Scientific Information About Delayed Ejaculation

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Scientific Information About Delayed Ejaculation

The British Association For Sexual Health and HIV (BASHH) has a special interest group which is concerned with sexual dysfunction. Daniel Richardson and David Goldmeier have written a paper which summarizes how the way in which the BASHH believes delayed ejaculation then needs to be managed by and on behalf of men who are experiencing the condition.

In their paper they review the etiology of the condition, along with the physiology, its prevalence, and how best to assess the condition in in individual men who have it. They also describe several possible treatment recommendations, and suggest how the outcome of treatment for delayed ejaculation might be monitored. This paper was published in the International Journal of STD & AIDS 2006; 17: 7-13.

As Richardson and Goldmeier observed, we cannot think of orgasm as the combination of the sensations which are at the moment of ejaculation as well as the ejaculation of semen. However, they are two separate events: extremely pleasurable feelings that are associated with the man's climax are not dependent on release of seminal fluid, nor is the release of seminal fluid dependent upon the subjective experience of climax. The mechanism by which semen is released, it usually simultaneously with the pleasurable feelings of orgasm, is well-known: it's an autonomic reflex response which is stimulated by pressure generated within the bulb of the urethra when semen is released into it from the seminal vesicles along with fluid from the prostate gland. This pressure in the urethral bulb, is thought to be responsible for closing the aperture opening into the bladder, so that seminal fluid is forced out of the body by the subsequent reflex contractions of the pubococcygeal and other public muscles. The reflex response involved is determined by action of the autonomic nervous system, more specifically the pudendal and hypogastric nerves, which are branches from the parasympathetic and sympathetic nervous system respectively.

Historically, along with many other medical conditions, delayed ejaculation has been through a series of name changes, which have included the now deprecated term retarded ejaculation, ejaculatory incompetence, anejaculation, ejaculatory over control, and inhibited male orgasm. It's also been referred to as male orgasmic disorder, although this term has not found favour since it refers to the part of the sequence of male climax that is not specifically related to the difficulties associated with ejaculation. A modern definition which promises everybody who has experienced this condition and the therapists who deal with it is: ... the persistent or recurrent difficulty or delay in obtaining, or complete absence of, orgasm even when a man has had enough sexual stimulation to bring him to climax in normal circumstances, and which elicits personal distress.

It's immediately obvious that this definition of delayed ejaculation includes an element of subjective judgment on two counts: first, what is regarded as sufficient sexual stimulation to help man the chief climax, and secondly as to whether or not he's experiencing distress because of it. It would seem more appropriate to include an element of this definition around the distress of the partner, or something to the effect that the condition happens whether or not the partners wish it to happen (because, although unusual, in the work that I've done with men you cannot reach orgasm during sexual relationships with their partner, there have been a few who have regarded it as being of advantage to them since it allowed the man and woman to make love for longer, possibly with the chance of the woman reaching a climax).

How often does delayed ejaculation occur in the male population?

It's rather hard to know, because research in this area hasn't been very extensive. However, we do know that it's a lot more common than has been supposed for a very long time: surveys on websites run by present reviewer suggest that the frequencies between 10 and 12%, which is much higher than 3.8% suggested by Masters and Johnson back in the 1950s. As time has gone by the estimated frequency of delayed ejaculation is increased: in the 70s people believed that it was occurring in between four and 10% of male population. One of the reasons why it's so hard to know how many men experienced delayed ejaculation eye from short or long-term basis is because it's actually something that men are quite reticent about discussing : there seems to be a high degree of shame associated with retarded ejaculation or any other kind of ejaculatory difficulties for that matter, which is one reason why discussion of the subject needs to be brought out into the open. Only in this way will the full scale of the problem be known.

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