Psychosexual and Relationship Therapy "Freedom-Enjoyment-Adaptability"
Psychosexual and Relationship Therapy"Freedom-Enjoyment-Adaptability"    

Ejaculatory Difficulties

These can be divided into three main groups: Problems with ejaculating/ coming too soon (Rapid

Ejaculation); Finding it takes longer than you would like to ejaculate (Delayed Ejaculation); and Failure to ejaculate (Anejaculation).

Rapid Ejaculation

Rapid ejaculation is quite difficult to define – what seems rapid to one person may seem like a long time for another! Perhaps the best way to define it is to say that rapid ejaculation occurs when the man does not have any control over the timing of his ejaculation and finds it happens much sooner than he and his partner would have wished, causing distress or disappointment in their relationship.

This may mean within a minute of penetration, or in severe cases, even before penetration has been

attempted. Rapid ejaculation is a common problem, especially among younger men who have not yet learned

control. The cause is usually psychological or linked to specific circumstances, such as infrequent

sexual activity or the beginning of a new relationship, where performance anxiety may be high.

Occasionally, there may be a physical cause and rapid ejaculation can be a precursor to developing

erectile difficulties.Fortunately, most men with this condition are able to overcome it with specialist help such as that

offered at clinics. “Overcoming Rapid Ejaculation”.

Delayed Ejaculation and Anorgasmia

Delayed ejaculation is where a man takes a long time to reach a climax and ejaculate during intercourse with his partner, even after prolonged sexual stimulation. If he never manages to reach a climax, this is called anorgasmia.

Both of these conditions can be frustrating and uncomfortable for the man and his partner. These problems can sometimes be caused by physical factors such as neurological disease or the side effects of drugs such as antidepressants, particularly if the problem has not always been there; but more often, there is a lack of sexual arousal due to a psychological or relationship issue. The poor arousal might be due to sexual boredom and inadequate stimulation by his partner (especially if the man is unable to tell his partner what he wants and needs). Alternatively, the man may be getting all the stimulation he needs but is blocking the sensation, making his erection relatively numb. This might be, for instance, because he is trying too hard to please his partner and not paying

sufficient attention to his own body; or he feels anxious or guilty about sexual pleasure or he is unconsciously angry with his partner. More straightforwardly, he may be afraid of making his partner pregnant and of fatherhood.


Psychosexual therapy can help to uncover the reason behind delayed ejaculation. It can also help the affected man to become more aware of what he finds arousing, and to incorporate this into his lovemaking. Drug therapy (such as ephedrine or yohimbine) can also be an effective treatment. Men with delayed ejaculation are advised to avoid alcohol before sexual play, as this can have the effect of deadening arousal.


Some men experience the feelings of an orgasm, but do not appear to ejaculate.

There are two possible causes for this: the first is called retrograde ejaculation, where the man is ejaculating upwards into the bladder instead of out through the penis, because of a failure of the bladder neck to close during ejaculation.

This is a purely physical problem; it can be caused by an inherited abnormality, spina bifida, diabetes, neurological disease or as a by product of medical intervention such as spinal surgery, prostatectomy, or medication prescribed to treat high blood pressure, benign prostate hyperplasia or depression. Diagnosis is simple, as there will be sperm in a urine sample taken after orgasm. Treatment is through drug therapy.

The second reason a man might experience orgasm but not ejaculate is a condition called aspermia. This is usually the result of damage to the sympathetic nerve supply, due to surgery or accidental injury to the pelvis or spine or to diabetes mellitus, multiple sclerosis or other neurological conditions. This condition is usually treated only if fertility is an issue.


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