Therapy for delayed ejaculation

Understanding and Treating Retarded Ejaculation: A Sex Therapist’s Perspective

N. Y. Weill Cornell Medical Center

Retarded ejaculation (RE) is probably the least common, and least understood, of all the male sexual dysfunctions. RE is one of the diminished ejaculatory disorders (DED), which is a subset of male orgasmic disorders (MOD). DED is a collective term for an alteration of ejaculation and /or orgasm that ranges from varying delays in ejaculatory latency to a complete inability to ejaculate, anejaculation, and retrograde ejaculation, as well as reductions in volume, force, and the sensation of ejaculation. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) defines RE as the persistent or recurrent delay in, or absence of, orgasm after a normal sexual excitement phase during sexual activity that the clinician, taking into account the person’s age, judges to be adequate in focus, intensity, and duration. The disturbance causes marked distress or interpersonal difficulty. Similar to the term “premature ejaculation, ” the most commonly used term—“retarded ejaculation”—is sometimes avoided because of its pejorative associations.

In general, RE is reported at low rates in the literature, rarely exceeding 3%. However, based on clinical experiences, some urologists and sex therapists are reporting an increasing incidence of RE. The prevalence of RE appears to be moderately and positively related to age, which is not surprising in view of the fact that ejaculatory function as a whole tends to diminish as men age.

Failure of ejaculation can be a lifelong (primary) or an acquired (secondary) problem. Many men with secondary RE can masturbate to orgasm, whereas others, for multiple reasons, will or cannot. A distinguishing characteristic of men with RE—and one that has implications for treatment—is that they usually have little or no difficulty attaining or keeping their erections—in fact they are often able to maintain erections for prolonged periods of time. Yet, despite their good erections, they report low levels of subjective sexual arousal, at least compared with sexually functional men.

This is not uncommon

by sameissue

I, for one, find it very difficult to climax with a condom on and yes I too have tried many different brands. The literature suggests that this is a psychological issue (delayed or no ejaculation) and can be dealt with through therapy but I disagree, there is definitely a physical component. Without getting TOO graphic I think it has something to do with the condom interferring with the feeling of a woman's wetness and her particular inner...errrr...shape.

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