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delayed ejaculation
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definition - delayed ejaculation
Delayed ejaculation is a medical condition in which
a male is unable to ejaculate, either during intercourse or with
manual stimulation in the presence of a partner. Ejaculation is the
action in which semen is release from the penis.
alternative names
Ejaculatory incompetence; Sex - delayed ejaculation;
Retarded ejaculation
causes, incidence, and risk factors
Most men ejaculate within 2 to 4 minutes after onset
of active thrusting in intercourse. Men with delayed ejaculation may
be entirely unable to ejaculate in some circumstances (for example,
during intercourse), or may only be able to ejaculate with great
effort and after prolonged intercourse (for example 30 to 45 minutes).
The most common causes for delayed ejaculation are
psychological. Common psychological causes include:
- A strict religious background causing the
person to view sex as sinful
- Lack of attraction for a partner
- Conditioning caused by unique or atypical
masturbation patterns
- Traumatic events (such as being discovered in
masturbation or illicit sex, or learning one's partner is having
an affair)
Some factors, such as anger toward the partner, may
be involved.
Other causes:
- Certain drugs (such as prozac, mellaril, and guanethidine)
- Neurological disease such as strokes or nerve
damage to the spinal cord or back
signs and tests
Stimulation of the penis with a vibrator or
other stimulatory device may determine if an underlying physical
(often neurological) problem exists. A neurological examination may uncover other
nerve problems associated with delayed ejaculation.
treatment
If the man has never ejaculated through any form of
stimulation (such as wet dreams, masturbation, or intercourse), a
urologist should be consulted to determine if there is a congenital or
physical cause.
If, however, he is able to ejaculate in a
reasonable period of time by some form of stimulation, he should seek sex therapy from a therapist specializing in
ejaculatory problems. Treatment usually includes both partners. The
therapist will usually educate the couple about the fundamentals of
sexual response and how to communicate and guide the partner to
provide ideal stimulation, rather than trying to make a sexual
response occur.
Therapy commonly involves a series of homework
assignments wherein the couple, in the privacy of their home, engage
in sexual activities that reduce performance pressure and focus on
pleasure.
Typically, sexual intercourse will be prohibited for
a limited period of time, while the couple gradually enhances their
ability to enjoy ejaculation through other types of stimulation.
In cases where there is a problematic relationship
or an inhibition of sexual desire between the couple, therapy to
enhance the relationship and emotional intimacy may be required as a
preliminary step.
Sometimes hypnosis may be a useful adjunct to therapy,
particularly if a partner is not willing to participate in therapy.
Self-treatment of this problem will probably be unsuccessful in most
cases.
If a medication is believed to be the cause of the
problem, other medication options may be discussed. (Never stop taking
any medicine without first talking to your doctor.) This may be
difficult in certain instances, especially when the medication is
working appropriately to solve a pre-existing medical or psychological
problem.
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