![]() ![]() Men with ejaculation problems undoubtedly have feelings of inadequacy, feelings of failure and a negative view of themselves. ![]() Overcoming an ejaculation problem when under stress and pressure from a partner is extremely difficult for any man.Įjaculatory problems can have a devastating affect on self-esteem. Otherwise, the partner’s frustration and distress may contribute to the continuation of the problem. This helps to insure a successful treatment. If the man is in a relationship, he needs the support and understanding of his partner. Resolving the problem is most successful when both partners can work together as a team toward a successful solution. Thus, ejaculatory dysfunction is always perceived as a couple’s issue. In spite of the lack of information regarding delayed ejaculation, the most successful approach, for sex therapists, is to engage both members of the couple into addressing the problem. For many men, feelings of shame prevent them from seeking medical and professional help. Unfortunately however, problems such as delayed ejaculation seldom disappear without professional intervention. At other times, there is the hope that ejaculatory problems will disappear without proper treatment. In many cases, the man himself may tend to delay treatment or to minimize the distress of the situation. For many men, finding the right professional, who has experience and realizes the seriousness of the problem may be one of the most difficult aspects in the treatment process. It is not unusual for doctors to minimize the dysfunction and to dismiss it. In addition, they are not well understood by most medical doctors and urologists. Problems of delayed ejaculation tend to be somewhat rare and not well understood by psychologists and sex therapists. Does this difficulty occur with self-stimulation, with all partners or with specific partners? This question will ultimately be important as a treatment program is designed and implemented. As a result, an important diagnostic question for sex therapists is the context in which the problem occurs. Interestingly enough, ejaculatory issues are rarely defined as a dysfunction if they occur only during masturbation. The psychological definition of delayed ejaculation refers to the inability to have an ejaculation during sexual intercourse. ![]() Other sexual dysfunctions such as low desire and erectile dysfunction may also accompany the ejaculatory problem and need to be addressed. In addition, a medical history is obtained paying particular attention to any previous neurologic injury or trauma to the penis. In such cases, penile sensitivity may be evaluated using various instruments that produce vibration. From a medical perspective, ejaculatory dysfunction is often considered to be a nerve related issue. In this manner, any medical considerations that contribute to the problem can to be understood from the onset. Regardless of the psychological issues, a good medical or urologic work-up is always encouraged before embarking on a behavioral treatment program. Issues such as depression, anxiety, past sexual experiences, psychological trauma and relationship history are important considerations that need to be discussed early in the evaluation. From an emotional standpoint, it is important to understand the history and background of the individual. In this way, both the emotional and physical aspects of the problem can be addressed. In the vast majority of cases, the most effective therapeutic approach for ejaculatory dysfunction is a combination of biologic and psychologic therapy. This column will explore some of the psychological factors and treatment options related to these two distinct male dysfunctions. These are: delayed ejaculation and early ejaculation. Typically, ejaculatory disorders fall into two categories. What may be a problem for one man may be acceptable to another. This time period is called the ejaculatory latency. The time from initiating sexual activity to ejaculation varies from one individual to another. When does an ejaculation problem become a disorder? This is a subjective question and is based on the level of distress that is experienced by the man or his partner. In contrast, ejaculatory problems continue to be commonplace among men and often create feelings of shame and embarrassment for those men who struggle with this difficulty. With the introduction of Viagra however, problems of erectile dysfunction are much less frequent and more easily treated. Early and Delayed Ejaculation: Psychological Considerationsįor men, erectile dysfunction and ejaculatory problems are the most common sexual difficulties. Ricardo Munarriz, a sexual medicine physician. Stanley Ducharme, a sex therapist, and one by Dr. Please be advised there are two sections on this topic, one by Dr. Ejaculation Problems: Too Fast, Too Slow or Not at All? ![]()
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