Situational Retarded Ejaculation

Many of the RE patients I have treated had given up on partner sex completely out of sheer frustration. Most had been getting their sexual release exclusively from masturation, and most of these supplimented or replaced their masturbatory fantasies with hard core pornography so widely available on the internet. I had read that atypical masturbation can cause RE but I'm wondering if heavy pornography use might also play a part.

This therory gets complicated in situational RE where the patient can ejaculate with some women but not others; but it may partly explain the theory of the Coolidge Syndrome mentioned earlier in this thread .The level of arousal during first time sex with a new partner comes close to the intense arousal they feel watching porn. Perhaps it is the LEVEL OF AROUSAL that needs to be high before these men can ejaculate. I'd like to se a study done to discover the relationship between pornography and RE also looking into the question of whether the patient turned to masturbation and pornography AFTER suffering the RE or perhaps, whether the RE itself could be caused by an ejaculatory threshold artificially raised by months or years of pornography use.

I think the level of sexual arousal you get with porn is the same as guys get with a first time partner. Because with porn it's a different fantasy every time. Whether or not heavy porn users also feel the need to change partners frequently is doubtful because many of the heaviest porn users are married men.

In my case I can no longer ejaculate with my wife but I can with porn and prostitutes. I think some men do have a high arousal threshold and need intense visual stimulation in order to have an orgasm. And it seems the longer you are married the higher the orgasm threshold. That's what happened to me.

Somebody mentioned atypical masturbation practices as one cause of RE. Compulsive masturbators also have a high incidence of retarded ejaculation during partner sex although not with masturbation. The reasons for the compulsive masturbation are similar to the RE patient who may not be classified as a compulsive masturbator. Anxiety, low self esteem, lonliness, poor social skills are the hallmarks of patients with this problem. The similarities are so prevelent that it makes me wonder whether compulsive masturbation is the result or the perhaps sometimes the cause of RE.

In long term marriages, the sudeen onset of retarded ejaculation or psychogenic erectile difficulty is usually caused by the husband no longer finding his wife sexually attractive. If these men have affairs or visit prostitutes both the RE and the ED seem to dissapear.

When it is an attraction problem that is causing the dysfunction, these problems are basically untreatable and a sexless marriage is usually the long term outlook.

i have had some success in treating married men with RE who's dysfunction is caused by little or no sexual attraction to the partner with daily doses of bupropion (Wellbutrin SR) at dosages between 150 and 300 mg (Wellbutrin XR)

The medication seems to promote sufficient arousal in most RE patients for them to achieve vaginal ejaculation/orgasdm. The reason(s) for the non attraction to the partner (ie: physical issues, anger, performance anxiety) seem to take on less importance or are overridden by a newfound level of sexual arousal and the feeling of need to experience orgasm.

I have not been able to find much to back me up but I do believe that what has up to now been looked upon as a psychogenically caused dysfunction may very well be physical. It would be interesting to do a study to see if dopamine levels in the brain are lower in RE patients causing them to have a higher desire threshold and a greater sensitivity to the visual, psychological and physical aspects of the sex act. A sensitivity, which in most people, is overriden by strong sexual desire.

Studies with both humans and animals are showing the relationship between dopamine and sex and bupropion and dopamine. I am providing two links for further information.

http://www.biopsychiatry.com/bupropion-dopamine.htm

http://www.biopsychiatry.com/dopaminesex.htm

Wellbutrin does work fairly well in treating situational retarded ejaculation, but one drawback I have found is that the most dramatic aphrodisiac effects tend to wear off after a few weeks as the body grows accustomed to the drug. It is in these few weeks that the most progress toward vaginal ejaculation can be made.

Even though this raised level of desire begins to wear off (more in some than others) Wellbutrin does seem to keep sexual interest levels raised to a level slightly greater than before the drug therapy was started. But the first few weeks of significantly raised sexual desire are extremely important as they can do alot of good psychologically for the patient as he tends to gain more confidence after finding he can ejaculate normally with his partner.

I cannot stress enough the importance of refraining from masturbation as this can defeat the progress made with Wellbutrin. It is important to monitor the patient's progress as his level of arousal drops after the initial boost so he does not become discouraged and return to old masturbatory habits.

I actually suffer from this problem (always have), and I'm currently trying to get past it.

I realize everyone's different, and I only speak for myself, but maybe this will help shed some light on the matter, and help others with similar problems. I've only recently become aware that this is a problem other people do actually suffer from.

In my case, I believe there are a combination of causes, both psychological, and physical.

First, here are my "symptoms" and some of my history.

1.) Shyness, or what I call "stage fright" - I can perform sexually just fine, but if I am to have an orgasm with somebody, I must concentrate very intensely, and repeat a repetitive motion for a very long time (sometimes an hour or even two).

A very important side note: I also have difficulty urinating in public, but do just fine when nobody is around - the feelings (or lack thereof) are very similar.

2.) When I masturbate I typically come close to reaching an orgasm every 5 minutes or so, but typically hold off purposely for up to an average of 20 minutes - so I have no physical problem reaching an orgasm - when I'm alone it's a given that "things will work".

3.) I usually masturbate to pornography either on television or computer - fairly frequently, about two to three times a week on average.

4.) When I masturbate, I'm very fascinated with men reaching an orgasm, especially on a woman,and especially involving oral sex. When watching a video, I typically fast forward to the end of each scene to see it, and typically hold my orgasm until I do see it. Pornography that I download is the same thing. (not sure if that's important, but I think it may be)

5.) What I feel when I'm trying to reach an orgasm is basically numbness. Not a tingly, leg fell asleep type of numbness, but just a lack of sensation (NOT a lack of desire or interest). I can feel an orgasm slowly building, but then it will level off - I will mentally note that "it aint going to happen" and it goes away leaving a feeling of nothing. At this point, sexual stimulation still feels good, but I know it will take a very very long time to get back to an orgasmic state.

6.) At that point, there is no apparent feeling of guilt or other negative emotions - for example I'm not consciously feeling bad about myself, or thinking about something in the past. The one negative thing I do feel is guillt about making my partner endure what I'm sure will be a long boring session to bring me to completion.

7.) I had sex with about 5 women before I ever reached an orgasm with another person. The girl that I finally reached an orgasm with had me straddle her and masturbate myself onto her breasts. What made the orgasm possible for me was the combination of me being able to masturbate myself, the "dirtyness of the act" and most importantly, the fact that I could hide my face from her over the head of the bed.

8.) Since then I found it somewhat easier to reach an orgasm with a partner, but that's relative to a zero success rate. With about 10 other women, I typically succeeded once out of 5 to 10 tries.
When I'm successful it almost always involves my face being hidden.

9.) I now have a wife who is extremely beautiful, and in very, very, very, good shape - I'm extremely attracted to her both mentally and physically. So there's no lack of interest on my part whatsoever. I have to stress this point because so many of the postings talk about a lack of desire. That is SO not the problem for me, and I believe most others. In fact, I find it even more difficult to reach orgasm, and even maintain an erection when she wears sexy outfits, as much as I enjoy looking at her. I get a sense that she's "way too good for me".

10.) I've found that sometimes it's been easier to reach an orgasm with a woman who is less attractive. If I feel "superior" in the looks department, it does help (but not totally cure) the problem.

11.) I have a history of very very low self esteem, although I've overcome this to a large degree (another relative thing).

12.) I started masturbating at a young age, and remember my fantasies very vividly. At about 4 or 5, I was too young to know about sex between a man and a woman. I fantasized about being food - as funny as this may sound. I would fantasize about a big giant sticking me between two big peices of bread and eating me. The fantasy was always the moments before being eaten, not actually being chomped on. This later went on to other things like being on a table covered with food that people were eating.

Why I think this is important is that I went on to develop some very strange eating habits. At about age 5 I became very embarrassed about eating certain foods. When my parents wanted me to eat something new, I felt somewhat VERY embarrassed - and insisted that they close the doors and shades so nobody could see me do it. I somehow got sex and food mixed up.
not so unexpectedly, I developed quite the oral fixation - I love to perform oral sex, and watch oral sex (woman performing on man)related pornography almost exclusively.

Also important to note is that I've never reached an orgasm through oral sex - not even close - even though it's by far my favorite thing to receive, both on a phsyical level and a mental level.

Something may be there with the embarrassment of food problem. Sometimes I think that being forced to eat strange food was almost like being made to have sex in front of my parents. Something to give some thought to anyways.

13.) my childhood was a mess. Extreme mental abuse by teachers(nuns - damn them)/classmates/father - mostly just constant ridicule - left my self esteem level at zero. Some physical abuse by the nuns/lots more by my father - he drank a LOT and took a lot of his frustrations out on the walls, using me to do it, but never with my siblings. I remember in 4th grade seriously wondering why they didn't make desks enclosed so people wouldn't be able to see you. By 5th grade I was EXTREMELY introverted, talking to nobody but my siblings, and through them to strangers in public. My mother was ok, unless she was drunk - I remember her thing was being disgusted by me for looking "so goddamned goofy" as she often put it.
By seventh grade, all sorts of other problems - I began to purposely cut and scrape my arms and hands constantly etc. etc.

Began seeing psychiatrists and psychologist from 7th grade on. Made some pogress.

14) the first girl I had intercourse with bled like a stuck pig. It was dark, everything got wet and sticky - like EVERYTHING - she got up and put the lights on and it looked like a very brutal murder scene. I was lying in a puddle of blood on the bed, blood all over my chest, legs, hands - she was covered with blood. I literally thought I killed her. She went on to have to tell her mother about it becuase she continued to bleed through the next day. So I was off to a pretty good start in my sexual career.

Ok - so some conclusions I've come to in my quest to beat this problem.

Mastrubation techniques and frequency DO have an effect.
Using a "rubbing the penis on something - like a pillow" technique - does seem to develop a need for a slight amount of texture to reach an orgasm. A vagina, mouth, or even a well oiled hand are a little too slippery to do the trick. Plus the required frontal pressure is hard to achieve with another person. So by doing this masturbation technique less, and relying on my hand more, I have made some progress. And I've gone back and forth from one technique to the other enough times to find that it does make a difference. As for frequency - I find that abstaining completely can be counter productive if actual sex is not very frequent.

I find that if I wait too long between masturbation sessions it becomes more difficult to make myself reach an orgasm, even alone. It becomes almost a technical challenge. However, I do believe that SOME time off helps. there's sort of a bell curve, a day between, things are just ok - wait a little longer up to about 4 or 5 days and things work much more easily, wait too long and they start getting more difficult.

But all that's far from a "cure"

Next - the "need to please" is very strong with me. I enjoy sex the most when I feel "desired". If I get even the slightest hint that my partner is killing time and is just trying to get me off - all bets are off when it comes to reaching an orgasm, and sometimes in even maintaining an erection. I feel this is definitely related to self esteem, as is the need to bury my face in a pillow, or stay somehow out of sight.

The only way I feel this can be overcome (which I'm still working on) is to open the issue completely through communication. I'm not sure I can fix the self esteem problem without more therapy, but I do believe I can work around it. My goal right now is to try for an intimate orgasm while face to face - eye to eye with my wife. I think through a little abstinance, some patience and understanding on her part, and a little determination on my part and I'll be able to do it. I feel that it's sort of like a 4 minute mile - once you break the record it's much easier to do again.

Getting back to "peeing in public" this is an area that I feel goes hand in hand with reaching an orgasm with another person. The most success I've had in the orgasm department coincided with forcing myself to pee more in public. Maybe it comes down to more of a percieved confidence issue and the two really aren't related -but the bottom line is that it has helped me.

It's an easy thing to practice, and nobody knows you're doing it. I just try to use a public bathroom as much as possible - sometimes drinking several beers to loosen things up. In the past, it didn't matter how much I had to go, I simply couldn't do it at a urinal if there was anybody else anywhere in the bathroom. Now I'm ok as long as there's nobody right next to me. Progress... : ) (although recently I've been slipping - and having more trouble - got to get out and practice more)

I have tried watching porn while having sex once, and it worked wonders. My wife doesn't like porn - her fear is that I'm thinking of other woman - which I'm NOT (believe it or not) I watch porn for the act of sex, the people involved really don't matter. In fact, I usually fantasize about her being the one in the movie. But that's a hard sell at home, true as it may be. But for couples more into using porn, I'd recommend trying it - I think it helps take the man's focus off of the "need to satisfy her" situation somewhat. But I would be afraid it might become a required crutch - I'd use it to break the 4 minute mile a few times then stop.

And that brings us back to that need to please. Again, self esteem. Communication certainly helps - it helps to hear over and over again that I DO make her very happy. (women reading this, you can't be too generous here, but you DO have to be believable!!!!!!!)
Furthermore, when my wife initiates sex - the problem is reduced substantially. I know that if she wants sex, and wants me, then she must be enjoying it. Sounds kind of basic and silly but this I think is one of the biggest cures for the problem. When a guy goes into sex having to almost beg, forget it.
Have a woman come to you begging for sex and you feel MUCH more confident.

Again, not a total cure.

I also believe constantly masturbating about oral sex, even as a child, has let me to believe oral sex is something you hide. Always fearing being caught masturbating about it has to have had some effect on me. I think that's one reason I have such a total problem reaching an orgasm that way.

So bottom line - for me I believe its causes can be varied. I'm not sure anybody will read my whole post here - i'm writing quite a bit so I'll stop here - but I do hope it can help somebody else.

I'll try to come back in the future to let you know how I do with fixing this problem. : ) And to hear any further advise.

Thanks!











First and foremost - it is not at ALL related to a lack of interest in my partner, in fact sometimes it's quite the opposite of that.

I can reach an orgasm much more easily with a woman that I'm NOT attracted to because

Many of the problems you report are classic symptoms of Retarded Ejaculation. The business about your wife being too good for you and you actually get less turned on if she tries too hard is also a symptom of the RE suffer's low self esteem.

Many RE men are also only able to cum with women who they feel are inferior to them. One guy could only cum with Philapina Bar Girls, another with the whores in the brothels of Central and South America. For some they can cum only with Asian women who they look upon as weak or prostutues, especially black or hispanic prostitutes.

I've find that if you are married but can't cum with your wife but
want to stay married then the Wellbutrin/Viewing Porn option is the best. Or just service her until she is satisfied then relieve yourself with your favorite masturbation method.

RE is a curse but you can learn to live with it.

As for actually fixing it...other than Bernard Apfelbaum...nobody has a clue how to treat this successfully. The Sensate Focus techniques are useless in treating RE and I personally believe that the cure will be found in some kind of aphrodisiac drug that raises arousal levels to the point where your own mental "demons" will be overidden by the intense desire to have sex and cum...with anybody.

I'm with Esther and Brandt on this one. It's either performance anxiety that prevents him from "letting go" for his wife, or the excitement of being with a mysterious stranger gives him that last little push. Probably some of both, though the former seems to be more common from what I've read. Has he talked with his wife about it? The body becomes a very scary place on the inside when performing sexual intercourse, and she might be able to reassure him that he's not going to scare her to death or grow snakes in his hair from letting himself get hugely aroused.

Also, have they tried different positions? Different pace? Exotic places? Sex doesn't have to be about orgasm either, does he feel guilty for not climaxing in his wife? Many people feel pressure to go at it missionary style, straightforward, all business-like. (You can thank St. Augustine for that) Maybe he just needs to realize that sex is about play as well as procreation, (The latter being optional in this day and age) about closeness and mutual pleasure. And not just on the genitals, guys.

I doubt different positions or some of the other things you mentioned will improve the sex life of a retarded ejaculator who is no longer (or perhaps never was) attracted to his partner sexually.

The "change of attitude" approach was tried by both Masters and Johnson (Sensate Focus Therapy) and Helen Kaplan (Demand Stratedgy) and both were dismal failures with their RE patients.

RE is the most difficult of all the male sexual dysfunctions to treat and only Dr Bernie Apfelbaum of Berkely California has had any success in treating men with RE and even then he only used surrogate partners and not the actual wife/girlfriend/partner of the RE patient.

Most men with Retarded Ejaculation end up as lone masturbators (as do their partners) I do agree with the poster who suggested that a pharmacolgical treatment to raise the level of desire to a point that overrides the pshychological block, whatever it may be, will be the key to curing RE. Wellbutrin has proved that but unfortunatly this drug's aphrodisiac effects wear off after a few weeks. More research into the area of dopamine and sexual desire
is badly needed by the millions of men who suffer with this and who view sexual intercourse as tedious, stressful and unfullfilling.