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Suffer difficult ejaculation and delayed masturbation. Suggestions?

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Practicing since : 2008
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About 6 months ago ejaculation has been very difficult for me. I can cum with masturbation, but only after a long time, I never cum with intercourse anymore.
Posted Tue, 6 Aug 2013 in Sexual Problems
 
 
Answered by Dr. Anjana Rao Kavoor 1 hour later
Hi XXXXXXX
Thanks for writing in.

You might be suffering from what is clinically termed as delayed ejaculation of retarded ejaculation (RE) which come under the category of delayed ejaculatory disorders (DED). Most men with retarded ejaculation (RE) will masturbate to orgasm after a long time but may not experience ejaculation during intercourse.

Retarded ejaculation can be caused due to following:

1. In some instances, a somatic condition may account for RE, and indeed, any procedure or disease that disrupts sympathetic or somatic innervation to the genital region has the potential to affect ejaculatory function and orgasm. Severe diabetes, and medications that inhibit a-adrenergic innervation of the ejaculatory system have been associated with RE.

2. Multiple psychosocial explanations have also been offered for RE, with unconscious aggression, unexpressed anger, and malingering recurring as themes. Specifically, many men with RE engage in self-stimulation that is striking in the speed, pressure, duration, and intensity necessary to produce an orgasm, and dissimilar to what they experience with a partner.

3. Anxiety surrounding the inability to ejaculate may draw the man’s attention away from erotic cues that normally serve to enhance arousal. This “ejaculatory performance” anxiety interferes with the erotic sensations of genital stimulation, resulting in levels of sexual excitement and arousal that are insufficient for climax (although more than adequate to maintain an erection).

You may consult a psychiatrist or sex therapist for further discussion and treatment. Some of the commonly used methods is treatment of retarded ejaculation are as follows:

1. Men are counseled to use fantasy and bodily movements during coitus, which help approximate the thoughts and sensations perhaps previously experienced only in masturbation. For those individuals the clinician or urologist will often need to counsel these patients to temporarily suspend masturbatory activity and limit orgasmic release to only the desired activity, which is typically intercourse.

2. To increase satisfactory outcomes from treatment, the partner needs to cooperate with the therapeutic process, finding ways to pleasure the man that enhance arousal and that can be incorporated into the couple’s lovemaking.

3. Certain medications are still under review for treatment of retarded ejaculation.

Hope your queries are answered.
Further doubts welcome.

Regards
Dr. A. Rao Kavoor
Above answer was peer-reviewed by
 
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