The Guide to Getting It On (119 page)

Again, the goal of this approach is to focus on pleasure rather than on orgasm. You’re trying to help him experience more pleasure and excitement. Technically, you’re trying to storm the guard that’s keeping sensation away from his orgasm trigger. You’ll need to be sensitive to how much he can handle. Some men will enjoy whatever you’ve got to throw at them. Others will reach a point of overload, after which all you are doing is increasing their resistance.

Note:
Some therapists advise that the man not attempt to have intercourse until he can actually feel that he’s sexually excited as opposed to just having an erection. Hopefully, you really will focus on pleasure as opposed to ejaculation. Sex is about sharing pleasure. Even if he never ejaculates, he might learn how to feel more pleasure and joy than guys who are able to come on command.

Harsh, Draconian Masturbation Techniques!

You’ll hear a lot about the possible role of masturbation in men with delayed ejaculation. There are at least two factors to consider: the physics or mechanics of how a guy strokes himself, and the fantasy he calls up to help himself get off. We’ll consider the fantasy aspect in another section.

One of the few researchers who has actually studied delayed ejaculation feels that super vigorous or unusual masturbation habits can be a contributor in some cases. He thinks that changing masturbation habits is essential in situations where the guy pounds his meat like he’s making chicken fried steak. This researcher often tries to get the man to stop masturbating for several weeks or months, with the hope that he will have to rely on his partner to help him come. When the man does masturbate, a goal is masturbate in a way that is kinder and more gentle. He’s encouraged to use his other hand, or perhaps to use oil in a way that makes masturbation more like intercourse.

If a forceful masturbation technique is the source of the problem, you don’t want intercourse to have to compete.

Sunny Side Up

Masturbating face down is thought to contribute to delayed ejaculation. If you have trouble coming and masturbate face down, see if you can teach yourself to start stroking it when you are on your back or while standing up.

Masturbation-Gone-Wrong? Or Is This One of Those Chicken-Egg Things?

One trouble with the masturbation-gone-wrong theory is that there are plenty of men who pound their meat mercilessly and have no problem ejaculating during partner sex. There may also be guys who masturbate face down and whose partners find them to be prolific comers.

So if these are problems, maybe they are only problems for certain guys who have some of the other contributing factors that we’ve talked about. Perhaps the man’s penis is less sensitive than most, or his threshold to reach ejaculation is higher, so he learned to masturbate the way he did because it’s the only way he can have an orgasm. If that’s the case, his strange way of masturbating isn’t the cause of the problem, but the result of it. Still, it’s hard to see a downside to at least try to change hands or ease up on the grip, or to masturbate face up rather than face down, or to turn over the reins to a significant other.

The Role of Fantasies

It’s possible that some men with delayed ejaculation have specific fantasies that they need in order to get off. But the realities of having sex with a partner might get in the way of being able to call up those fantasies.

Let’s say a guy has a secret fantasy where his partner is stroking his penis with her feet, or maybe she’s dressed in a special corset, or she pees on him, or he or she is being gang raped by Dopey, Grumpy, Happy, Bashful, Sneezy, Sleepy and Doc. These fantasies might work great for him when he’s strokin’ it alone. But how does he lose himself in them when he is having intercourse with a real-live partner whose physical presence is a sad reminder that the Seven Dwarfs are nowhere to be found?

One of the challenges for him and his partner will be to allow enough of the fantasy to safely emerge to help him get off during intercourse. This means that exploring masturbation fantasies might be fruitful in some cases of delayed ejaculation. This might not be a problem if what turns a guy on is his partner wearing a certain bra or maybe a pair of pantyhose with the crotch cut out. Most women won’t be offended by those kind of requests; some will even be turned on by them.

But things can get a little dicey when his fantasies are at the extreme end of good taste and propriety, or when he feels guilty about them. It can be particularly difficult to share a fantasy with a partner when he needs the same rigid scenario to get off each and every time. The partner can begin to experience sex as a mechanical ritual.

For That Rare Man Who Doesn’t Abuse Himself

There are situations when a man with delayed ejaculation can’t or won’t masturbate. If that’s the case, you might start to explore the reasons and beliefs that are behind that decision. This will require introspection, which is not necessarily the hallmark of males, let alone those with delayed ejaculation. Some men who are too embarrassed to masturbate might try doing it in stages. They can start while they are home alone, and work up to where they can do it when their partner is home but in a different room. Eventually they might try to do it when she’s in the same room but without the lights on.

When Porn Might Help

It could possibly help for a man to watch porn just before or while he is making love. The rationale is that it might increase his level of stimulation or excitement. This could theoretically help him learn to ejaculate during intercourse, or at least learn to associate ejaculation with the feelings of intercourse. Think of it as the ejaculatory equivalent of using training wheels. On the other hand, there’s absolutely no science to back any of this up.

Streaming your favorite porn while making love might not sit too well with your partner. On the other hand, it could be absolutely fine with her. So it’s important to talk it over first.

We consider the possibility that porn might help a person with ADHD to focus better while making love in the last part of this chapter.

When Porn Might Hurt

As a result of watching so much porn, you may have conditioned yourself to need more visual stimulation than most men in order to come. It’s unlikely you’ll get the kind of visual hyperstimulation from real-life lovemaking that you get from porn.

If you watch a lot of porn and have delayed ejaculation, weaning yourself from porn might be a sensible thing to try. Unfortunately, there are no easy answers.

Threshold Clinging

A consultant to this book offered his own theory on delayed ejaculation. When most men feel the sensations that tell them they are about to ejaculate, they either choose between letting themselves ejaculate or slowing down or changing positions in order to delay coming. However, some men with delayed ejaculation seem to have trained themselves to automatically go the other way once they start to feel an increase in sensation. That is, they mentally decrease their sensation or level of excitement even though they are still thrusting at the same speed.

This urology specialist advises the men to stop intercourse once they have backed away from the point of no return more than three times in one session of lovemaking. He feels that to keep thrusting away simply reinforces the tendency to delay ejaculation, which only teaches men to become even better at delaying ejaculation.

Unfortunately, this is anecdote rather than science, but it might have meaning for some readers.

Old Advice vs. New

It used to be that the advice for dealing with delayed ejaculation was to try having intercourse in novel situations or in places where there might be additional excitement from the lack of familiarity, like in the kitchen or in the back seat of a car. However, this doesn’t seem to be mentioned in the more recent articles on delayed ejaculation.

This novel-situation approach attempts to distract the man from his usual modus operandi where he’s thought to be the master of control. The goal is to help him relinquish his need for control, assuming that’s one of the things that might be causing the problem.

Another strategy has been to have the man bring himself close to ejaculating with his own hands, and then quickly put his penis in his partner’s cheering vagina and begin to thrust away. Hopefully he is able to ejaculate. As a result, he can start to appreciate that he can ejaculate inside of his partner without the world coming to an end. However, this assumes that he and his partner will find this to be of value as opposed to being yet another form of torture and torment.

Sex Toys?

Sex toys, including a vibrating cock ring or vibrating butt plug, might provide the extra stimulation that some men need to help them ejaculate during intercourse.

Just Imagine

One thing that sex therapists sometimes ask couples to do is to imagine what would happen if the problem were to suddenly disappear. The point of this is to see if certain fears or concerns might emerge.

Is there something about the problem that’s keeping both partners within a certain comfort zone? Would the man’s partner worry he’d want sex more often if he didn’t have the problem? Would he be tempted to try his newfound skills on other women? Would he be concerned that his partner might make new demands on him, or would he sense a loss of control? None of these fears need to be grounded in reality in order to be impacting sexual response.

Are There Drugs That Can Help?

In a word, none, as of press time. No drugs have been approved for delayed ejaculation. Dopamine agonists and anti-serotonergic drugs have been tried, but side effects can be significant and there doesn’t appear to be anything on the immediate horizon.

ADD, Bipolar Issues and Abuse As Contributors

A very perceptive sex therapist who has treated men with delayed ejaculation believes that some of his patients with attention deficit and bipolar issues might be at risk. He feels that some men with ADHD and bipolar problems could have trouble reaching high enough levels of sexual excitement to ejaculate during sex with a partner. This is because they are tuning in to everything in the room as opposed to the sex they are having. He wonders whether some of these men watch porn while having intercourse in order to to help them focus on the sex so they can eventually ejaculate.

If you have delayed ejaculation and struggle with attention issues, perhaps his observations will be meaningful for you. While no one is encouraging you to have porn blaring on a 60-inch screen during intercourse, perhaps there are things you and your partner can do to help keep you more focused on the sex you are having and on the building excitement in your body.

This same therapist has also seen men who were sexually abused as boys who he feels may have trouble ejaculating as a result.

RECOMMENDED READING:

Michael Perelman’s chapter on delayed ejaculation in the
Principles and Practices of Sex Therapy 5th edition,
edited by Y.M. Binik and K.S.K. Hall, Guilford Press, 2013.

David Rowland’s ten-page section on delayed ejaculation in his book
Sexual Dysfunction in Men,
Hogrefe Publishing, 2012.

Additional Resources:
Marcel Waldinger’s 2007 chapter on delayed ejaculation in the 4th edition of Sandy Leiblums’
Principles and Practice of Sexual Therapy,
and Perelman and Rowland’s chapter on delayed ejaculation in David Rowland’s 2008
Handbook of Sexuality and Gender Identity Disorders.
Special thanks to Stephen Braveman and Joe Marzucco.

CHAPTER

56

When Your System Crashes

W
hile this is a chapter on sexual problems, please keep in mind that it’s only a brief overview. You are encouraged to read articles and books on sex that offer a more detailed perspective, and check with a sex therapist or physician as needed.

This chapter starts with male trouble and ends with female trouble.

Deadwood—The Bummer in Your Pants

It is amusing to look at the impotence ads in the sports section of major newspapers. They are usually located next to the ads for hair removal and hair restoration, above the ads for nude female mud wrestling and sometimes on the same page as the penis-enlargement ads. Most of the men in the impotence ads are older, same as they are on TV.