Understanding Delayed Ejaculation by Karen Gless

Delayed Ejaculation

Delayed ejaculation (DE), which is also known as retarded ejaculation, is usually defined as a man needing 30 to 45 minutes of sexual activity to have an orgasm and ejaculate. In severe cases a man with this problem may be unable to ejaculate during sexual activity with a partner.

For those men who have a problem with premature ejaculation and want to last longer in bed, DE may seem like a wonderful solution to their problems. Just imagine, you can engage in sexual intercourse for a half an hour or longer and thoroughly satisfy your partner. Unfortunately that’s not the reality of this condition.

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Fear and Anxiety

Men with DE suffer from anxiety about their ability to climax while engaged in sex. Then toward the end of the sexual encounter it requires a lot of effort to have an orgasm and even then it may not happen. He may last longer in bed, but his partner can be left puzzled and confused.

Now the man faces the same quandary that a woman has to deal with who has trouble climaxing. He can explain that he didn’t have an orgasm but the sex was very satisfying without it. The other option is to fake an orgasm, withdraw and cuddle up. The whole situation can be very frustrating.

A review study (1) by the BASHH (British Society for Sexual Health and HIV) found studies that estimated the prevalence of DE at between four and 11%. This seems like an accurate range when you consider that some men have long-term problems with DE while others might experience it as a side effect from drugs, surgery or relationship difficulties.

There are three main areas that cause DE in men:

  • Psychological and emotional problems
  • Side effects of drugs
  • Physical problems

We will look at each of these areas in turn.

The Psychology of DE

Psychological challenges are at the root of a large percentage of problems with DE. This includes:

Psychology of DE
  • Strict religious upbringing
  • Relationship problems
  • Anxiety
  • Depression
  • Traumatic sexual experiences

Strict religious upbringing is a major cause of DE. A boy can get overwhelming messages about how evil sexual feelings are. Then as a man he may find that it’s difficult to make the transition from being aroused to surrendering to the overwhelming sexual pleasure of orgasm.

Likewise worry about problems in a relationship can lead to increasing* stress during sexual activity and make it hard to achieve climax. Anxiety about the workplace or depression about recent events can have the same result.

Occasionally trying to last longer in bed can lead to temporary DE because the man stops himself from having an orgasm too soon or for too long. Then when the woman is satisfied and he wants to climax, sometimes he finds that he can’t let go. This can be very frustrating.

In a similar way traumatic sexual experiences, especially something that happened to a boy such as being discovered masturbating by a parent or being molested by an adult can bring up negative feelings about sex just as he is about to have an orgasm as a man. Obviously this is very distressing to a man because he can’t have a satisfying sexual experience in the present and he relives those old painful memories.

Fortunately DE that is the result of psychological problems can be treated with about a 70 to 80% success rate according to the National Library of Medicine (2). For those with current problems such as relationship difficulties or anxiety about the job, getting those worries out in the open and dealing with them can relieve stress enough to make it possible to return to normal sexual functioning.

Psychotherapy

For those with a strict religious upbringing who are coming from a culture that is very sex negative the first step is dealing with negative sexual ideas and feelings. Then it’s time to get comfortable with intense sexual feelings and pleasure. This was the case with a patient that I worked with. We can call him Ted.

Ted was a good-looking man in his late 20s who was engaged to be married. He came to see me because it was very difficult for him to have an orgasm with his partner. He loved her and was very attracted to her, but he just couldn’t climax with her.

When he was young he received a very strict religious upbringing which taught him that sex and sexual feelings were terrible outside of marriage. Although he had relaxed his religious views and opinions, the old messages stuck with him and he just couldn’t let go during sexual intercourse. He was afraid that this could have a very negative effect on their marriage and he was probably right.

Too Much Control

Too Much Control

While interviewing Ted I found two factors that are common in those men who have trouble with DE based on psychological issues. First of all he liked to control things. He was a bit obsessive/compulsive and liked to have everything in its place. Unfortunately the shift from arousal to orgasm involves losing control and this was something that he wasn’t comfortable with.

In discussing his feelings during foreplay and sexual intercourse one thing stood out strongly. He didn’t have much in the way of feelings. He liked making out with his fiancée, but he was more concerned about whether he was doing things right and if she was enjoying herself. His own physical pleasure and experience didn’t seem to matter that much to Ted.

Partly this resistance to “getting into it” and enjoying himself may have been the result of the level of control that he tried to maintain in life. But the other part was that he never learned to be comfortable with sexual pleasure. Despite the overwhelming exposure we get on how wonderful sex is in movies, TV shows and commercials, it’s surprising how many men and women actually aren’t all that comfortable with sexual feelings and don’t enjoy them much.

Read Also: 10 Natural Treatments for Premature Ejaculation

Men have always had more permission than women in society to enjoy sex. However, like my patient Ted said, “I was expected to give my parents children when I grew up and married. But I could tell mom didn’t like being touched by dad. And all dad said to me about sex was, ‘Don’t get a girl in trouble.'”

So sex is expected to happen and be wonderful, but that can put a lot of pressure on a man. It becomes a job instead of being an opportunity to be in the moment and enjoy each other. The desire to control the sexual encounter and last longer in bed can lead to DE. Pleasure comes from feeling comfortable, secure and relaxed about what you are experiencing emotionally and physically.

Learning to Let Go

I had Ted begin to explore his sexual excitement by increasing* his awareness of his body by having him and his wife slowly caress each other and pay attention to how it felt. The hard part for Ted was focusing on his own pleasure, but gradually he got comfortable with enjoying making out.

I also worked on his getting more comfortable with his sexual thoughts. He initially was surprised to hear me tell him that it was okay for him to think sexy thoughts about other women as well about his partner. He admitted that he sometimes had sexy fantasies, but that he felt very guilty afterwards.

He confessed he felt guilty not thinking only of his partner and also for focusing on his excitement instead of hers. Ted was definitely surprised when his partner said it was okay with her a long as she was the only one he slept with. I told him our fantasies are whatever they are. It is our behavior that we are responsible for.

It wasn’t long before he and his partner were enjoying each other’s bodies and sharing more mutual fantasies. With time it was easier for him to climax because he was a part of the sexual excitement equation and not just trying to do a good job.

Side Effects of Drugs

A variety of drugs and medications can cause DE. Addiction to opiates such as heroin and morphine can make it possible for man to have an erection but not have an orgasm. He can last longer in bed, but frankly the activity is largely pointless. The same is true for painkillers such as OxyContin. Also alcoholism can lead to the same condition.

Some other medications that can cause DE are:

  • Antidepressants such as Prozac
  • High blood pressure medications
  • Diuretics

The side effects of these drugs and others are highly individualized. One man may experience extreme effects on his sex life while another doesn’t notice any problems at all. If you are experiencing problems with DE, it’s a good idea to read through that long list of side effects that comes with your medication. Often the solution can be as simple as switching to another drug. Of course, don’t make any changes in the medications that you take without consulting your physician first.

Physical Causes

Surgery, injuries and disease may also cause temporary or lasting DE. Physical causes of DE include:

  • Damage to nerves in the spine or pelvis
  • Certain prostate surgeries that cause nerve damage
  • Heart disease that affects blood flow to the pelvic region
  • Infections, especially of the prostate or urinary tract
  • Neuropathy (nerve damage) or stroke
  • Low thyroid hormone and low testosterone levels
  • Birth defects that impair the ejaculation process
  • Blockage of the seminal ducts
  • Stroke or a tumor in the central nervous system

This is not a complete list of the possible physical causes of DE which could go on a lot longer. When a man comes to me with a sexual problem such as DE or erectile difficulties, I have him see a physician for a complete evaluation of possible physical causes of his condition. He may need a combination of psychotherapy and medical care, but it’s important to address the physical causes first. Fortunately there are good treatments for heart disease, low hormone levels and other physical conditions that can lead to DE.

Even in cases where the man is unable to have an orgasm due to physical or nerve damage, learning to enjoy all the other pleasures of sexual activity can lead to a full and satisfying sex life for both partners. In most cases, learning to relax and enjoy sex is the best way of dealing with DE. That way you get both a pleasurable sexual experience and a satisfying orgasm.

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Author

Contributor : Dr. Karen Gless (Consumer Health Digest)

Karen Gless, Ph.D., is a Licensed Marriage and Family Therapist and a registered nurse with over 20 years in a successful psychotherapy practice. She has written many articles on relationships and sexual issues. She has appeared on TV shows, given internet interviews and has been quoted in Cosmopolitan Magazine. She often uses hypnosis to help her patients resolve sexual problems, relieve anxiety and improve self-esteem. She has successfully treated many individuals for a variety of sexual problems, including impotence, premature ejaculation, inability to have orgasms, and lack of sexual desire. She uses the latest scientific discoveries to help her couples create healthy, happy, fulfilling relationships. You can follow her on Facebook, Twitter, Linkedin, Google+, and visit her website bestpetreatment.com for more info.

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