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Feb18

1. What is delayed ejaculation?

Although it is something that is not talked about much, the truth is that it is not uncommon for men (or their partners) to consult a sexologist in Delhi for an ejaculation time that they consider excessive. They usually consult because the penetrations (or other genital stimulation practices) are prolonged in time, causing themselves, or their partners, to get tired or start to feel discomfort.

It is known as “delayed ejaculation” or “problems from an ejaculation time that is considered excessive”. In cases in which ejaculation fails to occur, we speak of anejaculation, absence of ejaculation, or ejaculatory inability.

Men with this difficulty often feel some degree of arousal and pleasure, but it is not enough to trigger an orgasm.

Difficulty ejaculating usually occurs mainly during penetration; it is estimated that 85% of these men can ejaculate without problems with masturbation and 50% also ejaculate with oral or manual stimulation from their partner (Masters and Johnson, 1966).

2. Is there a specific time to talk about delayed ejaculation?

Many sexologists in Delhi do not speak of a specific time. It must be taken into account that each man is different, and if there is a partner, each couple is different too. There are men who take 30 minutes to ejaculate from the start of penetration and are satisfied, and so are their partners, because of their particular tastes, because of how their erotic relationships are (possibly they alternate penetration with other relationships), or because of how they manage ejaculation times. Other men with the same time are dissatisfied and so are their partners.

Men who have times of 45 minutes or more, or who never ejaculate, tend to be the most dissatisfied, as are their partners.

In short, it is dissatisfaction that mainly defines whether a man suffers from a sexual problem or not, rather than the specific time. 

3. Is it frequent or is it a very unusual erotic difficulty?

Most studies place its incidence between 4 and 11% of the populatio.

In our sexologist clinic in Delhi, we have noticed a clear increase in consultations about this erotic difficulty from 20 years to now, although this increase may be due to the fact that there are more men with this difficulty or that the men with this difficulty are the same but now they feel less embarrassed when it comes to seeking help to improve their erotic life. 

4. What specialist should be consulted?

If the man never ejaculates, neither in solo masturbation, nor in shared masturbation, nor in penetration, nor in any erotic practice, the ideal thing would be for him to go to the urologist in Delhi first, to rule out an organic pathology as the cause of the ejaculation.

If the man ejaculates without problems alone, but has difficulties with a partner, the cause is most likely psychological or relational, and our advice would be to visit the best sexologist in Delhi.

It is not uncommon to work in coordination, that is, that different professionals (medicine, urology, sexology…) evaluate the person from their different areas, to offer better care together.

5. How does delayed ejaculation affect the quality of the erotic relationship?

Each case is different, but to offer some general keys, it must be taken into account that some penetrations last 30 or 45 minutes, or even more, without the man having ejaculated. This can cause some couples (both heterosexual and homosexual) tiredness, boredom, or even discomfort that can become important.

When the problem continues over time and occurs in practically every sexual relationship, it sometimes translates into a lack of desire from the partner, a lack of desire from the man himself, who feels frustrated and anguished by his difficulty in reaching orgasm, and that they are also afraid of the image they may give to their partner, what the other person may think or how they will react. Some men even end up having erection problems, if they are very worried and stressed by the absence of ejaculation. And sometimes it can lead to disagreements with the couple.

6. How do the partners of men with this difficulty usually react?

Couples, whether they are women or other men, tend to react worse when they relate the lack of ejaculation, or their partner’s ejaculation difficulties, with a low desire for them.

In other words, if the partner of this man who finds it difficult to ejaculate, attributes this difficulty to the fact that his partner does not find her attractive or exciting, or that the erotic life they have in common bores him, that he does not like his body… he usually Reacting negatively affects her self-esteem and she is less understanding of her partner’s ejaculation times.

It should be noted that on many occasions men’s ejaculation difficulties are NOT caused by a lack of attraction or desire towards their partner. When the problem is not attraction or desire, and this is made clear to both partners (sometimes with help from sexologist doctor in Delhi), the problem is much more easily resolved.

7. What are usually the physical causes?

Certain drugs can delay ejaculation or even prevent it (antidepressants, antihypertensives, antipsychotics, etc.). For example, it is estimated that people who are taking certain antidepressants (SSRIs) or antipsychotics present ejaculation disorders in 50% of cases. Therefore it is important to see what drugs the person is taking and their possible side effects.

Also certain chronic diseases (such as diabetes, multiple sclerosis…), spinal cord injuries, genital surgeries (prostate, for example), trauma, stroke, hormonal disorders, alcohol or drug abuse… can cause difficulties with ejaculation, among other physical factors.

It should be noted that with increasing age, the time required to ejaculate tends to increase as well.

8.  Does it usually have a psychological or sexological cause?

It is the most frequent. Some men who find it difficult to ejaculate in penetrative relationships are excessively concerned about their partner’s pleasure, about the possible image they may give, even about the fear of not ejaculating, and all of this makes it difficult for them to abandon themselves, become aroused and ejaculate.

In other cases, some men who do not have difficulties to ejaculate alone, with a partner, by matching their movements, the type of stimulation and the rhythm of said stimulation to the partner, manage to enjoy but they lack a plus of excitement to achieve orgasm.. Both causes can occur separately or together.

9. What advice could be offered to couples with this difficulty?

If there is a partner, dialogue with the partner is essential. If the man finds his partner attractive and that is not the cause of his difficulty in ejaculating, he should make this clear to her. When the people who make up a couple understand the motivations and causes of the behavior of the other party, it is much easier for difficulties to be addressed with serenity, assertiveness and patience.

It is usually useful not to be obsessed that the man with this difficulty reaches orgasm at all costs, there are relationships that can be given with excitement and pleasure for him and assume that he may not reach orgasm on some occasion. It is also useful not to focus everything on penetration and to carry out practices such as manual stimulation (by the partner or himself), oral sex, caresses and massages, etc.

10. How is it usually approached in the sexology consultation?

 First, an evaluation is carried out to clarify the causes of delayed ejaculation and the dissatisfaction of the couple.

If the causes are psychological or sexological, they are frequently addressed by offering guidelines for improving sexual life in the stable couple or with occasional partners.

Generally, keys are offered to improve arousal and abandonment in erotic encounters and that the rhythm, stimulation, and movements adapt to those that the man needs to achieve orgasm, ensuring that this also translates into an improvement of the relationship with the partner.

It is also favored that erotic relationships are not reduced to penetration, but that the range of erotic techniques is expanded. And work is done to improve the man’s self-esteem, the image of him as a man and as a capable lover, as a way to facilitate going relaxed and confident to meetings, and therefore, to achieve orgasm.

If there is a partner, you always try to work with your partner as a system, as a team, to achieve the best results.

 



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