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    When men can’t climax: let’s talk about delayed ejaculation

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      Some men would do anything to last longer during sex, thinking that’s what makes someone ‘good in bed’, which isn’t necessarily the case. But what if you found it difficult or impossible to climax?

      Delayed ejaculation (DE), also called male orgasmic disorder, retarded or absent ejaculation, isn’t a source of pride, but of frustration and distress.

      DE is talked about less than some more common male sexual problems such as erectile dysfunction (ED) and premature ejaculation (PE), however that doesn’t make it any less distressing for the man and his partner.

      What is delayed ejaculation?

      DE occurs when the ejaculatory reflex is ‘over inhibited’ – the threshold to orgasm is too high to achieve. Men suffering with DE tend to still feel sexual desire and arousal; they can get and maintain an erection. Sexual arousal can build up to a point where you feel very close to climaxing, but it just won’t happen, even after 30 to 60 minutes of thrusting during intercourse. This can leave you feeling starved of closeness to your partner as well as missing that release of tension and subsequent relaxation, which reaching orgasm can bring.

      You may have suffered with DE since you were sexually active or it may have begun gradually or suddenly. Many men with psychologically induced DE find that it only occurs during penetrative intercourse with a partner. Masturbation on their own, with a partner masturbating them, or oral sex may often lead to a fulfilling orgasm and ejaculation. The problem may be specific to a certain situation – often this is penetrative sex.

      Delayed ejaculation and relationships

      DE can lead to the avoidance of sex and relationships. If you are left feeling frustrated or disappointed every time you have sex, it’s understandable that you’d tend not to engage in sexual activity.

      A partner may feel that you don’t find them sexually stimulating enough, that they are bad lovers, or have an inadequate body. This is most likely not the case, but identifying and discussing the actual cause of the problem can be sensitive and far from simple. DE can lead you and your partner to become physically sore after lengthy penetrative intercourse. Using plenty of lubricant can help.

      What causes delayed ejaculation?

      DE can be caused by physical issues, psychological issues, or both.

      Physical causes of delayed ejaculation:
      Many conditions can contribute to DE:

      • Diabetes
      • Multiple sclerosis
      • Spinal cord injury
      • Bladder and prostate surgery
      • Certain substances: anti-depressants, blood pressure treatment such as Beta Blockers, antipsychotic drugs, muscle relaxants, strong painkillers, recreational drugs, steroids and alcohol.

      Ageing can also have a part to play. The penis may lose some of its sensitivity with age and testosterone levels decrease in older men, slowing the arousal process. Equally, a female partner’s vagina may become more slack with age, providing less sensation during penetrative sex. Pelvic floor exercises are a good way for women to maintain condition in the muscles around the vagina.

      If you have adopted a very fixed style of masturbation, perhaps with a very firm handgrip and vigorous movement, sex with a partner might not be as stimulating for you.

      Pin-pointing the cause of your DE can be difficult, which is why you’re encouraged to discuss any concerns with your GP.

      Considering treatment?

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      Psychological causes of delayed ejaculation

      Certain mindsets and attitudes may be having an impact on your DE:

      • Fear of causing pregnancy. Even if your partner is using contraception, you could try using condoms as well – the added benefit of that is protection from STIs and HIV and their associated anxieties
      • Inherited negative attitudes about sex
      • Feelings of shame
      • Strong cultural or religious beliefs about sex
      • Stress or depression
      • Sexual trauma
      • Relationship difficulties
      • Fear of feeling out of control or vulnerable – relaxing and ‘letting go’ does not always come naturally. DE may be a physical manifestation of psychologically ‘holding back’
      • Negative feelings about the look, smell or feeling of semen
      • Fear of losing physical control during orgasm, particularly the fear of sudden incontinence

      How to overcome delayed ejaculation

      You might be hoping DE will go away by itself. And maybe it will. However, if it has persisted for more than six months, start by visiting your GP to rule out any underlying health issues. Some medications affect your ability to ejaculate, so ask whether there are alternatives you can take, without those side effects.

      If the problem has psychological causes, the following suggestions may help:

      Explore what sexually stimulates you

      It may be that you require more intense or varied stimulation to reach orgasm. You may benefit from watching some porn, looking at erotic images or literature, using sex toys such as vibrating devices and masturbation sleeves, cups or strokers. There are even specific devices available designed to help provoke ejaculation, through penile vibratory stimulation. These can all be incorporated into sex with a partner and can liven things up for them too.

      Focus on the moment

      Don’t make ejaculation or orgasm your ultimate goal during sex. Try to relax, enjoy the entire process, and don’t think about how it’s going to end.

      Try alternating between masturbation and penetration with a partner

      Masturbate yourself very close to the entrance of your partner’s vagina/anus/mouth (whichever opening seems to cause you this problem) and when you feel ready to orgasm, or just before, insert your penis. This will get you used to ejaculating inside your partner.

      Try the ‘In-Method'

      If you experience DE only with partnered sex, there is a 5-step method designed to bridge that gap between only you being able to stimulate yourself to orgasm and your partner being involved in that process.

      1. Start stimulation with your penis in your own hand.
      2. Allow your partner to stimulate your penis with their hand.
      3. Insert your penis into your partner’s vagina/anus/mouth, whilst holding your penis at the same time.
      4. Insert your penis into your partner, this time with them holding your penis.
      5. Insert your penis into your partner without holding it.

      Find some alternative routes to arousal

      If pornography or a very specific sexual act is the only route to ejaculation, try different ways to get aroused (without porn). Explore how you like to be touched, focusing on all your physical senses, noticing what temperatures, textures and pressures you enjoy.

      Avoid ‘edging

      If you are very practised at ‘edging’ – the technique where you hold back from orgasm for as long as possible, particularly whilst watching porn – you might have conditioned yourself not to ejaculate easily.

      Extend the time between masturbating and partnered sex

      Masturbating very frequently may cause your body to not be ready to ejaculate again by the time you have sex.

      Talk about how DE makes you feel, either with a partner or a trusted friend

      With a partner, discuss both of your fears and anxieties. Talking can lead to more trust and openness, a lack of which might be maintaining the problem.

      Reduce your stress and anxiety levels

      Regular physical exercise, mindfulness exercises and cutting down on alcohol can have a very positive impact.
      If you have been experiencing DE most of the time, for at least six months and it is causing you distress, visit your GP.

      Sex therapy

      If physical causes are ruled out, and symptoms persist, you may wish to address the problem psychologically, by having sex therapy and working with a qualified psychosexual therapist. The College of Sexual and Relationship Therapists (COSRT) provides a directory to search for a psychosexual therapist in your area.

      Charlotte Simpson is an Accredited Psychosexual Therapist and Relationship Counsellor in Private Practice in North West London.

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