Causes of Delayed Ejaculation |
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Click here to find out about treatment for delayed ejaculation.
So we know what delayed ejaculation is: the guy has very hard erection and he can make love almost as long as he wants without reaching his climax -- a situation which might seem like a dream to anybody who suffers from premature ejaculation, but in reality is embarrassing and distressing to both the man and his partner. And while some of these men can reach orgasm and ejaculate quite quickly during, and really enjoy, self stimulation, many of them can't. (By the way, delayed ejaculation used to be called retarded ejaculation, though that term has gone out of favor because it's judgmental and old-fashioned. You might see the condition still referred to as inhibited ejaculation.) About 10% of men have this problem, so it's surprising that very little research into treatment has been carried out, which means that there is a shortage of reliable information available to anybody who has this condition. Your best option is to read websites like this one which have been put together by people experienced in the field of psychotherapy and sexual problems. If you're a man who has the opposite tendency -- towards rapid ejaculation -- you may be thinking that this male sexual dysfunction sounds like a dream come true, but of course the reality is very different: it makes lovemaking into hard work for both partners and tends to deprive them of any level of satisfaction (although some women do reach multiple orgasms if their partner continues to make love to them for extended periods of time). Obviously there are loads of things that affect how fast or slow any particular man will shoot his load, and when you take into account the individual variability between men who have this condition, you can see that what might be true for one man may not be true for others. There are, however, a certain general trends which affect all men with the condition. However, before we look at these it's just worth remembering that many years ago a woman who was unable to achieve climax during intercourse was described as "frigid". While frigid is a less demeaning term than "retarded", it's worth keeping in mind that it's generally regarded as absolutely normal for a woman not be able to reach a climax on every (or indeed any) occasion she has sex; moreover, we regard a woman as being absolutely normal if she is able to reach orgasm in other ways, such as by self-stimulation. Men are not regarded with the same charitable disposition: if a man's only able to achieve ejaculation through self stimulation, and he cannot reach orgasm during sexual intercourse we tend to regard him as having something wrong with him -- and so, of course, does he: he often thinks there really is something wrong with him, and his partner is usually certain that he cannot reach orgasms because he does not find her attractive enough or arousing enough, or because she can't satisfy him sexually. Keep this information in the back of your mind as you read through this website, because it's important to remember that there is a disparity in the way we regard men and women who have orgasmic disorder of one kind or another -- and remind yourself also, that there are plenty of ways you can enjoy intercourse and intimacy without regarding male climax as the finishing post, the flag signifying your interaction is over, the sign that it's been successful, or the way you reinforce your sense of masculinity. In particular, if you are a couple dealing with this issue, make sure that the woman is empowered so that she can say confidently when she wants the man to stop, or if for example she needs extra lube during intercourse to continue enjoying it. That level of communication is the very basic level you need to ensure this doesn't cause a major rift in your relationship: but any level of communication about the problem will remove the pressure from both partners and potentially prevent major disagreements arising. The research that we've done on this subject is based on our experience with men who find themselves in the challenging situation of not being able to reach orgasm during sex. We've also relied on two good research summaries: a piece entitled "Treatment of Delayed Ejaculation" which you can find in Sandra Leiblum's book "Principles and Practice of Sex Therapy", and a piece entitled "Retarded and Inhibited Ejaculation" which you can find in the "Handbook of Sexual and Gender Identity Disorders" by David Rowland and Luca Incrocci, published in 2008. The treatment of delayed ejaculation is conventionally regarded as quite complex, requiring skilled intervention of systemic, psychodynamic, and cognitive behavioral therapists. However, for any man who has a high degree of motivation and wishes to cure this problem, a self-help program such as the one presented on this website can bring about dramatic improvements in his capacity to enjoy normal sexual relations. For one thing, it is highly significant that men with DE often have a hard erection: what's often not clear to the man concerned is the fact that an erection alone does not indicate that he is ready for intercourse, and that communication of both partners' desires, needs and feelings is important - if not essential - in the process of successful sexual intercourse. Treatment achieves the greatest success when an approach is used which integrates all of the above methodology, especially when both man and his partner are involved. It's certainly true that underlying emotional issues must be resolved or at least explored since they may be reinforcing the delayed ejaculation. At the moment there are no pharmacological compounds which can be used to control delayed ejaculation. What are the causes of delayed ejaculation?Well, no one knows exactly, but there are certainly many theories about the origin and causes of delayed ejaculation. For one thing even the basic model of ejaculation and orgasm in men is not completely understood by scientists, which makes it no easier to understand why it might go wrong. However, there are some common factors which seem to be associated with the personality and characteristics of men with delayed ejaculation. 1 Men with DE often seem to have a disrupted relationship with their own sexuality You could describe this as a kind of remoteness from self. It's almost like the man's ability to perceive his inner world of thoughts and feelings is somehow disrupted or blocked. This results in him externalizing feelings, especially fear or shame; men in this situation often look for some kind of physiological explanation of the condition and some kind of drug treatment. So one of the first things that men need to understand is that there is a certain amount of work to be done in terms of changing thoughts and feelings. Men with delayed ejaculation have often been subject to enormous emotional stress and some very painful life events which often had a direct impact on the man at a time when his sexuality was emerging and his sexual identity forming. Furthermore, men with DE often refuse to acknowledge any connection whatsoever between events in their past and their sexual dysfunction. A lot of men believe that the male sexual response should be automatic and reliable (although we know only too well that this is rarely the case), and such an attitude can be interpreted as a defense against one's own sexual vulnerabilities. Often some of the most traumatic events a man with delayed ejaculation has experienced centered around the man's initiation into the world of adult sexuality. One of the factors that is often very noticeable in such a man is an upbringing in which battling against the environment and fighting to be strong was emphasized: in other words, he was taught as a boy that he needed to be tough, to be resilient, and to battle against all kinds of weakness. Our society does not help young men achieve healthy sexual adulthood, in particular because there is usually no transitional space where a boy can experience puberty; in historical societies, puberty and the rituals and ceremony associated with it often functioned as a place where young men could learn more about the transition to adulthood and the adoption of adult male responsibilities. A loss of the inner erotic world is another key factor in many men with delayed ejaculation. What this means in practical terms is that men often have difficulty distinguishing the everyday reality of erotic experience from normal perception. If you think about this, it's clear that any time that you are in the grip of sexual behavior, or sexual fantasy, or indeed engaging in any kind of sexual activity, your perception of the world around you, and your consciousness, is somehow changed. One example of this is how we are all likely to do things when we are sexually aroused that we would not consider doing during everyday life. So sexual arousal changes the nature of our consciousness and affects our perception, and it is clearly important for a healthy individual to have an understanding of how these two worlds are different. That's not to say they're always clearly differentiated from each other -- you may well have noticed how, when you're bored, you can suddenly slip into an erotic fantasy. But a man with delayed ejaculation may find that stepping from the everyday world into the erotic world of fantasy or sexual reality is somehow dangerous or risky. It seems that many men who have delayed ejaculation, especially those who are in long-term relationships, somehow have a preference for the avoidance of their inner erotic world. This isn't simply about the fact that you're better off not being absorbed by sexual fantasy when it's inconvenient or impractical -- it's much more about some kind of deep-rooted issue with sex. One hypothesis is that men with sexual dysfunctions, especially erection disorders, somehow can't find a way of translating their internal experience into an erotically arousing stimulus: in other words, sexuality can no longer provide the intensity needed to generate the arousal that produces an erection. One of the reasons for this might be the negative associations that have grown up between male sexuality and issues such as violence against women, child abuse, and sexual offences. When society regards male sexuality as a problem and every man as a potential rapist, it may be too threatening for some men to cross the boundary between everyday reality and erotic reality and arousal in their own minds. Because of this situation, the man's subjective erotic world may be either limited or inaccessible during sexual relationships with his partner: and at the same time, it's possible that a man may still feel safe enough to engage in "auto sexuality", either as sexual fantasy on his own, masturbation with pornography or Internet sex. It follows that some of the men who have delayed ejaculation are having difficulty in actually expressing what they want to do during sex: in other words, defining or expressing requests for the thing that would actually arouse them most; or maybe they simply don't know that it may be necessary for them to receive physical stimulation to get an erection. The outcome of this is that sex becomes some kind of mechanical process in which a couple has lost all sense of giving and receiving, and perhaps also all sensitive sensory orientated touching for pleasure. In cases like this it may be that the man develops erectile dysfunction or even begins to avoid sex altogether. In some ways it's almost like inhibiting your own breathing: normally, breathing is a reflex response, but we have the choice to stop breathing or to change the rate at which we breath. Some experts have speculated that delayed ejaculation is rather like this -- that some kind of conscious inhibition comes into play at the moment where the body should be relying on automatic reflexes to race towards orgasm and ejaculation. If this is so, then why is a man with DE holding back? One obvious explanation is that the idea of ejaculation is, at some level, anxiety provoking or threatening: this concept fits in with the reasoning of some experts who have suggested that such inhibition relates to a fear of negative experiences like unwanted pregnancy, the memory of past traumatic sexual experience, or the fear of damaging or contaminating the partner during sex. A less direct connection might be where a man has anxiety at some level about the likelihood or otherwise of getting his own sexual needs met; or perhaps he holds traumatic memories of "getting caught" while being sexual; or he has had some other trauma that has inhibited his ability to express himself sexually. As you'll see by now, such explanations of the causes of delayed ejaculation are drawing on deep rooted, unconscious fears and fantasies. To repeat, these could include fear of loss of control or anxiety associated with the altered state of consciousness that is associated with sex, orgasm and ejaculation; they could include fear of embarrassment, or sexual shame due to an inhibited sexual upbringing; there could be some kind of conflict about a man's own sense of masculinity, or around the belief that a real man doesn't show weakness, or vulnerability, even during the act of coitus; or a man may simply not be aroused enough because his sexual urges are focused on some kind of particular paraphilia or stimulus; or it might be something as simple as the fact that he feels hostility and anger towards his partner or even towards women in general. In all cases, these feelings can be traced to unresolved conflicts and psychosexual development which hasn't progressed normally. Now, as you can see, most of these explanations for the cause and origin of delayed ejaculation are fairly speculative, and they are certainly not easy to prove one way or another. 2 But what you may already know if you're a man who has delayed ejaculation, is that many men who have this condition display a high level of performance anxiety, feel very pressured to perform to a high standard, and have a real belief that it is their duty to satisfy their partner during sex. We also know that in some cases the explanation of the origin of DE is very simple: a man has learnt, as an adolescent, to masturbate with a technique that requires high frequency and perhaps high-pressure movements -- in other words the man has actually conditioned his sexual responses so that only one particular type of touch, and often a very vigorous one, delivered in a particular way, is sufficient to bring him to orgasm and make him reach the point of ejaculation. So now you might be asking how a treatment program can possibly get to grips with either the deep rooted insecurities and anxieties that are postulated as provoking delayed ejaculation, or even the straightforward conditioned response of a man who has masturbated too hard and harshly during his adolescence. In actual fact, self-help programs can address both of these issues: in the first instance, they give you the techniques and skills necessary to communicate with your partner about the issues that might be in affecting your ejaculatory competence (by the way, that's a rather pleasant expression but one which is purely descriptive -- no judgment is intended by the use of that expression). In addition, there are plenty of ways of reaching a higher level of arousal, which is almost always necessary for a man with delayed ejaculation to achieve climax. If you're in your head, relying on fantasy or some paraphilia or sexual fixation (which simply means a particular stimulus needs to be present before you're aroused enough to climax, for example the use of particular fabrics or clothing during sexual activity), then the effectiveness of the exercises in the program on this website can make it much easier to achieve climax. They are designed to enable you to obtain a much higher level of arousal in your body, and this can make it significantly easier to reach a sexual climax. Bernard Apfelbaum came up with the concept of partner anorgasmia, because he believes that this particular sexual dysfunction is usually only a problem for men when they were in the presence of a partner. He explains this as being an "autosexual orientation": in other words, a man can only fully enjoy self stimulation during masturbation. The difficulty that a man with delayed ejaculation has in obtaining sexual satisfaction (or even sexual arousal) with his partner is hidden behind his hard and prolonged erection - which usually develops during sexual activity. Apfelbaum, however, believes that such an erection is not really an expression of sexual desire and excitement, but an automatic mechanism which the man uses to fulfill his partner's expectations. It's not entirely clear from his work how a man who has these issues with sex could develop such a high level of genital response, and this seems to weaken his theories somewhat; however, he also made the observation that men with DE seem to be driven by a desire to satisfy their partner rather than to stand up for their own satisfaction and take care of their own sexual needs and desires. They are in fact, too conscientious, too controlled, and too aware of their responsibilities during sex - which they see as satisfying and pleasing their partner. This makes the man, suggests Apfelbaum, unable to satisfy himself, and gives the man an aura of being unable to enjoy sex, which in turn makes his partner feel that she cannot do anything pleasing for him. This model has a lot to commend it; in support, it's been reported in a recent study that men with delayed ejaculation do in fact have significantly lower levels of sexual arousal than either men with erectile dysfunction, men with premature ejaculation, or men who can enjoy sex normally. Indeed, this low level of sexual arousal is the chief characteristic of men with the sexual dysfunction of delayed ejaculation. We must bear in mind that there may be other factors at work here, such as reduced level of penile sensitivity, a lack of responsivity to sexual stimulation, or some kind of physiological issue with the man's ejaculation reflex which prevents him reaching a level of arousal sufficient to trigger it. And of course one of the most important issues is how a man experiences sex when he has delayed ejaculation; if you're in this category, you might like to consider the following points:
[ Delayed ejaculation - retarded ejaculation - how to ejaculate during sex ]
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