Always late for the party?
Delayed ejaculation is far more common than most people think. The inability or difficulty to climax through sexual activity affects most men at some point in their life. The prevalence is difficult to determine because it is even more difficult to diagnose. In our work, it is safe to say that every fourth man has problems reaching climax at some point in his life. For some men it may be chronic, but for most men it is a temporary problem.
The medical definition is that if it is taking longer than a man wants to climax and it puts one or both partners in distress, most doctors will agree that he delayed ejaculation. But even if it takes a man 60 minutes to achieve ejaculation and does not bother him or his partner, there is no problem! As you can see, this definition is very subjective.
Another definition we like is if the man or his partner are aiming to make him ejaculate during sexual activity and this interferes with the pleasure it would be considered delayed ejaculation. This definition is a bit more flexible and focuses more on the experience and less on the result.
Delayed ejaculation is part of a wider range of disorders called ‘decreased ejaculation disorders’. One study reports that these disorders can range from “varying delays in ejaculation latency to complete inability to ejaculate and can include delayed ejaculation (DE), retrograde ejaculation (RE), anejaculation, anorgasmia and painful ejaculation”.
DE is notoriously difficult to deal with. Unlike fast ejaculation where we try to turn triggers off, in DE we try to turn on as many triggers as possible. This requires a certain amount of self-confidence from the person. He must be aware of arousal levels, sensation and stimulation, sex drive / libido levels, and general ability to describe what he is experiencing. Finding a cause can be time consuming.
Some common causes of delayed ejaculation include low testosterone levels, relationship problems, anxiety, depression, prescription drugs (antidepressants, blood pressure drugs, heart medications), ADHD, alcohol and drug use, boredom, work pressure, sexual trauma / medical history, and even old age. Fixing the cause can be long and frustrating. Very often, men are reluctant to admit that they are bored with sex or have problems with resentment or anger with their partner.
The frustration of dealing with DE itself can make the problem worse. The more a man or his partner is focused on reaching a climax, the harder it can be! Self-inflicted pressure to perform is never helpful during sex! Sometimes guilt or shame can make DE worse. It seems that the possible causes of DE are endless!
Masturbation habits can affect ejaculation with a partner. Pornography is often blamed for DE, but there is no scientific evidence to support this belief. Watching porn can lead to more frequent masturbation, which can lead to DE. Masturbation habits such as stimulation intensity, type of stimulation, and even fantasy can also have a significant impact on a man’s ability to climax. The porn itself has not been shown to cause DE.
Treatment begins with a thorough medical review. Blood tests show hormone levels and other health problems. Mental health tests can reveal some feelings about sex, our partners, our history, our bodies, and even our penis! A thorough sex history can often help with these aspects.
As with other sexual problems, treatment is usually multimodal and includes medical treatment, mental health care, and sexual education. Very often, delayed ejaculation is a combination of medical and behavioral problems that combine to create a perfect storm. The solution, then, is to start medical treatment while changing sexual behavior and general approach to sexual expression to meet climax challenges.
Our therapeutic goal is to help a man whose partner is focused on pleasure-based sex rather than focusing on a sexual performance that conforms to culturally imposed beliefs about sex. For example, for most couples, the purpose of intercourse should be pleasure. Unless a couple is trying to father a child, vaginal ejaculation is completely optional. When the peak of the vagina is causing frustration, we simply change the focus from performance to play. Yes, we definitely want the ability to ejaculate in one partner to be on everyone’s menu. However, this should be optional and not mandatory.
When delayed ejaculation is affecting your sexual pleasure and connection, it’s time to address the problem.
Contact Maze Men’s Health for free telephone consultation and more information. The first step is to ask for help
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