Delayed ejaculation, also known as retarded ejaculation and ejaculation incompetence, is the inability to ejaculate or persistent difficulty in achieving orgasm despite the presence of normal sexual desire and sexual stimulation. Ejaculation is the ejecting of Semen from the Penis, and is usually accompanied by Orgasm. An orgasm (sexual climax is the conclusion of the plateau phase of the sexual response cycle, and may be experienced by both males and females Libido in its common usage means Sexual desire however more technical definitions such as those found in the work of Carl Jung, are more general referring to libido Sexual stimulation is any stimulus that leads to sexual arousal or Orgasm. Normally a man achieves orgasm within 2-4 minutes of active thrusting during sexual intercourse,^[1] whereas a man with delayed ejaculation either does not orgasm at all or orgasms after prolonged intercourse which might last 30-45 minutes or more. Sexual intercourse, in its biological sense is the act in which the male reproductive organ (in humans and other higher animals enters the female reproductive tract In most cases delayed ejaculation presents the condition in which the man can climax and ejaculate only during masturbation, but not during sexual intercourse. Masturbation refers to Sexual stimulation especially of one's own genitals ( self masturbation) and often to the point of Orgasm, which

Contents 1 Causes 1.1 Psychological causes of delayed ejaculation 1.2 Physical causes 2 Complications 3 Treatment 3.1 Urology 3.2 Sex therapy 3.3 Other 4 Prognosis 5 Prevention 6 See also 7 References 8 External links

Causes

Psychological causes of delayed ejaculation

Psychological causes of delayed ejaculation might include numerous factors that prevent a man from achieving orgasm during sexual intercourse.

Physical causes

One of the main causes of delayed ejaculation is adaptation to a certain masturbatory technique. The sensations a man feels when masturbating may bear little resemblance to the sensations he experiences during intercourse. Both pressure, angle and grip during masturbation can make for an experience so different from sex with a partner that the ability to ejaculate is reduced or eliminated.

Physical causes of delayed ejaculation may imply some diseases and conditions which affect a man's ability to orgasm. These include many neurological (for example stroke or damage to the back or spinal cord) and endocrine diseases (diabetes), prostate problems, some allergies and high blood pressure. Among the hundreds of endocrine diseases (or endocrinological diseases) are Adrenal disorders Adrenal insufficiency Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc The prostate (from Greek προστάτης - prostates, literally "one who stands before" "protector" "guardian" is a Allergy is a disorder of the Immune system often also referred to as Atopy. Blood pressure is also the title of a short story by Damon Runyan in Guys and Dolls and Other Stories As well difficulty in achieving orgasm can result from pelvic surgery that involved trauma to pelvic nerves which are responsible for orgasm. The pelvis (pl pelvises or pelves) or pelvic girdle is the irregular bony structure located at the base of the spine (properly known Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Treatment of physical trauma is described here and in First aid. Some men report a lack of sensation in the nerves of the glans penis, which may or may not be related to external factors, including a history of circumcision.

Delayed ejaculation might be a side effect of some medications, usually of some antidepressants. Side Effect were an influential Disco band that recorded between 1972 and 1995 Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease An antidepressant is a Psychiatric medication used for alleviating major depression or Dysthymia ('milder' depression Another reason for delayed ejaculation is excessive use of alcohol. In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon In this case physical and psychological causes might co-exist.

Complications

Delayed ejaculation can cause a variety of complications, both for men who suffer from it, as well as for their partners. A positive aspect can occur in cases where delayed ejaculation contributes to increased sexual satisfaction of a female partner (who can potentially experience multiple orgasms during long-lasting intercourse sessions). However, after some time this is likely to become annoying for both partners when the man suffering from delayed reaction cannot, in spite of all efforts, achieve orgasm (or only achieves it after an extended period of time). Overall, the situation can worsen: both partners can choose to avoid sexual contact which does not result in orgasm. Consequently, both partners suffer from sexual dissatisfaction, becoming likely to lose sexual desire.

Treatment

Treatment of delayed ejaculation depends on severity of the disorder and on its causes. For instance, a condition with no ejaculation at all may require urology, while e. g. absence of ejaculation only in sexual intercourse may be solved by sex therapy. Sexual intercourse, in its biological sense is the act in which the male reproductive organ (in humans and other higher animals enters the female reproductive tract

Urology

If a man has never had ejaculation through any kind of sexual stimulation (such as vaginal or anal intercourse, oral sex, masturbation, wet dreams) then he should consult a urologist in order to find out whether there is a physical abnormality and then get necessary treatment which depends on the abnormality revealed. Anal sex most often refers to the sex act involving insertion of the Penis into the Rectum. Oral sex refers to sexual activities involving the use of the Mouth, and may include use of the Tongue, Teeth, and Throat, in order A nocturnal emission is an Ejaculation of Semen experienced by a male during Sleep. Urology is the branch of Surgery that focuses on the Urinary tracts of males and females and on the reproductive system of males

Sex therapy

If the disorder is not so severe and a man can ejaculate through some form of stimulation, he should apply to a sex therapist specializing in this area. Sex therapy is the treatment of Sexual dysfunction, such as non- consummation, Premature ejaculation or Erectile dysfunction, low Libido This is very important in cases when a man can ejaculate through any form of stimulation but intercourse. Usually treatment for this disorder includes both partners.

Therapy usually involves homework assignments and exercises intended to help a man get used to orgasm through vaginal intercourse i. e through the way he is not accustomed to. Commonly the couple is advised to go through three stages. ^[2] At the first stage a man masturbates in the presence of his partner. Sometimes this is not an easy matter as a man might be used to orgasm alone. After a man learns to ejaculate in the presence of his partner, the couple gets to another stage where the man's hand is replaced with the hand of his partner. Step by step a man learns to ejaculate closer and closer to the vagina. In the final stage a woman inserts her partner's penis into her vagina as soon as she realizes he is about to ejaculate. The penis (plural penises, penes Thus a man gradually learns to ejaculate inside the vagina.

The therapy described above clearly applies to a treatment of this problem within a heterosexual context. Since especially young men often are ashamed of acknowledging their problem, or anyway do not have a partner yet, some authors recommend alternatives to this start-stop technique. By training the ischiocavernosus muscle, young men can quickly train to hold an erection on their own. The ischiocavernosus muscle is a muscle just below the surface of the Perineum, present in both men and women

Other

If relationships in a couple are found problematic, therapy intended to enhance emotional intimacy might be required as preliminary step.

Some sexologists recommend sex toys such as the fleshlight to train the patient to respond to vaginal stimulation. Sexology is the study of sexual interests behavior and function The Fleshlight (also marketed as the Fleshjack) is a Sex toy designed for use by males This is especially effective in cases where the masturbatory technique is the source of the problem.

In some cases hypnosis can help with the problem, especially if a partner does not want to participate in therapy. Hypnosis is often thought to be a wakeful state of focused attention and heightened suggestibility with diminished peripheral awareness

Naturally, if delayed ejaculation is caused by a disease, the disease is first of all treated. In those cases when delayed ejaculation is a side effect of medication the man's physician is to review other medication options.

In the case of alcohol addiction a man should get necessary treatment intended to help treat his addiction. Alcoholism is a term with multiple and sometimes conflicting definitions

For many people it has proven to be the case that overly frequent masturbation on the part of the man is the root cause of his delayed vaginal ejaculation. Ceasing masturbation for a few days is often an effective and easy way to achieve more rapid orgasm during intercourse, because doing this will stop sensitization of the nerves in the penis. Also, different positions and rates of pelvic motion on the part of the female can be instrumental in achieving simultaneous orgasm.

Prognosis

The following factors are signs of better outcome: having sexual desire, being in love with the sexual partner, being eager to get rid of the problem, absence of deep psychological problems, short duration of the disorder and having satisfying sexual experiences before.

Success of treatment for delayed ejaculation caused by medication recovery totally depends on whether the physician can discontinue the medication.

Prevention

First of all a man should have healthy attitude towards sexuality and his sexual response. Human male sexuality encompasses a broad range of issues behavior and processes including male Sexual identity and Sexual behavior, the physiological He should be fully aware of the fact that anxiety and fears cannot contribute to a normal and satisfying sexual experience.

A man who wants to avoid ejaculation problems should concentrate on the pleasure he gets rather than worrying about when and whether his ejaculation is going to occur. The partner should also be tactful and should not put pressure on the man by asking him whether he has ejaculated or not. Instead a partner should create a relaxed atmosphere in which a man will feel free and enjoy sexual pleasure without worrying about ejaculation. And of course, open discussing of anxieties and fears contribute to better sexual relationships and normal sexual satisfaction.

See also

• Premature ejaculation

References

External links

• Medline Plus Medical Encyclopedia - Delayed ejaculation.
• Delayed ejaculation

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