Erectile Dysfunction and Delayed Ejaculation

I think the first point worthy of note is the fact that ED is very common. A quick glance at the search results that pop up in Google when you search for erectile dysfunction or erection problems proves that there are a great many men looking for a cure, a great many websites who offer advice.

Erection problems are very troubling for a man: it is the essence of his manhood that is at stake when he cannot make love or even get an erection. He feels emasculated, less of man, unable to have sex and display his potent male power. And of course his partner is affected by his erection problem as well, for she may wonder if it is her attractiveness or lack of it that is causing the problem, and even if she doesn’t, she may well be frustrated by the fact that she and her partner cannot make love.

The important thing to remember, whether you are a man with erection problems or his partner is that none of these things are probably true. You are not less of  man just because you cannot get an erection; your partner is no more or less attractive than she was before your erection problems started; and you are not emasculated just because you are having some temporary difficulty getting hard. Nor are you emasculated if you experience  delayed ejaculation. Delayed ejaculation is a condition that occurs in around one man in twenty and means that a man cannot reach the point of ejaculation during sexual intercourse.

In case any men reading this book about delayed ejaculation don’t actually know the facts about delayed ejaculation the majority of cases, certainly in men under the age of fifty, are due to emotional or psychological causes such as anxiety, depression, stress or relationship troubles.

In other men, erection problems may be associated with diabetes or cholesterol, and there can sometimes be an effect when a man’s hormones begin to drop during his midlife – this may affect his erectile capacity.

There are plenty of reports on the internet which you can read if you would like to. For example, we have all heard of Viagra, which has changed dramatically the way patients are assessed as to the degree of their erectile difficulties.

Unlike some other conditions, where the importance of a sexual problem depends on how the couple feel about it, erectile dysfunction is best regarded with some seriousness by both patient and doctor, for it can be a primary indicator of high cholesterol or diabetes.

In case that last point is not clear, the simple explanation is that the small arteries of the penis get blocked much more easily by cholesterol deposited on the endothelium which lines the small blood vessels than the arteries of the heart. But in fact, when a man begins to suffer erectile dysfunction from high cholesterol, he is likely to have a heart attack within two or three years.

So obviously this is an important condition. But how is it to be cured? First of all, being relaxed and  confident is a useful starting point. The best situation in which a cure can be sought is for  a man to have a loving partner who genuinely wants to have intercourse with him, and who is willing to work on solving the erectile dysfunction with him.

 But even without that, a man can work on the problem on his own: he can start to improve his psychical health, reduce his cholesterol, eat better food, take more exercise, and have a physical check up to test for low testosterone, which may be contributing to his problem. That is not enough, of course: you need a specific methodology for treating the erectile dysfunction as well.

I do recommend trying Viagra if that is of interest to you and you are under the supervision of primary care physician. Viagra has short-circuited the treatments for erectile dysfunction, especially in cases where they are organic (i.e. physical) in origin. It may not be a complete cure, but for men whose erectile dysfunction results from psychosomatic issues like performance anxiety, it can be a great asset in overcoming the problem.

Coping strategies men use when they have an erection problem or they cannot get erect due to erectile failure

Find a new partner

I have lost count of the men who said they loved their partner but they just had to find out if a younger woman (or a more attractive/sexier/understanding/happy/loving/caring one) would help them get an erection again – in other words, asking if youth might be a cure for erectile dysfunction. This can seem especially appealing if you’re not in such a great relationship.

If you’ve tried this, then I hope it worked for you, and I hope you found that your penis did all you asked of it. But the chances are that it didn’t – and even if it did, where does that leave you when you go back to your full-time partner, the one with whom you originally had the problem? Even if you now suspect the problem lies with her, not you, this is still something you now have to deal with.

Try Viagra for a firmer erection

Depending on the circumstances in which you lost your capacity to stay erect, this can actually be a satisfactory answer. I had a friend who found a younger girlfriend when he and his wife split up. Unfortunately she was obsessed with sex, wanting intercourse many times a week (well, to be accurate, a day).

While this sounds like an older man’s dream woman, it wasn’t long before he found he was too exhausted to get an erection – and after discovering he couldn’t become erect  on one occasion, the same thing happened next time….and the next…….and the next. After an agonized phone call to me and a quick dose of Viagra as a result, he found his penis hard and his erection surprisingly long-lasting next time. That was all he needed to restore his confidence and get him back to full working order.

New sexual “pleasure”

Watching porn and masturbating to it, “talking dirty” during sex, getting her to wear “sexy” clothes, using extreme fantasy, sucking desperately on her vulva or breasts, trying things like BDSM….all this, and more, can be a way of stimulating yourself when you experience erectile failure. After all, it seems logical: the more stimulation you get, the more aroused you’ll be, right? Wrong.

The fear that lies behind your erection problem, and your fear about not being able to have sex, may be so great that when you do have sex you just ejaculate quickly, or you feel very unfulfilled after you’ve ejaculated, perhaps because you were more obsessed with the process than with your partner. Sex without emotional connection, as we all know, is not as good as sex with an aroused, engaged partner. 

Avoid sex altogether – that way there’s no problem with erectile dysfunction!

Well, it’s a strategy that some men use, but I strongly advise you to avoid it. Men are not designed to go without sex. You know that really. It’s part of who we are at our most fundamental level, and I don’t believe a man can feel complete unless he is able to have fully-erect sex. Besides which, if you use this strategy with your partner, it’s probably the first step on a rocky road to divorce.

Delayed Ejaculation

Treatment Of Delayed Ejaculation

One possibly useful treatment methodology for delayed ejaculation – read about treatment here – is to employ a series of exercises which are effectively a kind of CBT or cognitive behavioral therapy. 

Classically, a man would be encouraged to masturbate to orgasm in a series of graded steps, on successive occasions, starting with his partner some distance away, and ending with her on top of him, before finalizing the sequence by masturbating to the point of orgasm and then inserting his penis into her vagina just before he climaxes. In this series of steps, the woman would be encouraged to lend a helping hand by masturbating her partner firmly with plenty of lubrication.

We’ve observed that some men who’ve undergone this treatment are subsequently able to engage in sex and ejaculate much more easily. It’s almost as though a single act of release within the partner is enough to break down the psychological barrier and establishing a new behavior pattern. This is described in this new book on delayed ejaculation.

Unfortunately the technique often involves vigorous – if not rough – stimulation of the penis, and it does not, of course, address any relationship issues which may be at play.

Indeed, once intercourse is resumed, or more accurately once intercourse is again possible, the relationship issues that have been obscured by the delayed ejaculation often come bubbling to the surface very quickly. After all, not having sex will prevent many confliction issues from surfacing in a relationship.

It’s certainly true that a couple have to be highly motivated to solve this problem, and that good communication is absolutely essential, as is patience, mutual support, and a great deal of sensitivity.

The sensate focus technique, whereby a man is re-sensitized to the sensual input of his body during intimate relations, can be very successful in treating delayed ejaculation, with or without deep psychotherapy. There’s something about the relaxation and sensory input which allows a man who is ready for transformation to undergo some kind of internal change that allows him to “rewire” the neural patterns in his brain which appear to be responsible for the flawed sexual response that lies behind his retarded ejaculation, and allow him to ejaculate normally.

Perhaps the key factor in the success of this treatment is that a man already has a subconscious understanding that he is not getting the pleasure from sex that is his birthright, and he’s therefore ready to make the shift to a different way of approaching intimacy, physical stimulation and sex.

Although it’s occasionally of great benefit to a woman when her partner maintains an erection for a prolonged period of time without reaching climax, in the sense that she may be able to reach orgasm multiple times during intercourse, most of the time the situation just results in frustration, soreness, and irritability – not to mention self-doubt. The man will wonder what’s wrong with him, when he can’t achieve the most fundamental thing that men are expected to do with women, while the woman will wonder whether or not his failure to reach orgasm without receiving retarded ejaculation treatment – is due to the fact that he finds her unattractive.

The most fundamental dynamic of any sexual relationship is that the man has a deep instinct to penetrate and “give” to the woman, while she has a deep instinct to be penetrated and “receive” from the man. Anything that interrupts this dynamic will of course unsettle both partners.

Theory aside, what we’ve discovered in our practical sessions with men who seek out retarded ejaculation treatment is that about 80% of them will respond quickly to treatment, and in general another 16% will respond well to treatment over a prolonged period of time. And the form that this treatment takes? As we said before, it depends on the nature of the problem.

The form of DE that is acquired later in life is in fact slightly more common than the lifelong form. I’d say that it was also slightly more common for delayed ejaculation to be partner specific than generalized to all partners, which is a good clue that there are deep relationship issues at work in many cases.

If the man who has difficulty reaching his natural conclusion during intercourse has a very strict religious background, a degree of fear or anger against women, or a need to be in control in all situations, or if he has high levels of existential shame, then therapy needs to focus on both the sexual dysfunction and the deeper issues. And to turn sex back into a pleasure that produces joy rather than frustration,  the co-operation of the partner is essential, as is an approach that takes into account all the other personality traits which may be at play. These include perfectionism, anxiety, disconnection from the body, disassociation during sex, and generalized self-esteem issues.

It’s often also helpful to provide factual information about the nature of intercourse for an average couple (if any such thing exists!), and to provide a series of sensate focus exercises during which sexual contact is banned, so that the psychological pressure on both partners is reduced. In essence, sensate focus is one of our principal retarded ejaculation treatments, and works extremely well when a man is unable to ejaculate – the method is described on this website.

It’s also helpful to have some simple changes in routine such as extending the interval between sex so that mutual desire is higher; equally, changing sexual behavior so that the couple can focus on intimacy rather than orgasm as the expected outcome can be helpful.

Once again, this is about taking the pressure off the partners and removing the expectation that the man will have to reach orgasm. The very fact that it doesn’t matter whether he does or he doesn’t during a particular session of intimacy can in itself give both partners the permission to relax and enjoy the sensual aspects of their interaction.

This in turn often promotes greater arousal and desire; in this context, it’s a common experience for therapists who prescribe sensate focus to find that a couple will arrive for a session with big smiles on their faces – this is a pretty good indicator that the couple have reached a point where they naturally felt able to break through the “ban” on intercourse spontaneously.

The other useful thing about sensate focus is that it’s a progressive treatment which starts with a couple having completely nonsexual contact, and progresses through to full intercourse. Re-establishing connection with the sensual aspects of nakedness and mutual intimacy allows a couple to reduce their anxiety about sex and places their attention quite simply on what feels good.

Since most sexual arousal actually originates in the body anyway, it’s usually not long before a couple become aroused and wish to progress on to more overtly sexual contact.

Finally, it’s also important that a man who relies excessively on fantasy for his physical arousal is taught to respond to stimulation of his body instead. Moving from a place where a couple’s expectations are focused on orgasm to a focus on sensuality and physical pleasure instead can be the single most helpful factor in treating delayed ejaculation.

Video on delayed ejaculation