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Premature or Early Ejaculation
Summary •
Singular definitions •
Causes •
Treatment •
References •
Inhibited or delayed ejaculation
Summary •
Singular definitions •
Causes •
Treatment •
References •
Retrograde ejaculation
Summary •
Singular definitions •
Causes •
Treatment •
References •
INHIBITED OR DELAYED EJACULATION
TREATMENT
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Treatment:
Your therapist will take a history and do a physical examination to exclude or diagnose and treat any apparent cause, and change or adjust medication, and deal with lifestyle factors like fatigue, stress and alcohol, appropriate contraception, and suggest changes in sexual behaviour patterns so that ejaculation should be able to occur during intercourse. Specialised tests may be indicated.
Medication: men who have IE due to taking anti-depressants [namely SSRI’s] may find improvement by taking a particular antihistamine [Periactin] prior to intercourse [4], or changing the type of anti-depressant. This would have to be arranged by your doctor.
Sexual Exercises:Intercourse should not take place during the exercises which should take place under relaxed circumstances. You and your partner should caress one another while guiding each other to gain the most pleasure [see: Sensate Focus Exercises].
Sensate Focus Exercises should be done on 3 or 4 occasions. These pleasuring exercises provide an excellent means for reducing sexual anxiety, and encourage emotional and sexual expression between you, as you focus on sensual arousal and reduce your anxiety about reaching your ‘goal’ of ejaculation.
Then go onto Genital Stimulation Exercises: you can stimulate your partner to orgasm if desired and then she/he can stimulate you while you guide her/him concerning the type of movement, speed and pressure and site, and describe your ‘orgasmic triggers’ during masturbation, focusing on your feelings and erotic fantasy to maximize erotic sensations rather than trying to force an orgasm. Stimulation is enhanced by using oils or lubricants on the genitals. Once an intense level of arousal is attained and you feel confident, you should signal to your partner to stimulate you to orgasm. Once this occurs it reduces the ‘blocking mechanism’ between you. Ejaculation should be made to occur closer and closer your partner’s genitals until it occurs at the entrance to the vagina/anus. It may be helpful to rehearse sexual intercourse with your partner including ejaculation using fantasy.
Intercourse Exercises: once you are able to masturbate in your partner’s presence and you both feel confident, she/he stimulates you until you are very aroused, and then she/he places your penis near to the entrance of the vagina/anus. Genital stimulation is increased and she/he stimulates you with her/his hands until you are close to orgasm. When you feel you are about to ejaculate, you ease your penis into the vagina/anus. She/he can continue to stimulate the base of the penis and the scrotum while you are both thrusting. If ejaculation does not occur and arousal gets less, stop, and restart genital stimulation as desired until ejaculation occurs. Do not persevere if either of you becomes tired or anxious. Once ejaculation occurs with penetration, the effect is dramatic and most men are able to ejaculate on subsequent occasions. If it becomes a problem later, then repeat the exercises until you feel relaxed Then you can try any position that is comfortable and provides intense stimulation [for example: rear entry or side by side].
Relationship therapy: may be indicated to gain the co-operation of the partner and reduce resentment. Fears of being out of control, “letting go”, being vulnerable and being too close emotionally should be dealt with.
If you have difficulty with delayed or inhibited ejaculation, consult your general practitioner who will take your history, examine you, adjust medication, or refer you to a urologist, sex therapist or psychologist. Help is available, so it is advisable not to delay in seeking treatment as the problem becomes entrenched and more difficult to treat. If infertility is an issue, treatment should be undertaken at an infertility clinic.
Your therapist will take a history and do a physical examination to exclude or diagnose and treat any apparent cause, and change or adjust medication, and deal with lifestyle factors like fatigue, stress and alcohol, appropriate contraception, and suggest changes in sexual behaviour patterns so that ejaculation should be able to occur during intercourse. Specialised tests may be indicated.
Medication: men who have IE due to taking anti-depressants [namely SSRI’s] may find improvement by taking a particular antihistamine [Periactin] prior to intercourse [4], or changing the type of anti-depressant. This would have to be arranged by your doctor.
Sexual Exercises:Intercourse should not take place during the exercises which should take place under relaxed circumstances. You and your partner should caress one another while guiding each other to gain the most pleasure [see: Sensate Focus Exercises].
Sensate Focus Exercises should be done on 3 or 4 occasions. These pleasuring exercises provide an excellent means for reducing sexual anxiety, and encourage emotional and sexual expression between you, as you focus on sensual arousal and reduce your anxiety about reaching your ‘goal’ of ejaculation.
Then go onto Genital Stimulation Exercises: you can stimulate your partner to orgasm if desired and then she/he can stimulate you while you guide her/him concerning the type of movement, speed and pressure and site, and describe your ‘orgasmic triggers’ during masturbation, focusing on your feelings and erotic fantasy to maximize erotic sensations rather than trying to force an orgasm. Stimulation is enhanced by using oils or lubricants on the genitals. Once an intense level of arousal is attained and you feel confident, you should signal to your partner to stimulate you to orgasm. Once this occurs it reduces the ‘blocking mechanism’ between you. Ejaculation should be made to occur closer and closer your partner’s genitals until it occurs at the entrance to the vagina/anus. It may be helpful to rehearse sexual intercourse with your partner including ejaculation using fantasy.
Intercourse Exercises: once you are able to masturbate in your partner’s presence and you both feel confident, she/he stimulates you until you are very aroused, and then she/he places your penis near to the entrance of the vagina/anus. Genital stimulation is increased and she/he stimulates you with her/his hands until you are close to orgasm. When you feel you are about to ejaculate, you ease your penis into the vagina/anus. She/he can continue to stimulate the base of the penis and the scrotum while you are both thrusting. If ejaculation does not occur and arousal gets less, stop, and restart genital stimulation as desired until ejaculation occurs. Do not persevere if either of you becomes tired or anxious. Once ejaculation occurs with penetration, the effect is dramatic and most men are able to ejaculate on subsequent occasions. If it becomes a problem later, then repeat the exercises until you feel relaxed Then you can try any position that is comfortable and provides intense stimulation [for example: rear entry or side by side].
Relationship therapy: may be indicated to gain the co-operation of the partner and reduce resentment. Fears of being out of control, “letting go”, being vulnerable and being too close emotionally should be dealt with.
If you have difficulty with delayed or inhibited ejaculation, consult your general practitioner who will take your history, examine you, adjust medication, or refer you to a urologist, sex therapist or psychologist. Help is available, so it is advisable not to delay in seeking treatment as the problem becomes entrenched and more difficult to treat. If infertility is an issue, treatment should be undertaken at an infertility clinic.
