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Orgasms are great. You know it, and I know it. Often called the peak human physiological sensation, the urge to “have a genital sneeze” or “rub one out” is one of life’s great pleasures.

Unlike with women where orgasm is separate from the physical response of ejaculation, (and we can engage in orgasms over and over again) male ejaculation can often mean the end of sexual activity for the moment. Then your partner rolls over contentedly and falls asleep. Or gets up looking for pizza. Ejaculation, no matter how pleasant it may feel, is simply an unconscious reflex that is generated by the prolonged stimulation of blood flowing against nerves in and around the pelvis. I know it is a very clinical explanation for something that can feel so amazing. I spend a lot of my time talking to men about their orgasms. Some men have sorted out the sensation of orgasm as different from ejaculation. Meaning they can stay at the sensation of peak pleasure without the fluid, and continue prolonging the pleasure until they finally decide to “shoot some seed”. Ejaculation and orgasm happen almost instantaneously together but they are separate responses that make up what we call sexual climax. Doug Arama in his book The Multiply Orgasmic Man has a great understanding on how men can learn to separate out the difference of orgasm and ejaculation. I consider it a must-read for anyone wanting to improve their game sexually.

Given that premature ejaculation is so common, I’ve focused disproportionately on ways to solve those the too quick phenomenon over the years in my blog. With PE, there seems to be some solutions in sight given the success of some of the anti-depressants like Wellbutrin or other medications such as Percocet or Tramadol. I also like the new PE cream Promescent as a possible solution for quick ejaculation. But what do you do when the opposite is true? What happens when you just can’t seem to come? Or when you can only come through masturbation? It turns out that there more men are finding almost impossible in reaching orgasm.

Clinically the research suggests that 10% of men have difficulty ejaculating when they want to. I think it may be even higher than that given the increased number of men on anti-depressants and other medication that prevents ejaculation. It can mean anything from not being able to ejaculate during intercourse, to taking forever to come from any and all sexual pleasure. Or for some men, they even having trouble climaxing through masturbation. So if you are on anti-depressants, anti-anxiety meds, high blood pressure pills, or even Propecia for hair loss you might be experiencing a big problem filling the condom. These medications can lead to a delay in ejaculation in men who previously didn’t have any difficulty ejaculating. Traditionally sex therapists have had little training in the area of slow ejaculation. It was considered a good thing if you had a guy who could last all night without coming. Tell that to men who can’t come no matter how hard they try, or take an act of God with all the planets in alignment to get them to erupt. I see retarded ejaculation in men who are often what I call late bloomers who spent their adolescence and often their twenties with only their right hand as a partner. They have trained themselves to only come with their own hand.

So how do you treat delayed, or retarded ejaculation?

The longest established treatment for DE assumes that a man can work on his existing level of arousal, building on it by using techniques to increase his sexual arousal and desire. In essence,therapy can find ways to stimulate the man – with sexual fantasies and in the physical world – that work for him. DE can be a result of stress, fear of impregnating a partner (even with contraception), or a psychological desire for control. Counseling can help with the psychological challenges if there are any.

Pragmatically, other options include orgasm cream (sometimes called clitoral gel- I like the Pink brand) which opens up the blood vessels. You can turn down the heat in the bedroom (cooler temperatures make it easier to ejaculate), move the testicles up towards the body, or try some gentle vibration on the head of the penis or behind the scrotum on the perineum. Practicing with an artificial vagina, using cooling gels and hand stimulation until almost at the point of no return and positioning the penis close to the vaginal opening while there is direct stimulation on the glands may also help.

Increased arousal techniques might also work. These are exercises designed to sexually arouse him by touching his partner, both sexually as well as non-sexually; exercises to help him relinquish his need for control and techniques to desensitize him from whatever has become his accustomed method of gaining arousal.

Finally, if none of these things work there is a electrical current that can be gently applied near the prostate that helps men reach completion. It’s the technique used to get men with spinal cord injuries to produce semen samples.

I have a number of clients who are trying to get their wives pregnant and can’t. If you can ejaculate by hand, use a syringe (or the infamous turkey baster) to move the fluid up the vagina closer to the cervix. Nature should be able to do the rest.

So if you are struggling to feel sexually satisfied by having a full orgasm and ejaculation don’t give up. These are the tip of the iceberg of suggestions to help men more easily ejaculation. Send me an email at sue@sexwithsue.com and let’s talk about your satisfaction.