07 Apr Difficulty in Ejaculation
Delayed ejaculation or retarded ejaculation is a very distressing condition as the patient may feel embarrassed, isolated, confused and very frustrated. The spouse may also feel inadequate which may put more pressure on him and compound the problem further. If untreated, it may lead to marital stress, sexual dissatisfaction, inhibited sexual desire, and avoidance of sexual intercourse.
According to medical studies, most men ejaculate within 2 to 4 minutes after active thrusting in intercourse. Men with delayed ejaculation may be entirely unable to ejaculate or may only be able to ejaculate with great effort and after prolonged intercourse (up to 30 to 45 minutes).
The most common causes are psychological. These include:
- Performance anxiety. Sex becomes a performance and is no more pleasurable
- Distraction: Concerns about work or other tasks
- Feeling tired
- Lack of love towards spouse
- Perception of sex as sinful
- Psychological trauma in the past, e.g. illicit sex
Other medical causes include
- Nerve injuries to the spinal cord or back
- Psychiatric drugs (such as Prozac)
Drugs for the treatment of erectile dysfunction will not be useful for delayed ejaculation. Treatment would depend on the cause.
The following steps may help:
- Try to relax by doing breathing exercises
- Enjoy and focus on pleasurable sensations without sexual contact
- Have a sexual fantasy
- Maximize sexual stimulation by trying different positions
- Strengthen pelvic floor muscles by doing Kegel exercises
Should the symptom persist, medical consultation and sexual counselling would be helpful.