel treatment approaches that have benefited men with delayed ejaculation and their partners, who often lack sexual satisfaction and pleasure because of the man’s condition.
The main models that have been proposed to explain delayed ejaculation are the desire-deficit model, and the sexual inhibition model, both of which have been explained on this website.
I want to emphasize again that treatment of delayed ejaculation is generally successful, and that there’s no need to be depressed are upset about this problem; in particular if a couple are experiencing relationship difficulties because of delayed ejaculation, then it can often be a catalyst to the resolution of these difficulties through (1) both seeking and finding therapy, and (2) being able to learn a better system of communication within the relationship that allows the partners to understand each other’s point of view much more openly and honestly.