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ON DELAYED EJACULATION

Q: I'm a 45 year old gay man and I have had difficulty ejaculating with another man for as long as I can remember. I get stimulated and remain so throughout but it is highly rare for another man to get me to ejaculate. This is frustrating not only for them but for me as well. I've reached a point in my life where I really want to address this - in fact, it has started to depress me. I've seen doctors before who said I have no problems and should be able to perform. I've also seen a psychologist who not at all empathetic to the issue. What help can you provide?

A: This is a very good question. You might be surprised to know how widespread your condition (sometimes called delayed or retarded ejaculation) is among gay men. I have a lot of experience working with men who, like you, have difficulty ejaculating in someone else's presence. As sexual dysfunctions go, this is one of the more difficult to treat, if "treatment" = eradication. But there are some things you can do and think about.
     Causes: There are several medical reasons that men experience difficulty ejaculating. Some medications, especially the class of anti-depressants called SSRIs (Prozac, Zoloft, Paxil, etc.), have the side effect of making ejaculation difficult if not impossible. Most treatments for prostate cancer will interfere with or prevent ejaculation. If you’re not able to ejaculate under any circumstances, you should definitely check with a urologist to see if there’s something else organic going on that needs to be addressed. 
     Other than those situations, here are three common reasons that men experience delayed ejaculation, and they’re not mutually exclusive:
          1) Sometimes men who have a long-established masturbation ritual (such as jerking off to pornography) find it difficult to "let go" when having sex with a partner. The highly focused, high-stimulus experience of looking at porn creates very different biochemical responses from the more de-centered, multi-focused experience of interacting with another person, and that may prevent arousal from building to the familiar kind of climax.
          2) Tension and anxiety counteract the process of sexual arousal in the body.
          3) Complicated psycho-sexual issues around control and perfectionism, sex shame or body shame, religious guilt, or a not-quite-conscious fear that cumming with another man would be a betrayal of your strong attachment to your mother. (I know that sounds like textbook Freudian interpretation but, hey, Freud didn’t make it up out of thin air!)
     I think it’s also worth mentioning some misconceptions guys have in this area. One is the thought that “I should be able to cum with someone else stimulating me.” The fact of the matter is that you know what feels best to you, and “taking over” during sex to get yourself off is perfectly normal. Many heterosexual men have had to come to grips with the reality that many women can only achieve orgasm by stimulating themselves manually. Be careful not to turn it into a test of how attractive or sexually proficient you or your partner is.
     Another misconception guys have is that the ritual of jerking off once or more a day that they developed as adolescents should continue into their 30s, 40s, 50s, 60s and beyond. That’s expecting a lot from your aging male body. Chinese medicine suggests this formula regarding frequency of ejaculation: take your age, double it, divide by 10, and that’s the number of days that ideally should elapse between ejaculations. In this theory, ejaculating more frequently depletes the body of energy, so if you cum more often you may want to consider what you need to do to replenish your energy. 
     Treatments: I appreciate that not being able to ejaculate when you want to can be extremely frustrating, and I can't offer any treatment that guarantees that you will be able to squirt at will. But I know that there are three things that can help: meditation, to begin to observe and dismantle the mental activity that interferes with bodily pleasure; bodywork, to increase relaxation and distribute pleasurable erotic sensations around the body, whether ejaculation occurs or not; and counseling, to reduce the shame and anxiety that builds up around the frustrating experience of not being able to ejaculate with a partner. These are all forms of treatment that I offer in the realm of Body and Soul Work. If you would like to come in for a consultation, I'd be happy to spend some time with you to see if I can be of any help. 
     Other resources: I can’t recommend highly enough the Body Electric School’s weekend workshop “Celebrating the Body Erotic.” Based on tantric and Taoist teachings, this workshop specifically teaches participants to reframe sex as energy. Rather than limiting sex to “getting it up and getting it off,” the workshop shows you how to cultivate and contain erotic energy not just for pleasure but for creative and spiritual purposes as well as general vitality. You can find out more information about the workshop here.

Q. I suffer from a kind of "performance anxiety." I have a sort of built-in mental time piece, and when I’m having sex there comes a time where I feel like the spotlight is on me, and it's up to me to "perform." I know it's not my partner’s fault and, believe me, I wish I could rid myself of that impression, but it's pretty deeply ingrained, despite my best efforts at eradicating it. Rightly or wrongly, as my excitement builds, I always assume that I have a narrow "window of opportunity," which is only a very few minutes in duration, and in some cases that's proven very inhibiting for me.

A. I consider this as much of a spiritual challenge as a physical difficulty. When you tell yourself this story – “The spotlight is on me, it’s up to me to perform, I have a narrow window of opportunity” -- you RE-INSCRIBE an unsatisfactory thought pattern (re-open an old wound, you could say) and create pressure for yourself to ejaculate when you're erotically aroused. This pressure is guaranteed to create anxiety, and that anxiety is guaranteed to prevent the experience you're pressuring yourself to create. It's possible that this tension or frustration is pleasurable in a neurotic/ masochistic kind of way.....but if that's not consciously your intention, "what you can do" is practice making a choice. Choose to experience physical pleasure without any pressure from yourself or from your partner. Choose to let experience pleasure whether or not an ejaculation occurs. Anything else is a recipe for frustration. The spiritual practice involved is a meditative one (or in psychological terms, we could say a cognitive-behavioral task) of being aware of when you're going into anxiety-producing thoughts and consciously, kindly, gently redirecting your awareness to your breath, to pleasurable physical sensations. When your mind strays off into anxiety-producing thoughts again, as it will, redirect it back to pleasurable touch. This may take practice, practice, practice, but it’s definitely possible. For support in developing this practice, you may find it helpful to have one or more sessions with me or another sex therapist.

~ DON SHEWEY ~
Telephone: 212-956-4205 or email me at don@donshewey.com