Retarded Ejaculation - A Scientific Review |
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Science and retarded ejaculationDr D Richardson and Dr D Goldmeier, produced a review on how retarded ejaculation should be defined, managed and treated. International Journal of STD and AIDS, 2006, 17, 7-13. To go straight to the treatment method for delayed ejaculation, follow this link. Psychological therapies for delayed ejaculationSex therapy experts suggest relaxation combined with psychotherapy. Others suggest viewing porn films, reading sexually stimulating material or training in masturbation. To this list we would add our suggestion of using tantric sex therapists. All of these methods are intended to increase arousal so that a man finds it easier to approach the point of ejaculatory inevitability. If inadequate stimulation is the "block" to reaching climax, then in theory vigorous stimulation using plenty of lube might be expected to produce an improvement in a man's orgasmic capacity. And if a man can learn to ejaculate near the vagina, he can gradually get his penis nearer and nearer at the point of emission until he is able to ejaculate intravaginally. Other therapies which have been suggested include varying the sexual positions in which a couple make love to provide maximal stimulation for the man, or the use of vibrators to add extra stimulation to prescribed masturbatory exercises. Also, a therapist may be helpful in reducing a man's inhibitory fears - which may include fears of pregnancy, fear of commitment or other psychodynamic motivations (castration anxiety, fear of the vagina, vaginal revulsion) - all things which may impact on a man's ability to relax and "let go" during sexual intercourse. We believe hypnosis is a useful addition to any kind of therapy; but alone it is not enough, and psychotherapy for both partners is often helpful. But, fundamentally, if a man suffers excessive guilt and shame around sex, then psychotherapy of some kind will be need to ensure a liberated attitude to sex, with all its messiness, bodily fluids, and intimate transactions. Sexual healing is something which can be achieved in many ways, but the use of a good sex therapist is high on the list of desirable approaches to this condition. Surrogate sex partners and Tantric therapists are very useful: they are non-judgmental, accepting, and skilled in promoting a relaxed attitude to sex. Indeed, sex-play as a treatment for retarded ejaculation has been described both anecdotally and in a small cohort. 104,105 Some authors suggest the use of tantric sex home assignments to increase pleasure in couples with sexual problems. These methods draw from Hindu and Buddhist tantric traditions which reflect some Asian approaches to sexuality. 106 4 Masters WH, Johnson VE. Human Sexual Inadequacy. Boston: Little, Brown, 1966 5 Waldinger MD. Towards evidence based drug treatment research on premature ejaculation: a critical evaluation of methodology. Int J Impotence Res 2003;15:309–13 6 Gebhard PH. Factors in marital orgasm. J Soc Issues 1966;22:88–95 7 Kameya Y, Deguchi A, Yokoto Y. Analysis of measured values of ejaculation time in healthy males. J Sex Marital Ther 1997;23:25–8 8 Patrick DL, Althof SE, Pryor JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med 2005;2:358–67 9 Fisher S. Female Orgasm. Basic: New York, 1973 10 Darling CA, Davidson JK, Cox RP. Female sexual response and the timing of partner orgasm. J Sex Marital Ther 1991;17:3–21 11 Kaplan HS. The New Sex Therapy. Brunner Mazel: New York, 1974 12 Frank E, Anderson C, Rubenstein D. Profiles of couples seeking sex therapy and marital therapy. Am J Psychiatry 1978;133:559–62 13 Nettelbladt P, Uddenberg N. Sexual dysfunction and sexual satisfaction in 58 married Swedish men. J Psychosom Med 1979;23:141–7 14 Fugl-Meyer AR, Sjogren Fugl-Meyer K. Sexual disabilities, problems and satisfaction in 18–74 year olds Swedes. Scand J Sexol 1999;3:79–105 15 Lindal E, Stephansson JG. The lifetime prevalence of psychosexual dysfunction among 55–57 year olds in Iceland. Soc Psychiatry psychiatr Epidemiol 1993;28:91–5 16 Solstad K, Hertoft P. Frequency of sexual problems and sexual dysfunction in middle aged Danish men. Arch Sex Behav 1993;22:51–8 17 Catalan J, Klimes I, Bond A, Day A, Garrod A, Rizza C. The psychosocial impact of HIV infection in men with haemophilia: controlled investigation and factors associated with psychiatric morbidity. J Psychosom Res 1992;36:409–16 18 Catalan J, Klimes I, Day A, Garrod A, Bond A, Gallwey J. The psychosocial impact of HIV infection in gay men. A controlled investigation and factors associated with psychiatric morbidity. Br J Psychiatry 1992;161:774–8 19 Rosser BR, Metz ME, Bockting WO, Buroker T. Sexual difficulties, concerns and satisfaction in homosexual men: An empirical study with implications for HIV prevention. J Sex Marital Ther 1997;23:61–73 20 Nazareth I, Boynton P, King M. Problems with sexual function in people attending London general practitioners: cross sectional study. BMJ 2003;327:423–6 21 Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281:537–44 22 Mercer CH, Fenton KA, Johnson AM, et al. Sexual function problems and health seeking behaviour in Britain: probability sample survey. BMJ 2003;327:426–7 23 Gregoire A. ABC of sexual health: Male sexual problems – clinical review. BMJ 1999;318:245–7 24 Waldinger MD. The neurobiological approach to premature ejaculation. J Urol 2002;168:2359–67 25 McMahon CG, Abdo C, Incrocci L, et al. Disorders of orgasm and ejaculation in men. J Sex Med 2004;1:58–64 26 Edwards AE, Husted JR. Penile sensitivity, age and sexual behaviour. J Clin Psychol 1976;32:697–700 27 Kamischke A, Nieschlag E. Update on medical treatment of ejaculatory disorders. Int J Androl 2002;25:333–44 28 Colpi GM, Faniullaci F, Beretta G, Negri L, Zanollo A. Evoked sacral potentials in subjects with premature ejaculation. Andrologia 1986;18:583–6 29 Fanciullacci F, Colpi GM, Berreta G, Zanollo A. Cortical evoked potentials in subjects with true premature ejaculation. Andrologia 1988;20:326–30 30 Bindley GS, Gillan P. Men and women who do not have orgasms. Br J Psychiatry 1982;140:351–6 31 Sank LI. Traumatic masturbatory syndrome. J Sex Marital Ther 1998;24:37–42 32 Lipsith J, McCann D, Goldmeier D. Male psychogenic dysfunction: the role of masturbation. J Sex Relat Ther 2003;18:447–71 33 Hendry WF. Disorders of Ejaculation: congenital, acquired and functional. Br J Urol 1998;82:331–41 34 Schlegel PN, Shin D, Goldstein M. Urological anomalies in men with congenital absence of the vas deferens. J Urol 1996;155:1644–8 35 Mickle J, Mulunsky A, Amos JA, Oates RD. Congenital Absence of the vas deferens: a heterogeneous disorder with two distinct subpopulations based upon aetiology and mutational status if the cystic fibrosis. Hum Reprod 1995;10:1028–35 36 Holt B, Pryor JP, Hendrey WF. male infertility following surgery for imperforate anus. J Paediatric Surg 1995; 30:1677–9 37 Quinlan DM, Epstein JI, Carter BS, Walsh PC. Sexual function after radical prostatectomy: influence of preservation of neurovascular bundles. J Urol 1991;15:998–1002 38 Money J, Yankowitz R. The sympathetic inhibiting effects of the drug Ismelin on human male eroticism, with a note on mellaril. J Sex Res 1967;3:69–100 39 Munjack DJ, Kanno PH. Retarded ejaculation: a review. Arch Sex Behav 1979;8:139–50 40 Seagraves RT. Antidepressant induced orgasm disorder. J Sex Marital Ther 1995;21:192–201 41 Harrison WM, Stewart J, Ehrhardt AA, et al. A controlled study of the effects of antidepressants on sexual function. Psychopharmacol Bull 1985;21:85–8 42 Montejo-Gonzalez AL, Llorca G, Izquierdo JA, et al. SSRI induced Sexual dysfunction: fluoxetine, paroxetine, Sertraline and Fluvoxamine in a prospective, multicentre and descriptive clinical study of 344 patients. J Sex Martial Ther 1997;23:176–94 43 Bobes J, Gonzalez MP, Bascaran MT, et al. Evaluating changes in sexual functioning in depressed patients: sensitivity to change of CSFQ. J Sex Marital Ther 2002; 28:92–104 44 Morley JE, Korenman SG, Mooradian AD, Kaiser FE. UCLA geriatric grand rounds: sexual dysfunction in the elderly male. J Am Geriatrics Soc 1987;35:1014–22 45 Coleman R, McDonald D. Effects of isotretinon on male reproductive function. Lancet 1994;344:198 46 Evans BE, Adedort LM. Inhibition of ejaculation due to epsilon aminocaproic acid. New Engl J Med 1978;298:166–7 47 Epstein DL, Grant WM. Carbonic anhydrase inhibitor side effects. Arch Ophthalmol 1977;95:1378–82 48 Miller LG. Indomethacin associated sexual dysfunction. J Fam Pract 1989;29:210–1 49 Drugs that cause sexual dysfunction – an update. Med Lett Drugs Ther 1992;34:73–8 50 Bauer GE, Hull RD, Stokes GS. The reversibility of side effects of guanethine therapy. Med J Austr 1973;1:930–3 51 Chia SJ. Management of premature ejaculation – a comparison of treatment outcome in patients with and without erectile dysfunction. Int J Androl 2002;25:301–5 52 Choi HK, Jung GW, Moon KH, et al. Clinical study of SS cream in patients with lifelong premature ejaculation. Urology 2000;55:257–61 53 Choi HK, Xin ZC, Choi YD, Lee WH, Mah SY, Kim DK. Safety and efficacy study with various doses of SS-cream in patients with premature ejaculation in a double-blind, randomized, placebo controlled clinical study. Int J Impotence Res 1999;11:261–4 54 Haensel SM, Rowland DL, Kallan K, Slob KA. Clomipramine and sexual function in men with premature ejaculation and controls. J Urol 1996;156:1310–15 55 Hamid-Abdel IA, El Naggar EA, El Gilany AH. Assessment of as needed use of pharmacotherapy and the pause squeeze technique in premature ejaculation. Int J Impotence Res 2001;13:41–5 56 Kara H, Aydin S, Agargun MY, Odabas O, Yilmaz Y. The efficacy of Fluoxetine in the treatment of premature ejaculation: a double blind placebo controlled study. J Urol 1996;156:1631–2 57 Kim SC, Keun K. Efficacy and safety of Fluoxetine, Sertraline and Clomipramine in patients with premature ejaculation. J Urol 1998;159:425–7 58 Ludovico GM, Corvasce A, Pagliarulo G, Cirillo-Marucco E, Marano A, Pagliarulo E. Paroxetine in the treatment of premature ejaculation. Br J Urol 1996;77:881–2 59 McMahon CG. Treatment of premature ejaculation with sertraline: a single blind controlled crossover study. J Urol 1998;159:1935–8 60 McMahon CG, Touma K. Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 singleblind placebo controlled crossover studies. J Urol 1999;161:1826–30 61 Mendels J, Camera A, Sikes C. Sertraline treatment for premature ejaculation. J Clin Psychopharmacol 1995;15:341–6 62 Salonia A, Tommaso M, Colombo R, et al. A prospective study comparing paroxetine versus paroxetine plus sildenafil in patients with premature ejaculation. J Urol 2002;168:2486–9 63 Strassberg DS, Gouveia Brazao CA, Rowland DL, Tan P, Slob K. Clomipramine in the treatment of rapid (premature) ejaculation. J Sex Marital Ther 1999;25:89–101 64 Waldinger MD, Hengeveld MW, Zwinderman AH. Paroxetine treatment of premature ejaculation: a double blinded, randomised, placebo controlled study. Am J Psychiatry 1994;151:1377 65 Waldinger MD, Hengeveld MW, Zwinderman AH. Ejaculation retarding properties of paroxetine: a double blind randomised dose response study. Br J Urol 1997;79:592–5 66 Waldinger MD, Hengeveld WM, Zwinderman AH, Oliver B. Effects of SSRI antidepressants on ejaculation: a double blind randomised placebo-controlled study. J Clin Psychopharmacol 1998;18:274–81 67 Waldinger MD, Zwindweman AH, Oliver B. SSRIs and ejaculation: a double blind, randomised, fixed dose study with paroxetine and citralopram. J Clin Psychopharmacol 2001;21:556–60 68 Yilmaz U, Tatlisen A, Turan H, Arman F, Ekmekcioglu O. The effects of Fluoxetine on several neuro-physiological variables in patients with premature ejaculation. J Urol 1999;161:107–11 69 Bores E, Comarr AE. Neurological Disturbances of sexual function with special reference to 529 patients with spinal cord injury. Urol Surv 1960;10:191 70 DasGupta R, Fowler CJ. Sexual and urological dysfunction in multiple sclerosis better understanding and improved therapies. Curr Opin Neurol 2002;15:271–8 71 Zorzon M, Zivadinov R, Bosco A, et al. Sexual dysfunction in multiple sclerosis: a case controlled study. Frequency and comparison of groups. Multiple Sclerosis 1999;5:418–27 72 Minderhoud JM, Leemhuis JG, Kremer J, Laban E. Sexual disturbances arising from multiple sclerosis. Acta Neurol Scand 1984;71:299–306 73 Valleroy M, Craft G. Sexual dysfunction in multiple sclerosis. Arch Phys Rehab 1984;65:125–8 74 Thomas A, Lopicollo J. Sexual function in persons with diabetes: issues in research, treatment and education. Clin Psychol Rev 1994;14:1–86 75 Enzlin P, Mathieu C, Van Den Bruel A, Vanderschueren D, Demyttenaere K. Prevalence and predictors of sexual dysfunction in patients with type I diabetes. Diab Care 2003;26:409–14 76 Shull GR, Sprenkle DH. Retarded ejaculation: reconceptualisation and implications for treatment. J Sex Marital Ther 1980;6:234–46 77 Wincze JP, Carey MP. Sexual Dysfunction. A Guide for Assessment and Treatment. 2nd edn. London: The Guilford Press, 2001 78 Apfelbaum Retarded Ejaculation: A much misunderstood syndrome In: Lieblum SR, Rosen RC, eds. Principals and Practice of Sex Therapy. 3rd edn. New York: Guilford, 2000;205–41 79 Blandy J. Sexual Problems Seen in Urology, Psychosexual Problems, Sydney Crown. London: Academic Press, 1976 80 Ashton AK, Hamer R, Rosen R. SSRI induced sexual dysfunction and its treatment: a large-scale retrospective study of 596 psychiatric outpatients. J Sex Marital Ther 1997;23:165–75 81 Balon R, Yergani VK, Pohl R, Ramesh C. Sexual dysfunction with antidepressant treatment. J Clin Psychiatry 1993;54:209–12 82 Gitlin MJ, Suri R, Altshuler L, Zuckerbrow-miller J, Fairbanks L. Bupropion-sustained release as a treatment for SSRI induced sexual side effects. J Sex Marital Ther 2002;28:131–8 83 Labbate LA, Pollack MH. Treatment of fluoxetine induced sexual dysfunction with bupropion: a case study. Ann Clin Psychiatry 1994;6:13–15 84 Masand PS, Ashton AK, Gupta S, Bradford F. Sustained release bupropion for SSRI induced sexual dysfunction: a randomised double blind placebo controlled, parallel-group study. Am J Psychiatry 2001;158:805–7 85 Yager J. Bethanchol chloride can reverse erectile and ejaculatory dysfunction induced by tricyclic antidepressants and mazindol: case report. J Clin Psychiatry 1986;47:210–1 86 Gross MD. Reversal by bethanchol of sexual dysfunction caused by anticholinergic medication. Am J Psychiatry 1982;139:1193–4 87 Seagraves RT. Bethanechol reversal of imipramine induced ejaculatory dysfunction. Am J Psychiatry 1987;144:1243 88 Steele TE, Howell F. Cyproheptadine for imipramine induced anorgasmia. J Clin Psychopharmacol 1986;6:326–7 89 Sovner R. Treatment of tricyclic induced orgasmic inhibition with cyproheptadine. J Clin Psychopharmacol 1984;4:169 90 McCormick S, Olin J, Brotman AW. Reversal of fluoxetine induced anorgasmia by cyproheptadine in two patients. J Clin Psychiatry 1990;51:383–4 91 Arnott S, Nutt D. Successful treatment of fluvoxamine induced anorgasmia by cyproheptadine. Br J Psychiatry 1994;164:838–9 92 Riley AJ, Riley EJ. Cyproheptadine and antidepressant induced anorgasmia. Br J Psychiatry 1986;148:217–18 93 Seagraves RT. Treatment of drug induced anorgasmia. Br J Psychiatry 1994;165:554 94 Lauerma H. Successful treatment of citralopram induced anorgasmia by cyproheptadine. Acta Psychiatrica Scand 1996;93:69–70 95 Price J, Grunhaus LJ. Treatment of clomipramine induced anorgasmia with yohimbine: a case report. J Clin Psychiatry 1990;51:32–3 96 Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by SSRIs. J Clin Psychiatry 1992;53:207–9 97 Balogh S, Hendricks SE, Kang J. Treatment of fluoxetine induced anorgasmia with amantadine. J Clin Psychiatry 1992;53:212–13 98 Shrivastava RK, Shrivastava S, Overweg N, Schmitt M. Amantadine in the treatment of sexual dysfunction associated with SSRIs. J Clin Psychopharmacol 1995;15:83–4 99 Landen M, Eriksson E, Agren H, Fahlen T. Effect of buspirone on sexual dysfunction in depressed patients treated with selective serotonin reuptake inhibitors. J Clin Psychopharmacol 1999;19:268–71 100 Delmonte MM. Case reports on the use of meditative relaxation as an intervention strategy with retarded ejaculation. Biofeedback & Self Regulation 1984;9:209–14 101 Hawton K. Sex Therapy – A Practical Guide. Oxford: University Press, 1989 102 Jannini EA, Simonelli C, Lenzi A. Sexological approach to ejaculatory dysfunction. Int J Androl 2002;25:317–23 103 Zilbergeld B. Group treatment of sexual dysfunction in men without partners. J Sex Marital Ther 1975;1:204–14 104 Shaw J. Play therapy with the sexual workhorse: successful treatment with twelve cases of inhibited ejaculation. J Sex Marital Ther 1990;16:159–64 105 Dow Michael G. Retarded ejaculation as a function of nonaversive conditioning and discrimination: a hypothesis. J Sex Marital Ther 1981;7:49–53 106 Voigt H. Enriching the sexual experience of couples: the Asian traditions and sexual counseling. J Sex Marital Ther International Journal of STD & AIDS Volume 17 March 2006 [ Delayed ejaculation - retarded ejaculation - how to ejaculate during sex ]
Treatment of retarded ejaculation |
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