FOXSexpert: What's Taking So Long? When You Can't Reach the Finish Line

I think I can. I think I can. When it comes to slow, sensual sex, the Little Engine That Could isn’t what most couples have in mind.

However, a recent article about “finishing too soon” resulted in a number of inquiries from men who have the “opposite” problem. They take forever to discharge, if at all. With both lovers worn out and sore, couples afflicted with this sexual disorder are often at a loss as to what to do.

The good news is that most people can be helped.

When it comes to timing, we typically hear about males jumping the gun. But there is an equally distressing, much less common sexual condition known as delayed ejaculation, or inhibited ejaculation, or ejaculatory incompetence, that affects some men. Once known as “retarded” ejaculation, this is a condition where finishing occurs only after a lengthy period of time and great effort.

While it's uncommon, this sexual disorder may occur sometimes or even every time a man is sexually intimate. Some men never reach climax or ejaculate at all (called anejaculation). Others are eventually able to discharge with climax, but after what seems to be an eternity to him and his exhausted lover. Most men who have this problem say it takes them at least a half an hour of extremely vigorous thrusting before they make it to home plate.

Making matters more alarming, the proof of his virility is little, if anything, with climax. While this can be a symptom of this disorder, it is important to note that emission does not always accompany orgasm in healthy men. These are actually two different functions that just happen to occur almost always simultaneously.

So what puts a man in the predicament of chugging along during sex? The reasons for delayed ejaculation are many, and they can be physical, psychological, relational or a combination of factors.

Organic reasons for delayed ejaculation include:

— Medications (antidepressants are often a main cause of this condition);

— Diabetes;

— Nerve damage, such as pelvic nerve trauma, or neurological disease;

— Vascular disease;

— Spinal cord injury;

— Hormonal factors, such as androgen deficiency;

— Alcohol or drug addiction.

Psychological reasons for delayed ejaculation include:

— Mood disorders;

— Stress and/or anxiety;

— Guilt;

— Strict religious upbringing, where sex was viewed as a sin;

— Performance pressures;

— Fear about sexually transmitted diseases;

— Relationship differences;

— Sexual orientation issues;

— Safety issues in the relationship;

— Past traumatic events.

Issues in a couple’s relationship can also affect a male’s sexual performance with delayed ejaculation:

— Pressure to conceive;

— A lack of attraction for one’s partner;

— Infidelity (and the guilt that goes along with it);

— A lack of stimulation for adequate arousal during sex;

— Not wanting to surrender to a woman;

— Anxiety over emotional intimacy.

A male’s masturbatory patterns may also impact his game. For example, if he’s used to going at it very fast when he’s solo, he may have trouble adjusting to slower paced sex.

Yet another matter to consider is whether or not you’re actually experiencing “retrograde ejaculation,” a condition in which the bladder’s sphincter does not close off properly during ejaculation and semen goes back into the bladder instead of through the urethra. This is also known as a “dry come,” and is more common in men with diabetes who have suffered nerve damage. This is because nerves in the bladder and bladder neck allow semen to flow backward.

Retrograde ejaculation is also associated with other conditions like hypertension, and prostate or urethral surgery. It may also occur during Tantric sex practices. Ejaculating into the bladder is not dangerous to a man in any way, but it does interfere with fertility when trying to conceive. Symptoms of retrograde emission include infertility and cloudy urine after orgasm.

To get to the bottom of this disorder, afflicted men should make an appointment with their health care provider or urologist to determine any physiological causes. A thorough exam will help to determine if a medical disorder is to blame or if medication needs to be adjusted.

Most cases of inhibited emission are, however, psychological in nature. When this is the case, couples may need to work with a sex counselor or therapist. You can check out the American Association for Sex Educators, Counselors and Therapists on the Web for a list of counselors in your area.

In dealing with this issue, therapists often recommend that a man’s partner stimulate his penis with her hands and then switch to intercourse right before the man is about to orgasm. Other methods include the couple taking pressure off the need to ejaculate and allowing the man to focus on his sexual feelings or pleasuring his partner rather than trying to attain an orgasm.

Ultimately, the goal is to focus less on performance and more on the "play" of sex play!

Sexpert Q & A: Do you have any ideas for some new sex toys? Click here to read Yvonne's answer.

Dr. Yvonne Kristin Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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