The Effects of Delayed Ejaculation

Delayed Ejaculation & Relationships

This case history represents a typical course of treatment for delayed ejaculation, but it has some unusual features.

It’s typical in that it actually describes many of the usual aspects of delayed ejaculation, that’s to say the emotional aspects and the relationship aspects that are deeply rooted in the developmental history of the partners.

At the beginning of therapy the man in the relationship, John, aged 37, came to see the therapist because of sexual problems.

He explained that he’d been living with his partner for three years, who was slightly younger than he was: Helen, who was 35 years old, a nurse who appeared to have a great deal of tolerance and understanding of his sexual difficulties. Both partners described sex in the relationship as “difficult” and “conflictual”.

Although initially sexual intercourse produced only a little difficulty in ejaculating, these difficulties had become worse as time had gone by.

John’s inability to develop an erection, sustain it, penetrate his partner, and continue thrusting to the point of ejaculation had caused Helen a great deal of stress and anxiety. Indeed, he now reported losing his erection during intercourse. This sometimes happens as a consequence of delayed ejaculation issues.

However this was not the extent of his difficulties, for he could not achieve orgasm in Helen’s presence under any circumstances.

Regardless of how she applied stimulation – manual, oral, or any other form – his sexual responses were slow, delayed, late or non-existent.

In short, John could only reach orgasm during masturbation on his own. He told me he could easily achieve an erection during masturbation and relatively easily achieve orgasm, although his pattern of masturbation was what is known as “idiosyncratic”.

Idiosyncratic masturbation and problems reaching orgasm


In other words, he didn’t use his hand on his penis, but he rubbed his penis against the mattress or his clothes whilst lying on his abdomen.

This is a way of masturbating to climax commonly seen among men with delayed ejaculation. Whether this masturbation technique is a cause or a consequence of retarded ejaculation and ejaculatory inhibition is still not quite clear.

Indeed, on the few occasions that he had attempted to masturbate with his hand he had been unable to bring himself to orgasm and ejaculate.

He said that he used this method of masturbation because of the extreme insensitivity of his penile glans.

A urologist reported that John had no phimosis (tight foreskin), and therefore there was no reason why his foreskin would not retract normally, he did have a case of frenulum breve, which has been associated with premature ejaculation.

Phimosis and frenulum breve – causes of delayed ejaculation?

To complicate matters further, John readily admitted that he had a tendency to use fetish oriented sexual fantasies which generally involved women wearing latex.

John also said he had a degree of vaginal aversion, a fact confirmed by his partner, who said that when she asked him to touch her genitals, he became markedly stressed.

However, it turned out that the issues which probably underlay John’s delayed ejaculation were not unique to him: Helen herself a number of sexual issues which were not at first apparent, and only became clear on detailed questioning.

She claimed that a normal ability to become sexually aroused, but this was at variance with her reported difficulty in achieving orgasm, letting go of control in the presence of a man, and her concerns about her inability to become pregnant in the relationship with John.

John had grown up in a household where his father was unassertive and his mother dominant; he had been, as he said, “the chosen one”, by which he appeared to mean that his mother had established a closer relationship with him than any of the other children (four siblings, all boys). The subjective feel of the therapist was that this was a major element of his delayed ejaculation.

Male Delayed ejaculation and Sexual Taboos

Sex was not openly discussed in his family, although even if it had been, John reported that he would under no circumstances have approached his father with questions about sex and sexuality. He said his father regarded sex as a “waste of time”, not “something to linger over”, and he always held back on sexual discussion…
During puberty John said he had been a slow or late developer, and reported being far too shy to approach girls, simply fantasizing about them wearing latex clothing, and achieving sexual release by thrusting against the mattress in bed at night.

He gave up hope of ever having a relationship, and, despite the delay in his ejaculation, regarded it as somewhat miraculous that he had established what appeared to be a satisfying relationship with Helen.

Helen’s family environment was chaotic as a child: her father was an alcoholic, her parents fought frequently, and she was deprived of both material and emotional comfort.

She reported that her drunken father often demanded sexual satisfaction from her mother in front of Helen, and that when the mother finally left her husband because of the abuse, she simply replaced her husband with a series of male partners, one of whom abused Helen at the age of 10.

Initially Helen could not recall this event, and the inhibition of her memory only relaxed as therapy progressed. Her mother regarded Helen as a source of emotional support, which she regarded as both a nuisance and an obligation. She had also been slow to develop her sexual responses, and felt there had been a delay in experiencing her first orgasm.

During puberty she developed sexual interests and had always had a boyfriend, although she had problems reaching orgasm during partnered sexual activity. She reported that masturbation had always led to orgasm, but she seldom masturbated because she feared “losing control”.

During her previous marriage she had been asked for sex on many occasions by her husband, and came to the point where his demands felt excessive. She therefore stopped having sex with him on a regular basis, but even so was deeply hurt when she discovered that he had been having relationships outside the marriage.

This was when her relationship with John had flourished: both of them felt trust and affection for each other, but the sexual feelings seem to be somewhat lacking. In addition to this, the major difficulty, as reported before, was that sexual intercourse was unsuccessful and Helen wished to become pregnant.