Are ejaculation problems an issue of mind over matter?
Well, if a man and his partner don't mind how long it takes him to ejaculate, then it really doesn't matter. For example, Ian Kerner, PhD, a sex therapist and author of She Comes First, advises men to bring their partners to the brink of orgasm before having intercourse. Then, if he's prone to premature ejaculation, it doesn't matter since both of them come away satisfied.
"Help me ... help you. Help me, help you."
That famous line from the film Jerry Maguire may be the best advice a
doctor could give his or her patient.
"Some patients have the attitude, 'I'm putting myself in the hands of a
professional,'" says Stephen Permut, MD, chairman of family and community
medicine at Temple University School of Medicine in Philadelphia. "They want
you to make all their decisions for them."
Permut prefers to have patients get involved in their own care and engage
Conversely, if a man takes longer than average to ejaculate, but both partners enjoy marathon sex sessions, then delayed ejaculation can be a real plus.
However, some men do mind how long it takes them to ejaculate. They mind a lot -- and so do their partners. But while the mind often plays a big role in creating ejaculation problems, it's also key in overcoming them. Here are some tips on what to do.
Common Ejaculation Problems
When it comes to ejaculation, there are basically three different things that can go wrong.
Premature ejaculation is by far the biggest complaint that men have about their sexual performance. After studying data gathered by the National Health and Social Life Survey, sociologist Edward Laumann, PhD, estimated that a third of American men complain that they ejaculate too quickly. They want to last longer during intercourse to prolong the pleasure, both for themselves and their partners.
Delayed ejaculation (or retarded ejaculation) affects a much smaller number of men - as few as 3%, according to some estimates. It's one of the most poorly understood ejaculation problems. Some men cannot reach orgasm at all, at least not with a partner.
Retrograde ejaculation is the least common of the ejaculation problems. It causes semen to back into the bladder during orgasm instead of exiting by way of the penis. The semen is then later flushed out when you urinate.
Retrograde ejaculation can be caused by diabetes, nerve damage, various medications, and surgery that disturbs the sphincter muscle. It's harmless and won't interfere with the feeling of orgasm. (It can also make for an easy post-sex clean-up.) But since it does affect fertility, some men may need treatment if their partners are trying to get pregnant.
What Causes Delayed Ejaculation?
There are lots of different reasons for delayed ejaculation. Some medicines -- like antidepressants -- are common culprits. For many men, it's age. As we grow older, the nerve endings in the penis become less sensitive, according to Barbara Keesling, PhD, author of All Night Long: How to Make Love to a Man Over 50, and a professor of human sexuality at the California State University, Fullerton.
"When the reflexes slow down, it takes longer," Keesling says. "Another thing that happens with age is that your erection ability goes down too, so it becomes more difficult to ejaculate without a full erection."