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Men's Secret Sex Problem

Many men have difficulty with ejaculation and orgasm.

Men and the women who love them have heard of two sex problems that hit men below the belt, premature ejaculation (coming too soon) and erectile dysfunction (ED). But men may also develop a problem few have ever heard of, difficulty experiencing ejaculation and orgasm (E/O). When men develop E/O difficulties, they often believe they're all alone, that no one else could possibly face this situation. Wrong.

Non-ejaculation is men's secret sex problem. It can develop at any age, teens to elderly. According to the "Sex In America" surveys (1999 and 2008), It affects 28 percent of men under 50, 16 percent of those from 50 into the early sixties, 23 percent from age 65 to 74, and 33 percent of men 75 and older. Fortunately, E/O problems can usually be resolved with self-help and/or sex therapy.

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Many Possible Causes

Masturbation style. Some men self-stimulate in a particular way and train themselves to trigger E/O in that way only. Without knowing the man's erotic idiosyncrasies, a lover may not be able to help him get there. Palo Alto, California, sex therapist Marty Klein Ph.D., says "I've counseled guys who yank their penises harder than any woman ever would."

Stress. Sex therapists say that several emotional stressors may be associated with E/O difficulties: anger at one's lover, fear of pregnancy or sexual infections, or a fundamentalist religious upbringing. "I've seen ejaculatory problems linked to strict Catholic, Protestant, and Jewish upbringing," says Fair Oaks, California sex therapist Louanne Weston, Ph.D. "It's not the religion. It's fundamentalism's sex-negativity."

"Delivery boy" attitude. Lovemaking involves giving pleasure and receiving it, but some men believe their only job is to give it. "When a man pays too much attention to his partner's experience, and not enough to his own," Klein explains, "he loses erotic focus, which can interfere with ejaculation and orgasm."

Drugs. Antidepressants are notorious for impairing E/O. Alcohol is usually associated with ED, but in some men, it causes E/O problems. Many other drugs may also cause E/O impairment: pain relievers and blood pressure medications, anti-anxiety drugs, and psychiatric medications, among others.

Aging. "As men age," says Bloomfield Hills, Michigan, sex therapist Dennis Sugrue, Ph.D., "they notice that their penises need more stimulation, sometimes, a lot more, to trigger ejaculation. This is normal, but often disconcerting."

Weak pelvic floor muscles. Aging also weakens the muscles involved in E/O. When this happens, semen doesn't spurt, it dribbles, and orgasms may provide little pleasure.

Medical conditions. Neurological conditions (diabetes, paraplegia, multiple sclerosis) might damage the nerves that control O/E. Surgery for benign prostate enlargement has no effect on orgasm, but it eliminates ejaculation.

Resolving E/O Problems

First, consult your doctor. Your physician should investigate possible infections, drug issues, or pain or neurological problems. For antidepressant-induced E/O problems, ask if you can to switch to Wellbutrin. It's as effective as other antidepressants but less likely to cause this problem.

Practice Kegel exercises. These simple, discreet exercises tone the pelvic floor muscles, intensifying orgasm and strengthening ejaculation. To learn Kegels, visit GreatSexAfter40.com and read the article.

Value your erotic context. The myth is that men can function sexually under almost any circumstances, while women can enjoy sex only under a number of pre-conditions-a nice dinner, flowers, clean sheets, and a man actually interested in what they have to say. But men also have pre-conditions for satisfying sex, and as men age, the context becomes increasingly important. To trigger E/O, you may need particular conditions. Identify yours and work with your partner to provide them.

Value your own pleasure. You're more than a delivery boy. You, too, deserve erotic satisfaction and have every right to ask for the stimulation that produces it. If you engage in vaginal intercourse, it may not provide enough stimulation for E/O. "You may need very vigorous manual or oral stimulation," Klein says. "If so, ask for it."

Coach your partner. Most men with E/O problems can masturbate to orgasm. Show your partner exactly what works for you, and coach her to provide it. You may feel bashful about masturbating in front of her. But it not only teaches your lover what you need, it also involves self-revelation, which deepens the intimacy in your relationship.

Breathe deeply. It relaxes the nervous system so that erotic stimulation can trigger E/O

Heat up your fantasies. Recall the fantasies that have helped you with E/O in the past. Elaborate on them. (They need not include your lover.) They just need to arouse you. Or try X-rated videos.

Use lubricant. Sexual lubricants make the genitals more sensitive to touch, and often help resolve E/O problems.

Read a book. The one most often recommended is Becoming Orgasmic: A Sexual and Personal Growth Program for Women by sex therapists Julia Heiman, Ph.D., and Joseph LoPicollo, Ph.D. Though aimed at young women, the program also works for men of all ages. Its message is that each of us is responsible for our own sexual satisfaction. A lover can create an erotic context that allows E/O. But no one "gives" anyone else an orgasm. Orgasms emerge only when we let them.

Consult a sex therapist. If self-help doesn't provide sufficient relief, sex therapy can usually resolve E/O issues. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists, the Society for Sex Therapy and Research, or the American Board of Sexology.

San Francisco journalist Michael Castleman, M.A., has written about sexuality for 36 years. more...

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