Delayed ejaculation (retarded ejaculation)

Written by Dr David Delvin, GP and family planning specialist

What is delayed or retarded ejaculation?
The terms 'delayed ejaculation' (DE) and 'retarded ejaculation' (RE) mean the inability of a man to reach a climax.

Term watch The old term for this condition was 'ejaculatory incompetence'.

Most sex therapists now prefer to say delayed or retarded ejaculation.

To add to the confusion, you may find it referred to by other names such as:

ejaculatory dysfunction
ejaculatory overcontrol
anejaculation
inhibited orgasm
situational retarded ejaculation.

How common is delayed ejaculation?
It is the third most common male sexual disorder after impotence (erectile dysfunction) and premature ejaculation.

Delayed ejaculation is not easy to treat: only 58 per cent of cases I've seen were significantly improved by treatment.

All of the successful couples were well-motivated and willing to persevere with long-term therapy.

Because this disorder is not as common as the other two main male sexual problems, there is remarkably little medical literature on this subject. Exceptions are the pioneering works of Masters and Johnson, and of Helen Kaplan and her associates in the USA.

What causes delayed ejaculation?
Many of the men tend to have had a strict upbringing and are very controlled in their lives.

Some have terrific drive and detachment, and have risen to the top of their professions. A surprising number have been in the finance industry.

Some of them readily admit to having quite controlling personalities. Very often this is directed inward rather than at other people.

They may have difficulty in showing emotions and in 'letting go'.

Other possible factors include:

fear of causing pregnancy
fear that the vagina is dirty
over-strict religious upbringing
latent homosexuality.

Is delayed ejaculation always a psychological problem?
Nearly always, but there are exceptions.

Age and climax Quite a lot of men find it's not as easy to climax as they get older.

They have good erections, but do not always get to orgasm.

This phenomenon was first noted by US researchers Masters and Johnson.

It is not the same thing as delayed ejaculation, which occurs in a much younger age group.

Why does delayed ejaculation cause problems?
In your youth, you may not feel you have a problem and may well assume that other men are the same.

When you first have sex, you may be very popular because you can keep going for two or three hours.

But when you get into a regular relationship, especially if you hope to have children, delayed ejaculation can be a major problem.

Both the man and woman may become sore and frustrated, and the female partner often feels resentful or even insulted that her man does not ejaculate when they make love.

Not surprisingly, it is common for men with this problem to have had several broken relationships â€“ because their partners have decided that they want somebody who can 'come'.

Sometimes the man seeks help after a divorce. More commonly, a couple may ask for treatment when they are desperate to have a baby.

What can be done for men with delayed or retarded ejaculation?
Unfortunately, there is no instant cure. At present, there are no drugs that will make a man come.

But there is a good chance of putting things right through counselling, provided both the man and his partner really want to cure the problem.

Counselling The object of therapy is to gradually diffuse the man's anxiety about giving up control so he can climax inside his partner without difficulty.

The most common method is based on the work of American experts who have developed behaviourist ways of helping the man to relax and 'let go' when he is with his partner.

Generally, the man can reach orgasm by self-masturbation and maybe through love play, but not through intercourse.

So the therapist may encourage the couple to gradually proceed to a situation where the man can ejaculate just outside his partner's vagina, and eventually go on from there to a more 'advanced' situation where he is able to cope with ejaculating inside her.

American sex experts Masters and Johnson have also devised a slightly different therapy:

first, the couple go through a period of treatment in which actual sex is off limits, but kissing and cuddling are encouraged
they progress to a stage where the woman, sitting astride the man, masturbates him till he reaches orgasm - even if this takes two hours or more
finally, they move to a situation where she lowers herself onto him shortly before he climaxes.

. Other treatments
Beware of people who want to give you expensive hormones, or who try to relieve you of very large sums of money.

If you search the internet, you will find claims for Chinese herbal treatment that produces a near 100 per cent success rate. This does not seem very likely.

Claims are also made for yoga and for hypnotherapy as modes of treatment.

We want to have children. What if counselling doesn't work?
If the man cannot get to the stage where he ejaculates inside the vagina, couples can be helped to conceive by:

IVF (test-tube) techniques
artificial insemination (AI), in which a doctor injects the man's seminal fluid into the woman.

We know of couples who have tried 'self-insemination' without medical help. This involves getting the semen by masturbation and then putting it into the vagina.

There is something to be said for this approach, but some women who have attempted it have ended up with injuries to their cervix (neck of the womb). Do not use any sharp instruments.

There are numerous websites that have advice on self-insemination. Many of them are aimed at lesbians, but the information can be useful for any couple.

Where can I get help?
There is some NHS help available from psychosexual clinics. Your GP can refer you, if he knows of one.

Other organisations that can be of assistance include the following.

A few family planning clinics, but they're overworked these days and are unlikely to have the time to help.
Relate has excellent psychosexual counsellors.
Relate Scotland does similar good work to Relate, but north of the border.
British Association for Sexual and Relationship Therapy (BASRT) is an organisation whose members are trained in sexual counselling.
Institute of Psychosexual Medicine is another counselling organisation whose members are all doctors trained in psychosexual therapy.
Sexual Dysfunction Association.

There are also some private clinics, but only a few have any real experience in treating retarded ejaculation.

Can delayed ejaculation be cured?
Delayed ejaculation, also known as retarded ejaculation, is a frustrating and trying condition for both partners.

With some expert help and a determination to persist with therapy, it is possible to defeat it.

But if you cannot solve the problem, and are keen to have a baby, you should consider IVF or artificial insemination â€“ especially if your years of fertility are running out.

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use

Delayed ejaculation (retarded ejaculation)

Page: 12 3

Advertisement starts

Advertisement ends

Advertisement starts

Advertisement ends

More Links Within This Section

Page Footer

Access keys

Delayed ejaculation (retarded ejaculation)

Delayed ejaculation (retarded ejaculation)

Page: 123

Health Search

Related Links

Medicines By Alphabet

Disease By Alphabet

Advertisement starts

Advertisement ends

Tiscali Dating

Lose 10 lbs in 5 weeks

Advertisement starts

Advertisement ends

More Links Within This Section

Page Footer

Access keys

Page: 12 3