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Q: Delayed Ejaculation Problems ( Answered 4 out of 5 stars,   1 Comment )
Question  
Subject: Delayed Ejaculation Problems
Category: Health > Men's Health
Asked by: redshark66-ga
List Price: $50.00
Posted: 16 Sep 2005 11:58 PDT
Expires: 16 Oct 2005 11:58 PDT
Question ID: 568819
I am 43 and in good health, exercise regularly and take
multi-vitamins.  I usually have sex every day or two.  I am having
problems with acheiving orgasm.  Typically I go an hour to two hours
of having sex before having an orgasm, usually the orgasm is quite
large when it does occur.  I am not trying to hold back, it just takes
that long.  I am sweating to death at this point and wife is getting
sore.  I very commonly find that masturbation is the only way to
ejaculate in the end.  I know that there can be psychological causes,
but I am hoping for something easier to deal with!  I have searched
Google and while there is some information on the subject most of it
deals with the opposite of my problem, people who orgasm too soon.  I
have read some Google information that links Zinc and some
anti-depressants to perhaps encouraging a more timely orgasm, but
nothing definitive.  My question is this- "Is there anything I can
take or do that will reduce the amount of time before orgasm?"
Answer  
Subject: Re: Delayed Ejaculation Problems
Answered By: hummer-ga on 17 Sep 2005 10:54 PDT
Rated:4 out of 5 stars
 
Hi redshark66,

Well, you paint quite a picture, redshark66, but I realize it's no
laughing matter for either you or your wife. Maintaining an erection
for an excessive length of time is troubling, and although the
satisfaction of ejaculation is eventually achieved, the timing is
perceived as unsatisfactory for both partners. An inability to time
ejaculation, and a wife's feeling that she is unable to help, can put
a strain on any relationship. Treatment involves reducing anziety,
goal orientation, and learning techniques, not only on how to control
the timing of ejaculation, but also exercises to practise together as
a couple.  I've copied and pasted relevant sections below but please
click on the links for full details.

You'll find the following terms useful for searching online.

Delayed ejaculation (DE)
Retarded ejaculation (RE)
Inhibited orgasm
Male orgasmic disorder

What is Male Orgasmic Disorder?
"Male orgasmic disorder occurs when a man is unable to ejaculate into
his partner?s vagina. Like the other sexual dysfunctions, it can be
either lifelong or acquired and is either generalized or situational.
The lifelong form of this disorder is very rare; the acquired form is
more common and is usually the result of psychological factors-for
example, a very strict, religious background, a lack of trust, or a
high need to be in control. The treatment is to gradually desensitize
the man to the factors that keep him from experiencing ejaculation."
http://www.nku.edu/~hcp/MALE%20SEXUAL%20DYSFUNCTION.htm

What is retarded ejaculation (ejaculatory incompetence)?
The terms 'delayed ejaculation? (DE) and 'retarded ejaculation' (RE)
mean inability of the man to reach a climax. However, in most of the
cases which I have treated, the sufferer can actually achieve orgasm
during masturbation - but not during sexual intercourse."
http://www.netdoctor.co.uk/sex_relationships/facts/ejaculatoryincompetence.htm

First and foremost, you need to have a complete psychological and
physical evaluation. Most communities have specialist in the field and
if you don't know who to contact, a good place to start would be to
phone the nearest university teaching hospital.

Definition
Ejaculatory incompetence; Sex - delayed ejaculation; Retarded ejaculation
"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)."
"If, however, he is able to ejaculate in a reasonable period of time
by some form of stimulation, he should seek sex therapy from a
therapist specializing in this area. Treatment usually includes both
partners.
The therapist will usually educate the couple about the fundamentals
of sexual response and how to communicate and guide the partner to
provide ideal stimulation, rather than trying to will a sexual
response to occur.
Therapy then commonly involves a series of homework assignments
wherein the couple, in the privacy of their home, engage in sexual
activities that minimize performance pressure and maximize focusing on
pleasure.
Typically, sexual intercourse will be prohibited for a limited period
of time, while the couple gradually enhances their ability to enjoy
ejaculation through other types of stimulation. "
Expectations (prognosis)
"Outpatient treatment commonly requires about 12 to 18 sessions with
an average success rate in the range of 70 to 80%."
http://www.nlm.nih.gov/medlineplus/ency/article/001954.htm

What is retarded ejaculation?
"Difficulty in ejaculating is known by doctors as retarded
ejaculation. Although men who suffer from this problem may be fully
sexually aroused during sex and enjoying the stimulation, orgasm seems
to take for ever and may not happen at all.
Retarded ejaculation (RE) can be a very distressing condition.
Sufferers can feel embarrassed, isolated, confused and very
frustrated.
Partners often blame themselves and feel inadequate, which puts even
more pressure on the sufferer to perform and compounds the problem
further."
 Possible psychological reasons include:
    "You're a perfectionist..."
    "You're scared to lose control..."
    "You're worried that you're not a good lover..."
    "Deep down, you believe sex is wrong..."
    "You're distracted..."
    "You're spectating..."
    "You're unhappy..."
http://www.bbc.co.uk/relationships/sex_and_sexual_health/probs_difficultyejaculating.shtml

Sexual Disorders
Classification  /  Treatment Self assessment /  References /  Swaab references
http://www.priory.com/sex.htm

"Retarded ejaculation is often treated by reducing anxiety and
learning to control the timing of ejaculation. Sensate focus exercises
may help; you should withhold penetration until you sense that
ejaculation is inevitable. A common cause of retarded or delayed
ejaculation is side effects from medication. The most common drugs
that cause this are antidepressant medications such as the SSRIs."
http://www.hipusa.com/eTools/webmd/A-Z_Encyclopedia/malesexualproblemstreatment.htm

>>> THINGS TO TRY

Briefly, stop having sex so often!  Here's hummer's official tip: do
not make love with your wife for one week (cuddling is ok and
encouraged - see Sensate-Focus Exercises). If a week sounds like an
eternity, try 3, 4, or 5 days of abstinence. After a "successful"
night, don't return to your present schedule right away but wait
another interval, gradually reducing the times.  When you notice it is
taking more than 45 minutes again, lengthen the time intervals again.
You should also withhold penetration until you sense that ejaculation
is inevitable by asking your wife to position herself astride you (on
top). When you are nearly ready, switch positions.

Sure as shootin', if you sign up with a sex therapist, you will come
home with homework assignments in the form of "Sensate-Focus
Exercises".  These traditional exercises, developed by Masters and
Johnson decades ago, still work and may be all that is needed. At the
very least, they won't hurt. They take you through a series of levels
by first learning to stop focusing on orgasm and learning to focus
more on the sensory pleasures of the moment (that's why they are
called "Sensate Focus"). Level one usually begins with your clothes on
and you'll gradually advance to touching and communication, to
enjoying being inside your wife without moving and finally to
thrusting.  But each step must be taken one at a time.

Sensate Focus
"Sensate focus is a therapy that is commonly used as one technique
among several for to treating sexual problems such as anorgasmia,
erectile difficulty, and hypoactive sexual desire disorder. Namely, it
can help both females and males who have a hard time becoming sexually
excited and reaching orgasm. This technique is designed to reduce
anxieties about reaching orgasm by focusing more on what feels good to
you and your partner. People often mistakenly believe that the "goal"
of sex is to reach orgasm. When individuals get anxious about reaching
that goal, they often miss out on the joys of simply being with their
partner and taking their time to experiment with touching and feeling
many parts of their partner?s body."
http://www.soc.ucsb.edu/sexinfo/?article=difficulty&refid=016

Sensate Focus
"Touching is an important part of any sensual relationship, but is all
too often forgotten. Psychosexual therapist Paula Hall decribes
sensate focus, a series of exercises designed to help couples become
more comfortable with touch and build trust and intimacy."
http://www.bbc.co.uk/relationships/sex_and_sexual_health/exercise_sensate.shtml

Sensate-Focus Exercises 
Most sex therapists assign sensate-focus exercises in their treatment
of patients with sexual dysfunction. During these exercises, the
patient couple is instructed to refrain from intercourse and orgasm.
There are four levels of exercises, described as follows:
Level I. Each partner touches his or her partner?s body but avoids the
genitals and breasts. The purpose of this exercise is for each partner
to learn about the other person?s body. The person being touched is
silent except when feeling uncomfortable.
Level II. The purpose of the touching is to bring pleasure to one?s
partner but still avoids the genitals and breasts. The one being
touched tells the partner what feels good and at what pressure.
Level III. This exercise is similar to Level II but includes the
genitals and breasts, along with the rest of the body. The couple
still must avoid intercourse and orgasm.
Level IV. This exercise involves mutual touching but avoids intercourse and orgasm.
The sex therapist will assign subsequent exercises that depend on the
needs of the couple.
http://www.nku.edu/~hcp/MALE%20SEXUAL%20DYSFUNCTION.htm

"Some men get into the habit of thinking about how difficult it's been
in the past to reach orgasm when they're having sex with a partner.
This slows down arousal and makes orgasm more elusive. How can you
avoid this? Focus on things that are sexy to you. It can be some
aspect of your partner's personality or body, a hoped-for experience
or an embellishment of the situation you're currently in. The brain
has an amazing way of propelling sexual arousal forward even when the
physical stimulation is different or less intense than usual."
"Teach your partner how to stimulate you by hand in the way you like best..."
"Check whether you are focusing excessively on giving your partner pleasure..."
"There's another common approach to sex that slows things down. Often
intercourse is begun too soon in the sexual encounter..."
"Give up watching the clock with an arbitrary time limit in mind..."
"Take a look at how you feel emotionally during sex. Are you angry?
Anxious? Afraid? Depressed?..."
"Some men are so anxious during the closeness of sex that they protect
themselves from the overwhelming feelings by not permitting orgasm..."
http://boards.webmd.com/webx?THD@281.5GRNaaNwddv.0@.59aefddd/2!thdchild=.59aefddd/2

Try these at home!
"These exercises use techniques employed by psychosexual therapists to
help people get the most from their sex life. Some are to be done on
your own and some with a partner - and the idea is to have fun!"
http://www.bbc.co.uk/relationships/sex_and_sexual_health/exercise_index.shtml

Self-help tips and exercises
For ways to put these tips into action, see the section on practical exercises.
    * Make sure you're feeling relaxed. Try breathing exercises or buy
a relaxation tape.
    * Enjoy being sensual first, taking time to focus on pleasurable sensations.
    * Escape into your favourite fantasy to block out any negative
thoughts or distractions.
    * Try different positions to maximise stimulation.
    * Strengthen your pelvic floor muscles. 
http://www.bbc.co.uk/relationships/sex_and_sexual_health/probs_difficultyejaculating.shtml

Sexual Dysfunctions, Counseling, and Therapies
Brief History of American Sexual Therapy
http://www2.rz.hu-berlin.de/sexology/GESUND/ARCHIV/IES/USA15.HTM 

Following is a good overview on what to expect when you visit a sex therapist.

Principles of Sex Therapy
http://www.hsph.harvard.edu/Organizations/healthnet/SAsia/suchana/0719/rh256.html

>>> For Your Wife

Ejaculation - delayed
"Delayed ejaculation means that even though your sexual desire
(libido) and erections are normal, you have difficulty reaching a
climax (i.e. the point at which semen spurts out) when you are inside
your partner."
How to help a partner with delayed ejaculation
    * There?s nothing biologically wrong with most men experiencing
ejaculation difficulties. However, men who cannot come inside a woman
may have a combination of technique and attitude problems. For
instance, many men learn how to do sex by masturbating. When they
bring themselves to orgasm, they may agitate with their hands far more
quickly than two people can ever have sex. Hence when they start
making love, the sensations seem under-stimulating. The answer to this
part of the problem is to increase the eroticism of foreplay, make
your partner wait until he?s practically on the edge of climax before
allowing him to insert his penis.
    * If it doesn?t help, anxiety is probably preventing him from
triggering his ejasculatory reflex. Tell him there is a remedy, which
you can jointly try over a period of weeks.
    * When the time is right, and you are feeling intimate and
relaxed, ask him to show you how he masturbates all the way to orgasm.
Be light-hearted and make it fun. Next time, ask him to masturbate
with a little assistance from you. Next time, see if he can do it just
inside your vulva again with assistance from your hand if he enjoys
it. At this point, if the process has proved successful, draw his
attention to the fact that you are virtually having normal sexual
intercourse and that he HAS managed to ejaculate where you both want
him to.
    * On the next occasion, he could insert himself fully and try
coming deep inside you - and so on. The important point to remember is
that if at any stage he meets with a reverse, you don?t fret but
simply return to the previous stage and get comfortable with that
again.
http://www.embarrassingproblems.co.uk/ejacdelayed.htm

I'm sorry there isn't a magic pill to take or cream to use, but the
exercises are much more fun, anyway!  It's important to me that you
are very happy with my answer, so if not, or if you have any
questions, please post a clarification request and wait for me to
respond before closing/rating my answer. And if you think of it,
please send an update later on and let me know how you are making out!

Thank you and good luck,
hummer

Google Search Terms Used:

Delayed ejaculation 
Retarded ejaculation 
Inhibited orgasm
Male orgasmic disorder
Sensate Focus
redshark66-ga rated this answer:4 out of 5 stars
thank you for your help!  a magic potion or cream would be appreciated
though!  I will see how this works.

Comments  
Subject: Re: Delayed Ejaculation Problems
From: mystified1966-ga on 30 Dec 2005 07:39 PST
 
In severe cases of Retarded Ejaculation Sensate Focus therapy has
proved ineffective. This is especially true of cases where anxiety and
chronic masturbation/pornography conditioning is the cause of the
dysfunction. Masturbation re-conditioning is the usual method to treat
R.E. when Sensate Focus fails.

more info here:

http://www.psychforums.com/viewtopic.php?t=1796&postdays=0&postorder=asc&start=0&sid=64feebfeda15f2f3f3110b73d0fd7dbc

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