What Causes Delayed Ejaculation - and What Are Its Effects? |
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What is the cause of delayed ejaculation?To go straight to the treatment method for delayed ejaculation (also known as retarded ejaculation), follow the red link. Difficulty in ejaculating during sex is called delayed ejaculation. Men who experience delayed ejaculation may be able to maintain prolonged thrusting for 30 minutes or more before they ejaculate (often even longer) during either sexual intercourse or masturbation. This leads to massive frustration for both the man and his partner. Physical causes of delayed ejaculation include the following:
But by far and away the most frequent cause of delayed ejaculation is any one or more of a whole load of psychological issues. For example, cultural or religious taboos about sex, or inhibitions about performance or sexual activity, can cause delayed ejaculation. And another very common cause is a kind of behavioral conditioning from certain masturbation patterns. This is called idiosyncratic masturbation and often involves hard and fast movements which leave a man unable to reach orgasm during the less gentle stimulation received from intercourse. A medical history and physical or neurological examination can determine if delayed ejaculation is due to a some significant underlying medical condition or if it is the result of a side effect of medication. Treatment of delayed ejaculation will therefore depend on the underlying cause but may include:
Psychological factors in delayed ejaculation are also mentioned elsewhere. There aren't many well designed studies on men who have had delayed ejaculation all their lives. This is because many men with the condition prefer to keep it secret rather than seek help, but the importance of the condition is also underestimated by doctors - it can certainly severely impact on the quality of life of a couple where the man has delayed ejaculation. You sometimes even find the opinion expressed that delayed ejaculation is useful in allowing a man to satisfy his partner (i.e. bring her to climax during intercourse - perhaps even more than once).The reality, of course, is that delayed ejaculation is beyond the control of the man concerned, and it can produce many emotional and physical reactions, not least because of the difficulty in conceiving and the attendant emotional reactions. Naturally enough, men can also become frustrated by not being able to ejaculate and reach orgasm. The partners of men who have delayed ejaculation also have difficulties: they may see themselves as victims, believing that the cause of the delayed ejaculation is their lack of attractiveness or that they may be unable to sexually arouse their man. In addition, the prolonged vaginal intercourse which follows the development of delayed ejaculation may be uncomfortable if not downright painful. Ejaculation and orgasm are two separate processes, though we tend to think of them as being simultaneous. They actually involve separate responses in the body: ejaculation is specific to the genitals, and orgasm is a whole body phenomenon. There is an experience colloquially known as "numb come" (which doctors term anesthetic ejaculation) which illustrates how the experience may be physiologically and psychologically separated. There is ejaculation, but no experience of orgasm - probably due to lack of sexual arousal. Delayed ejaculation is a similar phenomenon, although there may be neither ejaculation nor orgasm. DSM-IV defines delayed ejaculation as Male Orgasmic Disorder: that is, a persistent or recurrent delay in orgasm or even a complete absence of orgasm after normal sexual that should have raised a person's sexual arousal to a level adequate in focus, intensity, and duration. The difference between orgasm and ejaculation is not made explicit in the DSM IV, where ejaculation disorders are grouped under Orgasmic Disorders. However, "male orgasmic disorder", something similar to "female orgasmic disorder", muddles the classification of premature ejaculation. Anesthetic ejaculation and partial ejaculatory incompetence do not even feature in the DSM IV. This means that DSM IV makes the process of ejaculation and orgasm more or less synonymous, which is not in line with current medical and especially neurobiological views. The difficulty of leaving such judgments to the clinical practitioner means that "normal" and "adequate in focus, intensity and duration" are not objectively defined. and these criteria are notoriously subject to variation between couples anyway. It's better to suggest that delayed ejaculation is a condition where a man cannot ejaculate, easily or indeed at all, even when he has plenty of sexual stimulation, has an erection and wishes to achieve orgasm. The effort of trying to get to orgasm and ejaculate may be fruitless and exhausting for both a man and his partner. This can apply to intercourse, masturbation and oral sex. Synonyms for delayed ejaculation are retarded ejaculation, late ejaculation, anejaculation, ejaculatory incompetence, lack or loss of ejaculation, and failure to ejaculate. There is lifelong delayed ejaculation and acquired delayed ejaculation where delayed ejaculation starts in life after a man has previously had normal ejaculatory functioning. Symptoms of delayed ejaculationIf a man has difficulty ejaculating in all situations, regardless of what sexual activity he is enjoying, and with all his sexual partners, the delayed ejaculation "generalized". If his delayed ejaculation is limited to certain situations or specific sexual partners, it is "situational" - for example, he may be unable to ejaculate within the vagina of his partner but can do so by masturbation, or he may be able to ejaculate during sex with a man but not with a female partner, and so on. This would include difficulty in ejaculating with one partner at some times and not others. PrevalenceLifelong delayed ejaculation occurs in about ten per cent of men. Acquired delayed ejaculation under 65 years of age is somewhat higher. (This reflects the natural tendency of men to last longer during sex as they get older.) However, the problem is that there is no agreement on what constitutes delayed ejaculation: nor is there any agreement on what is a "reasonable" time before ejaculation during intercourse. Psychological & physical causes of delayed ejaculationLifelong delayed ejaculation may be caused by fear, anxiety, hostility, resentment and relationship difficulties. In psychodynamic terms, this fear could be about death, loss of self, loss of self in the feminine, fear of emasculation by the female genitals, fear of hurting the woman, fear of being hurt by the female, having sexual performance anxiety, being unwilling to give semen as an expression of love, fear of getting the woman pregnant, and sexual guilt or shame. Some clues to the origin of delayed ejaculation lie in how often it occurs - or if it is generalized or situational (in other words, whether it is specific to certain places or activities or partners), and whether it is acquired or life-long. Acquired delayed ejaculation may happen suddenly caused perhaps by psychological trauma (a partner's unfaithfulness, or poor sexual and psychological stimulation. A moderate delay in ejaculation occurs with ageing, the result of androgen deficiency; loss of ejaculatory capacity can be caused by traumatic or surgical injuries with damage to the lumbar sympathetic ganglia and associated nerves, various kinds of surgery, and neurodegenerative disorders, such as multiple sclerosis or diabetic neuropathy. And many drugs (including SSRIs and tricyclic antidepressants and alcohol) can cause a reduction in ejaculatory capacity. Ejaculation distribution theory Waldinger and his colleagues formulated a neurobiological theory about the origins of both premature ejaculation and delayed ejaculation. They concluded that lifelong delayed ejaculation, and also premature ejaculation, are simply part of a normal biological variability of latency time (time between penetration of the sexual partner and ejaculation). Any sample of men will include some who ejaculate too soon, and some who always, or almost always, experience delayed ejaculation or an inability to ejaculate at all. Lifelong delayed ejaculation, they say, is therefore a neurobiological variant found in the population, which may or may not cause psychological or psychosocial distress. Unfortunately, Waldinger has done much of his work on rats. You can read more about his work in the section of this website about scientific research into delayed ejaculation, should you so wish.
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