Male Anorgasmia - Inability To Ejaculate during Sex |
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How common is male anorgasmia (retarded ejaculation)?Male orgasmic disorder is certainly more common than you might think. In one study, about 8% of men said they had experienced difficulty achieving an orgasm during intercourse for a period of at least 2 months in the previous year. Other estimates for delayed orgasm have ranged from 1% to 10% of the population, with most hovering around 3 to 4%, while in the older age groups of 70 to 79 years, 12% of men found it difficult to ejaculate during sex. In clinical studies, the percentage of men with signs of inhibited orgasm is around 6% - so it is not uncommon. Despite this, few men seek help for it, and indeed it is the least common male sexual problem for which help is sought. To go straight to the treatment method for male anorgasmia (retarded ejaculation), follow this link. A case history of male anorgasmiaThis case history reflects that fact that treatment of delayed ejaculation has to take a mixed approach - behavioral, cognitive and psychodynamic therapeutic approaches are usually needed to deal with a man's inability to ejaculate, for the causes of delayed ejaculation (aka ejaculatory incompetence or male anorgasmia) are multifaceted and can be quite varied. Treating male orgasmic disorder effectively can make demands on the therapist and test his or her repertoire of skills and strategies. Often many of the causes are deeply rooted in psychopathologies in both partner's histories, which come out in the relationship dynamics between a couple. Jim, aged 42, came to see me with his partner for treatment because he was simply "unable to come during sex". He was a charismatic man with bonhomie, flair and a cultured attitude, a successful business and a taste for the finer things in life, as he put it. This extended to women, for his partner, Rose, aged 39, was a cultured and intelligent woman who gave the impression of "good breeding". Both partners affirmed that their relationship would be great were it not for his "small sexual challenge" - his inability to ejaculate during sex, a problem which denied them both pleasure, and made Rose in particular feel unappreciated and unattractive. They had been in relationship for six years, and Rose confessed that she had always believed her attractiveness would be sufficient to increase Jim's sexual arousal to the point where he could overcome his delayed ejaculation and reach orgasm and ejaculate during intercourse. Needless to say this had not happened, and she was now becoming irritated by his constant assurances that she was indeed attractive, and that the problem was nothing to do with her. She also reported that Jim had always seemed distant and preoccupied during sex, and that although she could not complain about his attentiveness in everyday life, sex was in fact a disappointment to her, because his delayed ejaculation meant that she never got to share the pleasure of his orgasm. Her own orgasms were mostly achieved through oral sex with Jim, and masturbation, generally when Jim was not present. Jim expressed dissatisfaction with his delayed ejaculation and his general sexual performance, stating quite clearly that it was his belief that the man had responsibility to give the woman pleasure during intercourse and that it was a source of "utter frustration" to him not to be able to do this. He believed that there must be a problem with him, for, as he put it in a solo therapy session: "she's sexy enough to make any man come." His failure to ejaculate during intercourse was clearly reducing his self-esteem and sense of self-worth. He was eager to explore any treatment for delayed ejaculation which would help him come normally during sex. Rose was a tall, thin woman with an elegant bearing and a mature attitude who was very feminine and well-groomed. She was intellectually equal to or perhaps slightly superior to Jim, and very articulate about sexual issues, having started training as a sexual therapist but switched careers to Veterinary Science. She freely admitted adopting the attitude of therapist to Jim in the early days of the relationship, and expressed a desire that the problem of his delayed ejaculation be resolved for "the sake of our future together". Initially, sex had been "OK"; Jim had been able to ejaculate once in every five or so times they engaged in intercourse after about thirty minutes' thrusting. Rose had initially enjoyed this, although she invariably finished sex with a sore vagina, and occasionally resorted to artificial lubricants, which she disliked because they caused a loss of sensitivity. She had been able to reach orgasm through G spot stimulation, though after about eighteen months together, she began to resent the sense of distance which Jim seemed to maintain during sex. When challenged, he said that he was concentrating on making sure she had a good time: the irony that Rose was enjoying sex less and less seemed to escape him. At the point where they came for therapy, Jim's inability to ejaculate during sex had progressed to the point where even an hour of sex was insufficient for him to reach orgasm, though as Rose said, she was not going to allow him to thrust for this long in her vagina since if he couldn't come during sex there was no reward in it for either of them. There were signs that Jim's delayed ejaculation was actually beginning to pose a threat to the relationship, which was why they had come for therapy. On the occasions when they did engage in sex it was now limited to mutual kissing, fondling, and oral sex, which would produce an orgasm for her, but not for Jim. He admitted to masturbating to orgasm once or twice a month, always on his own. Indeed, his ability to reach orgasm in her presence had completely disappeared, about which he said he felt "anxious" and "despairing". He clearly expected an effective treatment for delayed ejaculation and was looking forward to "being able to come naturally during sex". Jim's masturbation allowed him to reach orgasm with some effort, though he did admit to feelings of self-disgust from time to time. He masturbated by lying on the mattress and forcing his penis between his body and a pillow, exerting, by his own account, considerable force on his penis to make himself ejaculate. Masturbation with his hand alone did not produce an orgasm. He said that he believed his penis to be highly insensitive, due partly to keratinization from his boyhood circumcision. He was examined by a doctor and found to have no physical problems or abnormalities. This clearly indicated a case of traumatic masturbatory syndrome, a condition frequently at the root of a man's delayed ejaculation and inability to ejaculate during sex. Jim relied to a large extent on images of women in fantasy to get aroused, especially focusing on fantasies of bondage and dominance. He and Rose had played some of these out, although she was "not keen" on them. By her own account, Rose did not have any real difficulties "letting go", though this statement seemed contrary to her expressed desire to have intercourse in the dark, with the lights out. As they were both aware that things were becoming more problematic in the relationship, they had agreed to seek treatment for Jim's delayed ejaculation and his ejaculation problem, with a view to establishing a healthy sexual relationship. They had discussed splitting up, but had agreed to seek help before doing so, in case the sexual issues they faced due to Jim's delayed ejaculation and male anorgasmia were capable of resolution. They maintained they were in still in love with each other, though Rose admitted to an affair with a work colleague involving around a dozen episodes of intercourse after work and at weekends and a number of occasions when she had engaged in mutual masturbation and oral sex in various outdoor locations. Jim was unaware of this affair, which was now terminated. Jim's delayed ejaculation case history continued here. [
Delayed
ejaculation - retarded ejaculation - how to ejaculate during sex ] |
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