DELAYED EJACULATION =================== INTRODUCTION ============ This article explains what is 'delayed ejaculation'. What causes delayed ejaculation, physical and psychological factors. What treatments can cure the specific physical or psychological causes. Cautionary notes. Living with it. How does normal ejaculation work? What is retrogade ejaculation? Project 'P', Masturbation video. This is not superficial overview of the topic, but a detailed discussion. It will explain details that most doctors don't know or could not be bothered to tell you in a 20-30 minute consultation. Some of the practical 'tips' could not be known to any doctor unless he has had to solve this problem for himself! (Although you can't always solve it without medical assistance, you will benefit much if you understand exactly what is going on, i.e. what is normal, what is wrong, how to solve it and what to watch out for.) Although it has been written for the man who has the problem, doctors, psychologists, prostitutes with problem clients and normal men who want to optimize their sexual act, will benefit too. WHAT IS DELAYED EJACULATION? ============================ Note that ejaculating is also known as 'to cum'. Delayed ejaculation is also known as 'retarded ejaculation'. It is the problem of regularly ejaculating too slowly or having difficulty to cum at all. Although many men ejaculate too fast, you may be 1 of a small minority (less than 1%) suffering from delayed ejaculation. (If you can't stop cumming before 2 minutes, you are a premature ejaculator. 3-5minutes are normal.If you take longer than 5 minutes to cum, you are slow.) You will naturally be frustrated by yourself and embarrassed in front of your partner. Sometimes she might be too. If she is not aware of your problem, she might think it is her 'fault', that she does not turn you on enough, or even 'Hey, I have had enough now! It is beginning to hurt! When are you going to finish?', etc. Although she does not 'need' you to cum, intercourse is just not the same if you don't cum - even she understands your problem. And of course, it will be difficult to make babies if you want to. WHAT CAUSES 'DELAYED EJACULATION'? ================================== 'PHYSICAL' issues that can cause delayed ejaculation are: F1. Your use of alcohol, DRUGS or medication like: -- anti-depressants (Prozac and other serotonin reuptake inhibitors), -- paroxetine (trade name Seroxat), -- drugs that lower blood pressure. F2. The NERVE SUPPLY to your penis may be damaged. If it is the sensory nerves that are damaged, then you will not only loose (many of) the pleasurable feelings of intercourse,but you will also loose the feedback to your brain that is necessary to trigger the ejaculatory reflex, i.e. the feelings that you have penetrated deep enough, long enough, that her pussy is contracting, i.e. she is at optimum readiness to receive your ejaculation. Note that these problems can exist even if you have minor damage to your sensory nerves. It sometimes happen that after SPINAL INJURIES the sensation in the penis is not completely lost, i.e. you have sensation on only 1 side of your penis, you have only a numb sensation or you can only feel pain but not warmth. Then you may find that you can cum if you apply enough stimulation to your penis to overcome the sensory limitations,i.e. you can cum if you masturbate vigorously enough for a prolonged period. Unfortunately no woman's pussy can grab and pull your penis as tight as your own hand. F3. You may not be erect enough, i. e. ERECTILE DYSFUNCTION. Although ejaculation is possible without an erection,it is difficult to get enough stimulation necessary for ejaculation during intercourse if you are not erect enough. And of course, penetration is not thorough enough. F4. As you grow OLDER, you may find that you take longer to cum. This is because your refractory period (i.e.the time you need to wait before you can climax again) increases as you grow older. Nevertheless, your age is more likely to increase the time it takes you to get an erection rather than delaying cumming. F5. Your cause is due to a DISEASE. -- Most bodily functions will work less well when you are ill,even if you have just flu, -- If you have multiple sclerosis, -- You may have a disease or surgery that affects your prostate (usually men over 50), kidneys, blood pressure, heart, hormone (endocrine) system or your spinal nerves, -- If you had an operation like a colostomy or an ileostomy, i.e. removal of a part of your intestines. During such operations the nerves that supply your sexual organs may be damaged, -- You have Peyronies disease, i.e. hard patches of tissue developed in the shaft of your penis. You will also find that your erections are partial, painful and your penis may be curved when erect. F6. Although CIRCUMCISION causes your penis to be less sensitive, it is unlikely to be the only cause of delayed ejaculation. PSYCHOLOGICAL causes : Although you see sex as important, your views about sex and relationships are rigid. S1. You regard sex almost entirely as a means of farthering a child, rather than as something to be valued for its own sake. S2. You may fear loss of control. This is often the case if you are a particularly self-disciplined person. S3. You may have an inferiority complex or feel not good enough for your partner. S4. You don't want to 'soil' her with your semen. S5. You are afraid of making her pregnant. Or you are afraid of getting it right because then she might want you to marry her (or want you to make her pregnant) and you are not ready for that yet. S6. Your excessive use of coitus interruptus (the withdrawal method of contraception) became a habit that is difficult to break. S7. You may have (unconscious) feelings of anger or hostility towards women. (1 instance of such feelings may be : 'I hate women, but I need her.') This may have grown from some experience in your childhood. S8. You may have (unconscious) feelings of guilt which may be due to some earlier experiences or problems in your relationship with your current partner. S9. You may not be aroused enough. You may need a more active or beautiful partner or just a different setting. (Sometimes prostitutes have an attitude that is too casual and artificial to make it happen.) SA. You may be under stress or rushed to get the intercourse over. In most cases the problem is a complex COMBINATION of physical and psychological causes. WHAT TREATMENTS CAN CURE DELAYED EJACULATION? ============================================= Delayed ejaculation is not easy to treat and because it is so rare, there are not many reliable reports on success rates for the types of treatment available. The first is to find out of your MAJOR CAUSE is physical or psychological. The causes may be PSYCHOLOGICAL if you observe that : - You can cum when you masturbate when you are alone, but you cannot during intercourse with her, - You have 'wet dreams',i.e. you can actually ejaculate although not when you want to, - You can cum with a casual partner or a prostitute,but not with your regular partner that you love, - You never had problems with your previous partner, but suddenly in your new relationship, you cannot cum, - You never had problems, but after a bad experience (e.g. the telephone rang the moment you were going to cum and you got a fright), you cannot cum any more. This is called traumatic learning, - You have ambiguous feelings about ejaculation: you want to shoot into her, but when you are ready, you stop yourself and you don't understand why. TREATMENTS FOR PHYSICAL CAUSES: F1. Your use of alcohol, drugs' or medication. - Consult your doctor for possible alternative medications. F2. Damaged nerve supply. - Surgery: None are known and it is doubted if any operation exists that could solve this problem. - Exercise: if your nerves are only partially damaged, it may be possible to optimise whatever is left. The same way you give physiotheraphy to an injured leg, you can exercise your sexual system to stimulate recovery of your sexual system. Combine Project 'P' (see appendix) with masturbation. Practise self-masturbation as often as possible so that you can get an ejaculation within 4-5 minutes. 2 problems may arise here: - Your natural refractory period may limit how often you can practise, - Overstimulation ( this is related to the above). After initial improvement you may find that your sexual system becomes 'tired' and ejaculation becomes difficult once again. Just 'rest' for a week and then continue again. Practically this 'physiotheraphy' can be very frustrating, humiliating and time consuming; 3 - 6 months. Once you succeed to masturbate yourself, you can attempt intercourse. (See 'behavioral theraphy' later.) Although your main problem may be physical, expect many of the psychological problems mentioned above to appear the moment you have attempted your first intercourse. It might help if you know what your penis is suppose to experience during intercourse. To get round the limited sensation in your penis, put your finger in your partner's aroused vagina once. It is possible that your ejaculatory reflex requires so much stimulation that normal intercourse is just not able to provide this. Then try some of the following : - Optimize your sexual technique (see appendix: the ejaculatory reflex trigger), - Although covering your penis with KY jelly or cream sometimes help it can be counter productive, i.e. too slippery, - Experiment with a artificial vibrating vagina, - Experiment with different positions (1 way to add extra stimulation is to insert your penis and then to keep her thighs together, kind of clasping your penis in between. Avoid a position where she opens her legs widely and/or pulls her knees up to her chest. Also in this position it is difficult for her to contract her vaginal muscles and you the extra stimulation.) - Try a different partner. All women's vaginas are not the same.Someone with a tighter vagina (a young girl who has not born babies yet) might just fit you better. Or find a partner that can control her vaginal muscles, i.e. can squeeze them together to clasp your penis tighter. (Oriental prostitutes have a reputation for this skill.) - Make sure she is well aroused, because then her vagina will contracts and stimulate you more, - Let her press your penis between her fingers. Pressure is applied to the part of your penis that is outside her vulva during the intercourse, - Try anal sex, because her anus is tighter than her vagina. - Experiment with different types of condoms.Condoms that are very thin will allow for extra sensation that might be necessary to trigger your orgasm. Condoms that are too tight might restrict the gliding action of your penis within its foreskin. F3. Erectile dysfunction. This has been discussed in a previous article. F4. Refractory period. - Experiment to see how many days you have to rest before you can attempt another ejaculation. Unfortunately (especially for older men) this clashed with your need to experiment often enough. F5. Circumcision. Try to develop a foreskin. See Project 'P' for details. TREATMENTS FOR PSYCHOLOGICAL CAUSES: There are 2 APPROACHES. You probably have to do a combination of both. The 1st approach is BEHAVIORAL THERAPHY, a practical training. - You must be able to masturbate yourself to an orgasm with 5 - 10 minutes. - Involve your partner. Let her sit next to you (in the dark if necessary) while you masturbate yourself. - If you succeed at this, hold her close to you with your 1 arm while you masturbate yourself with your other hand. - She might help you by 'talking dirty' to you or by enacting some of your fantasies. - Let she help you masturbate,put both your and her hands on your penis (hand- job).Remember, most women don't know that a man's penis is not as sensitive as their sexual organs. Because you might need vigorous stimulation,you must remember to tell her that she is unlikely to hurt you if she masturbates you vigorously. - Let she masturbate you. Don't assume that if she grab your lever she will get it right first time. Although you may be able to masturbate yourself,you may need to have it done in a very particular way. You may have to think how you are doing it and then teach her your trick. (This may be less obvious and more difficult than it seem.) Also you could have become so used to your own particular way of getting it done, that it might be difficult to cum if she does it only slightly differently. - Before you attempt intercourse with a real partner, you can experiment on 1 of those plastic inflatable dolls. The argument is to get stimulated in a different way from your own hand without actually involving a real woman. In practise those dolls are cumbersome. Even those with 'water filled vibrating pussies' are not realistic substitutes (no matter what the sex shop tells you). - Now try intercourse. Masturbate almost to the point of orgasm and then try to ejaculate between the lips of her vulva. Each time try to ejaculate deeper into her vagina. - If you still don't succeed, use the technique of distraction. Engage in a situation that will distract your attention from yourself and your failure. It should be novel or spontaneous: -- Make love under the shower, -- Try a different position, -- Try a different partner, -- Have sex in the open air or in a car (ensuring some degree of privacy of course), -- Have intercourse fully clothed and spontaneously, -- Do as usual until you become frustrated for not succeeding. Then stop, stand up, go wash your face, switch on the radio and return immediately to continue where you left off. This also serves as a 'rest' for your system before it shoots off. The 2nd approach is a type of PSYCHO-ANALYSIS to sort out your particular psychological problems. S1, S7, S8. Consult a psychologist to bring your fears and conflicts about sex and relationships to the surface. S2. Drink a moderate amount of alcohol beforehand. Ejaculation is a kind of 'letting-go'. This is unlikely to solve your problem directly, but if you are less rigid, communication with your partner will go smoother which will help to set the mood for what is to come. or Try to loosen yourself in exciting erotic fantasies, viewing sexually explicit videos (see masturbation video in appendix). S3. Try a partner that you feel comfortable with. (Avoid very beautiful, domineering and young (16-23) women.) S4. Try a partner that you don't hold in high regard. ('Go get yourself a bitch and fuck her!') CAUTION ======= Although it is suggested that you experiment with other partners, only try this as a last resort (whether you are single or married), because: - It can cause secondary psychological conflicts, fears and guilts (remember, delayed ejaculation is mainly due to psychological causes the 1st place), - Although prostitutes are an option, they are not well suited for this task: -- Many don't give a damn, -- Even if they do have sympathy with your problem, they are not sex therapists, -- Most have psychological and sexual conflicts and fears of their own, -- They work against time (R250 - R 300 / hour) and the rush is going to place you under stress, something that you should avoid in the first place, -- They are expensive and you are not going to get the trick right in 1 or 2 attempts. LIVING WITH IT ============== You have tried everything and still don't succeed 100%. Then you have to make the best of what you have. - Although you might not be able to cum during intercourse, you might still be able to enjoy her hand-jobs. - Because you can last so long, you can actually please her more, provided that: - you stop frustrating yourself trying to ejaculate and rather focus on pleasing her, - you learn to realise when she had enough,else you will begin to hurt her, - she understands you problem. (If you do the above 2 very well, a new partner might not even realise you have a problem). 1 final tip to help you keep your sanity : remember to give love/sex it due, but no more. APPENDIXES ========== HOW DOES NORMAL EJACULATION WORK? First note that : - Ejaculation is possible without an erection, provided that you can get a firm enough grip on your flaccid penis to stimulate it adequately, - It is the testes make the actual sperm cells, - It is the prostate gland and the seminal vesicles make the semen (the milky fluid containing the sperm). The ejaculation of semen at orgasm is a reflex, like a sneeze or a cough. The reflex has to be triggered by external stimuli : - Friction to glans (cap of the penis).There are various opinions about which part of the glans is the most sensitive: -- At the opening of the urethra, -- At the area where the shaft and the glans meet at the corona (usually at the bottom part), - Friction along the shaft, (although harder friction would be an obvious way to increase the stimulus, it has also been noted that the reflex can be triggered by a lighter friction but faster up-and-down movement along the shaft. Practically this means that, if her vagina is not tight enough to provide adequate friction, you have to pump faster.), - Pressure to the base of the penis, - Stretching the frenulum by pulling the foreskin as far back as possible.The frenulum is the small piece of skin that connects your foreskin to the bottom of the glans. Practically this means that you have to pump harder and deeper into her vagina. Even if you are circumcised your frenulum is usually still intact. Few men's foreskins are cut back so far that their frenulum is damaged, - Condoms tend to block the friction to the glans.Put a small amount KY jelly on the tip of glans before you put the condom on. It will cause the condom tip to slide over the top of your glans and this will increase the stimulation. - Put the condom on correctly to ensure the maximum gliding action. Pull the foreskin as far back as possible before you put on the condom. Then let go of the foreskin. Because this is very difficult to do with 2 hands, let her hold your erect penis at its base while you put the condom on. Once it has been triggered,the semen is ejaculated. This happens in 2 stages. The 2 stages follow one another very quickly and most men can not distinguish them apart.They just feel their penis suddenly becomes hot as blood is rushed up into it, a small spurt of pre-ejaculate and then the contractions. The 1st stage is quite involuntarily. The testes are elevated up close to the base of the penis, i.e. they are not hanging loosely as usual. (This is less true for older men.) The tubes that deliver the sperm from testes contract. The prostate gland and the seminal vesicles contract too. These contractions pump the semen to the base of the penis. During the 2nd stage the muscles at the base of the penis contract rhythmically (every 8/10ths of a second) and shoot the semen out through the penis. (This group of muscles are called the pubococcygeus muscles and run from the pubic bone to the tailbone. These are also the muscles you use to stop the flow of urine from your bladder.) RETROGATE EJACULATION This is when you can actually feel the orgasm happen,but nothing is shot out, i.e. there is no pumping action in the penis, it is a 'dry run'. What happens is that the semen passes backwards into the bladder instead of being shot out through the penis. The reflex that should close off the valve to your bladder at orgasm does not work. This may be due to injury, surgery, disease or medication. This problem can sometimes be solved by surgery or medication. PROJECT "P" (also know as PROPENIS) This is a program to develop your penis naturally. Results are achieved with physio-therapeutical training and special exercises. Although PROPENIS may not cure delayed ejaculation directly, the exercises will strengthen your penis that in some cases is the starting point of treating delayed- ejaculation. For more details, see Project 'P' in the Advertising conference. MASTURBATION VIDEO If you have problems to masturbate yourself, you will benefit by watching how how other men do it. Compare yourself with these men. Are you bigger/smaller? Faster, better? Get a few tips. NB: Although they used the PROPENIS program, these are normal men, they are not actors, they are not putting up a show. They simply show how to do it. For more details, see Project 'P' in the Advertising conference. --------------------- The end ---------------------