Retarded ejaculation
Alternative names:
delayed ejaculation; ejaculatory incompetence; sex - delayed ejaculation
Information:
DEFINITION
An inhibition of the ejaculatory reflex so that the male is unable to ejaculate, either during intercourse, or with manual stimulation in the presence of a partner.
BACKGROUND INFORMATION
Estimates of the incidence of retarded ejaculation range from 1 to 4% of men. Most men ejaculate within 2 to 4 minutes after onset of active thrusting in intercourse. Men with retarded ejaculation may be entirely unable to ejaculate in some circumstances (for example, during intercourse), or may only be able to ejaculate with great effort and after prolonged intercourse (for example 30 to 45 minutes). The cause is most commonly due to strict religious backgrounds causing the person to view sex as sinful, lack of attraction for a female partner, idiosyncratic conditioning caused by unique or atypical masturbation patterns, traumatic events (such as being discovered in masturbation or illicit sex, or learning one's spouse is having an affair), and homosexual attractions. Some factors such as anger toward the partner may be involved; however, organic causes are sometimes present. A variety of drugs (such as Mellaril and guanethidine) may sometimes impair ejaculation, as well as nerve damage to the spinal cord or back.
PREVENTION
Developing healthy attitudes toward sexuality and one's own genitals may help prevent retarded ejaculation. It is also vitally important to realize that you cannot will a sexual response, just as you cannot will yourself to go to sleep or to perspire. The harder one tries to "help out," the more the sexual response becomes inhibited. Absorbing yourself in the pleasure of the moment, without worrying about whether or when you will ejaculate, helps to minimize the problem. The partner should create a relaxed atmosphere, free of pressure, rather than create pressure with questions about whether or not ejaculation has occurred. Finally, any fears or anxieties, such as fear of pregnancy or disease, should be openly discussed.
SIGNS AND TESTS
When the man is unable to ejaculate in a reasonable length of time with some form of stimulation (as with masturbation) is a good indicator that organic factors are very unlikely to play a role in the problem.
TREATMENT
If the man has never ejaculated through any form of stimulation (such as wet dreams, masturbation, or intercourse) in his life, a urologist should be consulted to determine if there is a congenital abnormality. If, however, he is able to ejaculate in a reasonable period of time by some form of stimulation, seek sex therapy from a therapist specializing in this area. Treatment should include both partners. It usually involves the therapist educating the couple about fundamentals of sexual response and important principles, such as communicating and guiding the partner to provide ideal stimulation, and not trying to will a sexual response to occur. Following the individualized education, therapy commonly involves a series of graduated homework assignments wherein the couple, in the privacy of their home, engage in sexual activities that minimize performance pressure and maximize focusing on pleasure. Treatment typically begins by prohibiting sexual intercourse for a limited period of time, while the couple gradually enhance their ability to enjoy ejaculation through other types of stimulation. In cases where there is a problematic relationship or an inhibition of sexual desire between the couple, therapy to enhance the relationship and emotional intimacy may be required as a preliminary step. Sometimes hypnosis may be a useful adjunct to therapy, particularly if a partner is not willing to participate in therapy. Self-treatment of this problem will probably be unsuccessful in most cases.
PROGNOSIS AND OUTCOME
Outpatient treatment most commonly requires about 12 to 18 sessions with an average success rate in the range of 70 to 80% when treatment is rendered by a specialist in sex therapy. Many psychiatrists, psychologists, social workers, and marriage and family therapists try to treat sexual dysfunctions, even though only a small number of specialists have met the National Institute of Mental Health criteria to ethically treat such problems. Seek a specialist. A more positive prognosis (probable outcome) is associated with having a previous history of satisfying sexual experiences, a short duration of the problem, feelings of sexual desire, feelings of love toward one's sexual partner, motivation for treatment, and absence of serious psychological problems.
COMPLICATIONS
A continuing problem with retarded ejaculation is usually taken personally by the partner, who begins to feel less attractive, sexy, or sexually adequate. Marital stress, sexual dissatisfaction, inhibited sexual desire, and avoidance of sexual contact may result if the problem is not addressed and remedied.
|
|
The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2000 adam.com, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
|
|
