Treatment For Retarded Ejaculation

No matter what the cause of a man being unable to ejaculate during sex, the ultimate goal of any treatment is to enable a man to reach climax normally during intercourse - and preferably enjoy the sex that leads up that point!

The treatment usually aims to encourage the man to relax his high level of self-control and increase the level of sexual stimulation which he is receiving so that he can become more sexually aroused. Obviously if the cause of your delayed ejaculation (also known as retarded ejaculation or DE for short) is the fact that you aren't aroused enough during sex, then anything that helps you become more aroused will help you reach a level of arousal sufficient to ejaculate during sexual intercourse.

Treatment Protocol

The longest established treatment for DE assumes that a man can work on his existing level of arousal, building on it by using techniques to increase his sexual arousal and desire. In essence, it's about finding ways to stimulate the man - with sexual fantasies and in the physical world - that work for him.

This might include exercises designed to sexually arouse him by touching his partner, both sexually and non-sexually; exercises to help him relinquish his need for control; and techniques to desensitize him from whatever has become his accustomed method of gaining arousal.

But all of this is based on what works for a man right now. If he can only ejaculate when his partner is, say, in another room, then that has to be the starting point for his progression towards normal sex - i.e. sex with easily achieved ejaculation. The next step might be to have his partner in the room, but some distance away from the man as he stimulates himself. A series of additional steps is then put in place so that they end with the man reaching orgasm in the close presence of his partner, perhaps using the method where he is stimulated to near orgasm before he inserts his penis into her vagina to experience his ejaculation inside her.

All of this takes place in what are thought of by the man concerned as ideal conditions for the exercises. He needs to be selfish as he goes through this process of retraining his sexual responses to cure delayed ejaculation. He needs to be able to "take" sexually without being over-concerned about giving to his partner, and he must only undertake intercourse when he is aroused enough. The mere presence of his erection is not a sign that he is aroused enough!

It's also helpful for a man to work through any feelings of guilt, hostility or anger towards his partner before he attempts a cure for his DE. Reframing can be an important part of the treatment program. This means that the man comes to acknowledge his lack of desire (for his partner, for intercourse) and lack of arousal.

Many men with such difficulties often think they should be more "giving", but in reality it is probably the case that he is unable to take, has difficulty in meeting his own needs, and any treatment should work in encouraging the man to be more selfish during sex, to be more demanding, to ask for more stimulation of the right kind that will enable him to become more aroused, and to seek out his own pleasure.

If a man can check his own sexual arousal he may understand that it is not high enough - even if he has a good erection - to allow him to ejaculate during sex. Many partners take their man's ejaculatory unresponsiveness as rejection; if she can come to see that he is trying "too hard" to have an orgasm for his partner, she is likely to be more tolerant and less demanding.

There is much more information on the subject of idiosyncratic masturbation here.

Psychological therapies

Sex 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. 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.

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