SEX PROBLEMS IN MEN: RETARDED ORGASM AND AN INABILITY TO EJACULATE
Some men suffer from a delay in reaching orgasm and cannot ejaculate with their penis in a vagina. Some can be masturbated or fellated to orgasm by the woman if they withdraw, whereas others cannot be brought to orgasm by a woman at all, by any means, and may not be able to ejaculate if a woman is even in the same room. Some men who are successfully treated for premature ejaculation then suffer from retarded orgasm and vice versa. The majority of the partners of such men are distressed by it. Some women conclude that they have over-stretched their vagina during masturbation or childbirth and that this is the explanation.
However, the problem sometimes presents itself directly in the form of complaints that the vagina is too large or too wet or that the penis, or some portion of it, has lost its sensation. Some men in this group are discovered to compress their penises tightly during masturbation. They have simply mis-trained themselves and now cannot respond without tight penile pressure. Others complain of intense penile pain, which they naturally want to avoid, at orgasm. In all such cases intercourse or pleasure is being avoided in order to reduce anxiety.
Diabetes and various drugs can be the cause in men who complain of a lack of sensation, but more often their ultimate unconscious need is to deny that they are having intercourse. It is only by doing this that they can function at all. Some, who unconsciously equate genital fluids with excretion, want to avoid soiling the woman and others unconsciously equate the woman with their mother. Their response is not to stop sex with her but not to ejaculate inside her. Others who, it is easily imagined, were rebuked and punished by women — sometimes even by older sisters — for genital activity in childhood, are simply afraid to lose control and reach orgasm in the presence of a woman.
Relatively inexperienced men who have this problem say that at some point during intercourse the whole business loses its excitement and that distracting thoughts enter their minds. The explanation is that as their level of pleasure and therefore, to them, sinfulness, rises, so does their anxiety, so reducing the pleasure. Some maintain their erection and others simply lose it. Although most, but not all, men enjoy intercourse more if the woman also moves her pelvis, this activity or what she says can be the distraction which intrudes into the man’s mind. It increases his self-awareness and thereby his anxiety about what he is doing.
Various fears can cause the same problem, although they may only be vehicles for yet deeper fears. These include a fear of making the woman pregnant, a fear of VD or AIDS and fears about other men with whom the woman has had intercourse. Thinking about other men makes him jealous or makes him worry that her previous lovers were better endowed sexually than he or were better lovers.
Treating the underlying cause, together with re-education, a decrease in anxiety, a reduced emphasis on orgasm, and an increase in penile pleasures and eroticism, all with the involvement of the woman, with the aim of increasing the efficiency with which the man responds to her manual or oral stimulation, forms the first stage of treatment. Once the woman can reliably bring the man to orgasm she, without saying anything, can on occasions, when he is near orgasm, quickly get on top of him and thrust rapidly so as to make him ejaculate in her vagina. Usually his perceptions change and his anxiety falls.
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