Delayed ejaculation


Dear Dr G,

I am a 26-year-old, who is reasonably fit. I smoke and drink occasionally with my friends during the weekend.

Admittedly, I have minimal sexual experience, apart from “self-indulgence” since the teenage years.

I recently met this girl, and we have engaged in several occasions of sexual intimacy.

However, I have a problem of achieving orgasm during intercourse.

Sad to say, I could rise to every occasion, but failed to ever experience the happy ending during sex!

Don’t get me wrong, when I masturbate (which I often do), I still manage to ejaculate normally.

However, I just cannot manage to reciprocate the experience when I engage in “real sex”.

Sometimes, despite 20 minutes of “marathon sex”, there was still no outcum!

Can you tell me what is happening to me? Is this related to excessive masturbation?

Is this treatable? Is this condition common?

I know it might be a dream come true for most guys to be the “marathon man” between the sheets.

Truthfully, I am running out of steam and just hope to be normal in the bedroom, like any other guy. So, please help me!

Regards

Marathon sex man 

The inability or persistent difficulty for men to achieve climatic orgasm, despite normal sexual desire and stimulation is a condition recognised as delayed ejaculation.

In a normal circumstance, a man should reach orgasm, within a few minutes of active thrusting during sexual intercourse.

Although the intervals can be variable between individuals and sexual partners, the average time for men to ejaculate should be between five and eight minutes, from the point of penetration.

A man who encounters delayed ejaculation - also known as retarded or inhibited ejaculation - does not typically reach orgasm unless after prolonged intercourse that may last up to 45 minutes.

According to the International Society of Sexual Medicine, such condition is encountered by around 8% of sexually active men.

Although the vast majority of men with such condition may have delayed ejaculation only under certain circumstances, in severe cases, the sufferers cannot ejaculate at all during sex.

Whichever the degree of difficulty, this often generates frustration in the relationship!

The typical men with delayed ejaculation observe the normal ability to perform during masturbation, but fail to climax during intercourse.

It is speculated the sensation a man feels when masturbating bear little resemblance to the experience of true sexual intercourse.

According to some researchers, the other association of delayed ejaculation with masturbation is the intrinsic link of visual input of pornography.

As the excitement of “real sex” may not be comparable with the pornographic images, the threshold of ejaculation is often unachievable.

Psychological factors such as performance anxiety, distraction from environment, insufficient sleep and relationship issues are thought to contribute towards such sexual dysfunction.

Well recognised medical causes of delayed ejaculation also include hypothyroidism, pituitary disorders, prostate operation and excessive alcohol consumption.

Other common etiology may also be the side effects of medications such as morphine, benzodiazepine and SSRI group of antidepressants.

The treatment of delayed ejaculation often involves the sex therapist advising couples to go through stages of “sexual assignment”.

The aim of the exercises is to help men to familiarise with achieving orgasm through normal intercourse.

Although this may sound straightforward, the idea of going through steps of masturbation in front of the partners and slowly progressing to insertional intercourse is often awkward and has poor "outcum".

The All-American Football Player and decathlete, Lewis Howes once said: “There is no way to become great overnight, but in the marathon of success, it takes a lot of intention to see you through each day of the journey.

When Dr G is put on the spot, he sees many resemblances of sex with sports: “There is no way to become great overnight. In the bedroom, it takes a lot of love and couple 'exploration' to see you through the sexual journey!”

On that note, I wish our bedroom marathon man less of “self-indulgence” and healthier lifestyle.
Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Putting Dr G on the spot” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at askdrg@thestar.com.my