When a man finds he is unable to control his orgasm it can lead to a very unsatisfactory relationship for both partners. If he climaxes very quickly (premature ejaculation) it may well mean that the woman never reaches a high level of arousal or is unable to obtain orgasm when they are making love. Over a period of time she may become very frustrated and resentful and begin to doubt her own sexuality. And, even if she constandy reassures him, the man will often feel inadequate as a lover and guilty that he is letting his partner down.
Though male orgasm is a reflex action centred in the spinal cord, it can, like other reflexes, be partially brought under the conscious control of the brain. Most men learn to control their orgasm through a combination of practice and experience although it is possible to ‘retrain’ if things are going wrong.
The early experiences of orgasm are usually through masturbation and this is where many adolescents start to learn control. As a man becomes more aware of the sensations in his penis, he learns to delay an orgasm by stopping or slowing the rate of friction from his hand. Later on, he ‘remembers’ these experiences during sexual intercourse, where hopefully he adjusts and refines them to meet the changed circumstances of stimulation. However, it’s not unusual for his early experiences to end in premature ejaculation.
Research has shown that when premature ejaculation occurs the man moves from a state of relatively low excitement to high orgasmic excitement with litde intermediate build up. The penis erects rapidly and discharges at once without the usual relatively long period of erection. In time it is possible for a man to become more consciously aware of the sensations in his penis and learn to avoid the sort of excessive stimulation which can lead to premature orgasm. He should then be in a position to decide when he will ‘come’.
Though there are physical conditions and medical treatments which make it difficult to achieve orgasm, the commonest reason is psychological. And, etc, taken to alleviate anxiety and improve performance can actually make things worse, although one or drinks may help as a relaxant.
Anxiety is the major psychological cause of remature ejaculation. For instance, a man may e able to control his orgasm with his wife but fail to perform adequately in an affair for fear of being found out More general anxieties, such as worries about work, may also lead to a temporary bout of premature ejaculation.
Another very common anxiety has to do with fears about performing badly. Here, because the man worries so much about his ‘poor’ performance, he aggravates his condition even more and a vicious circle builds up – the more he worries the less control he has and vice versa. Clearly, if his partner is also unsympathetic the situation will deteriorate still further.
Anxieties may also originate from deep underlying causes related to his past experiences. If a man felt a lot of guilt about masturbating or making love when he was younger, he may have deliberately learned to come very quickly in order not to be discovered or to get it over as soon as possible, so as not to prolong his guilty feelings. His penis then becomes conditioned to ejaculate rapidly and once this pattern is established it may prove difficult to alter, so that the problem persists even in a relaxed atmosphere with a partner he loves.
Or a man who has learnt that it is dangerous to get close to another person because it is so hurtful to lose them may be afraid that in the closeness achieved during sexual intercourse (which is after all the most intimate of human activities) there is a danger of revealing his innermost feelings and giving his partner the power to hurt him. This anxiety about intimacy is alleviated by ejaculating quickly and reducing contact to the briefest possible interlude. It is common for such a man to find a partner who also has this fear of intimacy and unconsciously welcomes the failure as a solution to her own particular problem.
While most men who ask for sex therapy see themselves as having the ‘problem’ while their partner is completely’blameless’, sex therapists often find that the difficulty has arisen because of die general way the couple relates.
John referred himself for help with premature ejaculation. He was seen with his wife, Pam, who was very unsure whether she wanted help because she did not see the premature ejaculation as a problem. It emerged that she was very prudish about sex, had never really enjoyed it and saw it as primarily a way of making children. Her emotional ties were closer to her father and her children than to John. By preventing them from getting too close Pam ‘used’ the problem as a way of remaining faithful to the rest of her family. Also, a closer and more enjoyable sex life would, she felt, lead John to feel he was competing with her family For her affections. Somehow she believed diat by reducing intimacy to a minimum she was sparing John from feeling rejected. In her discussions with John, she was mildly sarcastic, which increased John’s difficulty.
Claire, on the other hand, referred herself for lack of interest in sex. It emerged that Peter, her husband, had always come, after a few seconds “p n wm of entering her, and she had never been close to orgasm. Peter was very adamant that the problem was Claire’s, largely because he was ignorant about sexual matters. However, it turned out that their sexuality mirrored other aspects of their relationship. They had never learned the ‘give and take’ philosophy of a happy relationship, both preferring to be on the receiving end of things. Both had come from homes where all discussions of sex had been avoided or carried on in hushed tones. Open discussions and the discovery that there is joy in giving helped them achieve a happy relationship.
What effects can this problem have on a relationship? A man who suffers from premature ejaculation will often feel very inadequate, thinking himself as only’half a man’ and taking out his frustrations on his family, friends and work mates. At the same time his partner is probably feeling sexually frustrated and used, and she too may take it out on other people. She may also feel rejected and begin to doubt that she is sexually attractive.
The problem may create such tension that it indirectly causes some kind of emotional disturbance in the family. In some cases, a therapist may only become aware of sexual problems between a couple after he has been asked to help with a child who has trouble with delinquency or bed wetting.
Both partners may embark on affairs – the man to prove himself and the woman to cope with her sexual frustration and to reassure herself that she is sexually desirable.
How can a man overcome premature ejaculation?
Many men unsuccessfully attempt to treat them selves by distractions v during intercourse – they think of non-sexual things or inflict pain on themselves by, for example, sticking their nails in-to their hands. The reason this won’t work is because it takes the man’s attention even further away from the sensations in his penis and so increases his lack of control.
It really is worth seeking professional help because premature ejaculation is the easiest sexual difficulty to treaty with some therapists reporting a success rate of up to 90 per cent. Overcoming premature ejaculation is a combination of learning to let go and learning that you have a right to enjoy sex.
What are the techniques used to treat it?
Most modern sex therapists prefer to see both partners, pardy because treatment requires the co-operation of the female, but also in order to discover the underlying cause of the problem. They avoid blaming either of the partners, attempting to teach them to see the difficulty as a shared problem which hopefully can be resolved by changing not only the physical aspects of their sexuality but also the general problems in the relationship. After learning not to blame one another for the problem, the couple must be taught to accept and enjoy their own and each other’s bodies and in this way to come to see sex as an act of love.
A therapist will teach the man control by suggesting exercises designed to increase the couple’s awareness of eacn other’s bodies. He will ask the woman to stimulate the penis manually and the man to concentrate on his own physical sensations rather than his partner’s sexual needs. When the man feels an orgasm is close (the premonitory sensation) he must tell his partner to stop until these feelings have abated. The exercise is repeated four times, and only on the fourth occasion is the man allowed to ejaculate. After this, he can bring his wife to orgasm either manually or orally.
This technique is called the’stop-start5 method and is designed to teach the man to be aware of the sensations in his penis so that he can learn to consciously control them. When he has a reasonable degree of control by this method, the woman repeats the exercises with lubricated hands to simulate the secretions of the vagina.
When the man is able to exercise reasonable control in these circumstances he is asked to try the ‘stop-start5 technique as part of intercourse. He lies on his back and the woman straddles him and moves up and down on his penis. When he feels the premonitory sensation he asks her to stop until the sensation has passed. Again the exercise is repeated four times, at the end of which he is allowed to ejaculate. The woman is asked to be in this position because it is less stimulating for the man than when she is under-neath. When they can do this with reasonable success, they can repeat the exercises in a side-to-side position and finally with the man on top.
Some sex therapists introduce a modification to this technique by asking the woman to firmly squeeze the ridge around the tip of the penis for about three seconds after the man has asked her to stop. This leads to the man losing the urge to ejaculate. There is also some loss of erection.
A similar sequence of stages is followed with this ‘squeeze’ technique as for the stop-start method. Here, however, the woman will have to remove the penis from her vagina during the later exercises to apply pressure to the tip.
Is it true that some men find it difficult to ejaculate at all? This is a less common problem than premature ejaculation, but when it does occur it can have an equally disruptive influence on the man’s self image and the relationship as a whole.
Most men will have had problems with delayed or absent ejaculation at one time or another, either because they were tired or had too much to drink. There is only a real problem if a man is frequently unable to reach orgasm or is only able to do so after very prolonged love play.
Men who suffer from delayed or absent ejacu-lation are, typically, able to maintain a firm erection for long periods and although the problem is often confined to intercourse it may also happen during solitary masturbation. In a small percentage of cases, the man may be unable to ejaculate with one partner but be successful with another.
Although the problem may be due to illness or medication it is more likely that the cause is psychological: the man is over-controlling his orgasmic reflex and is unable to ‘let go’. In addition many retarded ejaculators suffer from ‘spectatoring5 – they are too conscious of what they are doing during sexual intercourse and the more they observe themselves having sex, the less able they are to achieve orgasm.
There are many possible reasons why a man may find it difficult to ‘let go’. He may have had a restrictive childhood when sex was equated with sin and masturbation, and was seen as something evil and shameful. Fear of making his partner pregnant or homosexual tendencies can also contribute to the problem.
It may be that the man was severely frightened while having sexual intercourse in the past -perhaps he was caught making love in his parents’ house or in a car – or that he uses the affliction as a way of preventing himself from getting too close to his partner. Or he may have hostile feelings towards his partner and want to ‘punish’ her by not giving her his semen.
Joe, who was treated for retarded ejaculation, illustrates some aspects of these causes. While he had a great deal of sexual desire and could get and maintain an erection for over an hour, he had never ejaculated in a woman, although was quite capable of it during masturbation. He had been placed in a children’s home at an early age and felt rejected by his mother. He had several bad experiences with bossy and sadistic female workers in the children’s home who had punished him when he had ‘wet dreams’. He had developed the idea that women did not deserve trust or love and subconsciously believed that they should be punished. He had never established a permanent relationship and his casual affairs tended to be with women who had an equally low opinion of men.
In order to stop over-con trolling his orgasm a man must learn to relax and enjoy his sexuality and rid himself of his anxiety about coming in a woman. Therapists usually recommend a series of exercises which involve getting his partner to stimulate him and then allowing him to ejaculate by going into the next room and masturbating. On each successive occasion he is brought closer to the woman in order to ejaculate and eventually, if treatment is successful and he becomes confident in his ability to control his orgasm, he is able to come inside her.
Both partners need a great deal of patience and tolerance in carrying out the treatment They must express their difficulties and even their anger with the therapist and with one another. These discussions are likely to embrace aspects of the relationship which appear to have nothing to do with sex. In doing this, they can achieve a greater degree of security and closeness which is, after all, what it is about.