or Retarded Ejaculation
Advice For Couples
When A Man Can't Ejaculate, Is It
Because Of Inhibition Of Sexual Impulses Or
Lack Of Sexual Desire?
There are two basic
theories to explain why a man might not be able to ejaculate — the first involving inhibition
of sexual impulses, and the second involving a lack of sexual desire (a
Helen Singer Kaplan came up with
the inhibition model, and Bernard
Apfelbaum came up with the desire deficit model. And the treatment
strategies for these two theories are very different.
method of treating retarded ejaculation was to encourage the man to ejaculate intravaginally
by using strong stimulation of the man's penis, gradually bringing him
nearer and nearer to his partner's vagina, before finally having him
ejaculate inside her.
This has been
criticized as "aggressive". And indeed it is.
Yet an approach which simply consists of trying to
understand the psychological forces at work in the man's subconscious
might also be criticized because delayed ejaculation is partly a couple's
problem, not the man's alone.
effective treatment program requires a suitable combination of approaches
which work together effectively.
thing that a sex therapist might suggest is "guided stimulation
Techniques To Achieve
Ejaculation When A Man's Unable To Ejaculate
A video worth watching if you suffer form the
inability to ejaculate
If delayed ejaculation is an
unconscious process, caused by something that inhibits the man's sexual
responses, one approach to solving his ejaculatory difficulty is to find a
way of enabling him to drop his excessive control.
And also increasing the sexual stimulation he's
receiving so he can reach the point of ejaculatory inevitability.
The first option to do this is to use a
desensitization process that helps him ejaculate intravaginally.
And this might be combined with guided stimulation
exercises using sexual play and sexual fantasy which take the man's mind
off his fears of failure and reduce his performance anxiety.
series of desensitization exercises might start from a man's existing
sexual capacity – which might be, for example, masturbating on his own in
private – and lead up towards the goal of intravaginal ejaculation.
Desensitization has to be done creatively. So, for
instance, if a man is only able to ejaculate without his partner present,
then the first step may literally be that: self-stimulation to the point
of ejaculation in the absence of his partner.
The next natural step would be to have his partner
somewhere in the house, an adjoining room, perhaps, and then finally in
the same room.
Of course the man has to
have a high level of sexual arousal throughout the process, so techniques
to increase this, and to reduce his anxiety, are essential.
A couple could use as many steps as they need to
allow the man to finally feel comfortable with the idea of ejaculating his
partner's presence, and from there might move to sexual stimulation by the
sexual partner until the man is near to climax.
At this point, the "bridging maneuver" can be used.
This involves the man receiving stimulation until he's close to orgasm and
ejaculation, and then promptly inserting his penis into the vagina, where
he experiences his orgasm.
stimulation of the nipples, anus, prostate or testicles can help achieve
Diagram of the prostate location
should you feel moved to try prostate stimulation.
Because the man needs to feel comfortable with what's
going on, he is often instructed to be "selfish" and experiment with
sexual techniques, to ensure he feels comfortable in "using" his partner
only for the purpose of sexual gratification.
There is lots more information about how this
technique can be adapted to use at home successfully in the treatment
One of the key factors, though, is
that the man should only engage in sexual intercourse when he is
adequately aroused (i.e. likely to have an orgasm).
Remember, low arousal is one of the characteristic
features of delayed ejaculation.
approach to treatment is to combine desensitization exercises with some
kind of approach that reframes the man's beliefs and attitudes towards
So, for example, this might be about
getting a man to acknowledge his true feelings around sex (for example,
does he really want to have sex with his partner?) and also around his
lack of sexual arousal (what really turns him on?)
But it's also important to deal with fundamental
aspects of delayed ejaculation like the belief that a man should be "more
giving" to his partner during intercourse.
All the other faulty myths and false beliefs that men hold around sex can
inhibit their sexual expression and ability to ejaculate.
That means one objective of any treatment program must be to draw these
out, examine them, and reframe them into more realistic beliefs and ideas
So, for example, if a man believes that he is unable
to give sufficiently to his partner during intercourse, he may be
encouraged to see that the problem is actually that he's unable to take
his own pleasure in sexual interactions with his partner.
Similarly, the reasons for his need to have excessive
control over his own emotional and physical release during intercourse can
be examined and reframed. Is this a bigger issue of a need to be in
should be involved in this because she often believes that the man's
delayed ejaculation is somehow a form of rejection.
In fact, when a woman can understand that her man is actually trying too
hard to have his own orgasm for her benefit, she's much more likely to be
sympathetic and ready to assist with treatment.
Powerful, simple, effective, and fast.
With a 96%
Cognitive behavioral approaches
These tend to combine features of both the
inhibition and the reframing approach to treatment as described before in
the left hand column of this page.
We know a lot of men with the inability to ejaculate use high-frequency and hard masturbation
methods, and we know a lot of them also find it hard to translate their
own inner world of erotic fantasy and imagery into the reality of sex with
To overcome these problems, it's possible for a couple to
integrate the man's masturbation fantasies into their sexual activities,
which tends reduce guilt and increases the likelihood of a man reaching
Simple tricks can be very enlightening: if a man simply switches hands
while masturbating, he may immediately see much more clearly the kind of
stimulation he needs to reach orgasm and
For example, if he can't masturbate to orgasm with his own left hand, then
it's hardly surprising that his partner also fails to do this for him!
So from a
cognitive behavioral point of view, the basic strategy to
treatment is to identify the man's inhibitions and fears and develop
sexual scenarios and techniques that help to overcome them.
When they are explored, some might lose their power, others might be
accepted and worked around. The point is that the man and his partner can
change their sexual behavior and find "orgasm triggers" that excite the
man enough to reach orgasm.
These orgasm triggers are very important. Some common ones include nipple
stimulation and anal stimulation.
Make sure your partner knows what excites you during
In addition, targeting faulty beliefs and encouraging a change in attitude
towards sex is just as important.
This may involve something as simple as showing the man how to ask his
partner for increased intimacy and different types of sexual experience,
or something as sophisticated as exploring the beliefs about sex that
inhibit the man's arousal.
When a couple manage to work together effectively on curing
retarded ejaculation, the likelihood of success is much greater.
Mutual involvement in sexual pleasuring is an essential element of any
treatment strategy, as is better communication: the level of verbal and
physical intimacy between the partners is always improved with better
communication, because good communication overcomes emotional isolation
and sexual inhibition.
As I've said before, one of the main things about getting over
problems with the inability to ejaculate is
ensuring that you and your partner are communicating effectively about
what's going on in the relationship in general, and sex in particular.
To understand that an erection doesn't necessarily mean a man is aroused,
and that he need not immediately engage in sexual intercourse when he gets
hard is really important.
Both partners can be selfish in enjoying sexual stimulation and
experiencing and savoring the eroticism of their interaction. This
"selfishness" – which is more about him ensuring he gets his needs met –
tends to increase the man's arousal and makes it more likely he's going to
This can be encouraged by knowing what will trigger his orgasm: various
possibilities include discussing fantasy during intercourse, testicle
stimulation, stimulation of nipples or anal area.
Orgasm triggers tend to be very different from person to person but can be
easily identified by the man during masturbation before being brought into
sex with a partner.
There are many other important questions that need to be asked as well.
For example, what underlies the man's delayed ejaculation?
Sidebar: Physical causes of delays in orgasm
What factors are hidden beneath the surface? You may
wish to consider what's at risk for the man and his partner if he gains
normal sexual function.
In other words, what are the consequences for him and for his partner if
the symptoms of delayed ejaculation disappear, and what the consequences if they remain?
There are many subconscious fears and other emotional feelings attached to
sexual behavior. For example, if the man was to gain normal sexual
function, his partner may be worried what might happen.
Would he, for example, want to catch up on his missed sexual experience with
other women? If he was able to ejaculate in a timely fashion, would that
perhaps expose the fact that his female partner didn't enjoy sex or was anorgasmic (unable to achieve orgasm)?
These are the sort of questions that need to be exposed and dealt with
during therapy and treatment, because left unattended, they can often
prevent a successful treatment outcome.