The definition of delayed ejaculation (DE for short) is explained on this video, which might help you understand the problem a bit better.
There are various ways of defining delayed ejaculation
Helen Singer Kaplan, one of the pioneers of modern sex therapy, categorized delayed ejaculation (DE for short) into levels of severity, measured by how long it takes a man to ejaculate.
The mild form of delayed ejaculation (also known as male orgasmic disorder) is defined by the fact that a man can have intercourse resulting in an orgasm and ejaculation inside his partner perhaps under certain, very specific or occasional, circumstances.
The next form would be described as moderate, and it refers to a man who can ejaculate in the presence of his sexual partner – but not during vaginal intercourse.
A more severe expression of difficulty with ejaculation would be seen in a man who could only achieve orgasm and ejaculation when he was alone, with self-pleasuring.
And finally, the most severe form of delayed ejaculation would be marked by a complete absence of ejaculation. (Yes, it does happen.)
Perhaps you can see that these various degrees of male ejaculatory inhibition may all mean something important – and different – about what’s going on for the man, emotionally and physically.
You see, although you might think that only a complete inability to achieve orgasm and ejaculate during sexual intercourse would be a serious problem for a couple in a sexual relationship, the truth is that any level of ejaculation difficulty is potentially both stressful and destructive.
Arriving late at orgasm can suggest to a man’s partner that his slowness and delay may be a reflection on her desirability as a sexual partner.
And even though you might think that delays in reaching orgasm must surely represent a distinct advantage for a man, because he is able to continue making love during intercourse for a long period of time, thereby being able to satisfy his partner and give her multiple orgasms, this isn’t usually true.
Indeed, both of these ideas are off the wall. To start with, most sexual relationships involve many forms of sexual expressions.
Some or all of these tend to be less enjoyable or spoiled when a man can’t ejaculate: masturbation by oneself, masturbation in the presence of the partner, masturbation by the partner, mutual masturbation, oral pleasure and various other forms of frottage, and sexual intercourse.
Many of these options are ruled out when a man’s climax is enormously delayed.
Of course you might say, and you’d be right, that sexual intercourse isn’t always the be-all and end-all of sex for some couples. True.
However, slow or non-existent ejaculation is mostly an extremely challenging and often unsatisfying experience for both partners, even in a relationship where the man can finally ejaculate after extended thrusting during intercourse.
Making Love and Ejaculating Is An Ordeal
Helen Singer Kaplan wrote about sexual dysfunction in the book Principles and Practice of Sex Therapy, edited by Sandra Lieblum.
She pointed out that when a man can’t ejaculate, intercourse is desperately overshadowed by the man seeking ways to achieve orgasm, leaving little opportunity for intimate pleasure between the partners.
Indeed, a description commonly used by male clients who have problems with delayed ejaculation when seeing sexual therapists is that sex becomes “hard work”.
Furthermore, there is rarely a satisfactory outcome to intercourse, because the man will usually slow down, recede from the interaction, and finally stop making love when his erection subsides, or when he emotionally withdraws from the sexual act because of his failure to ejaculate.
The man’s partner will also experience long, long intercourse as difficult because her vaginal lubrication may well dissipate completely, giving her unpleasant sensations or even pain as the man thrusts.
And the delay in reaching climax (orgasm) and ejaculating almost always decreases the level of intimacy between the partners.
And that’s important. We now know that intimacy plays a major part in generating sexual desire.
You see, originally sexual desire was thought to be something that developed by thinking about sex, indulging in fantasy, and culminating in a conscious desire for sexual experience. But now we know that desire also comes from intimacy – especially in long standing relationships.
Male and Female Sexual Response Cycles
You might wonder how a person’s need for intimacy causes sexual desire. There’s another question to be answered as well, while we’re on that subject – how is it that many women don’t think or fantasize much about sex, yet they still want to make love.
We do know that women often regard sexual stimulation as multifaceted and require an appropriate erotic but familiar and safe context for sex to be acceptable to them.
So how does intimacy play a part in sexual desire?
A good way of summing this up is to say that women want sex when they feel intimately connected to their partner; and men tend to find intimacy during lovemaking, particularly after its climax (ejaculation).
So not being able to ejaculate deprives men of significant emotional fulfillment and intimacy.
This is one of the reasons why delayed ejaculation can be so disruptive to relationships.
Women can feel their sexual desire by recognizing their need for intimacy, and drawing on their experience of sex as a fulfilling act.
So sex, for women, is a way of satisfying emotional needs, and as it proceeds it will actually generate sexual desire; this is not independent of the need for the relief of sexual tension (feeling horny, you might say).
There is another important point here, again particularly with women: arousal and desire are not necessarily successive or simultaneous.
In other words, arousal can occur before desire, a fact which has been shown many times when woman women become physically aroused in response to viewing pornographic material but report no subjective sense of sexual desire.
Women may find they become more sexually aroused as sex continues; men experience more intimacy as sex continues.
When arousal is a positive experience, and there is a safe environment in which negative thoughts can be avoided, the intensity of the woman’s arousal tends to increase so that sexual desire or “wanting” is “accessed”.
This is then experienced as a part of her sexual arousal. And it’s certainly true for some women, some of the time, that orgasmic release is not necessarily required for complete sexual satisfaction.
Finally, within this intimacy based model of human sexual response, you have to see desire, arousal, satisfaction and fulfillment as variable factors that can be strong or weak at any point in time.
So although the pioneering work of Kaplan on delayed ejaculation was important – and it has certainly influenced treatment ever since – the theoretical basis of her work seems incomplete.
Video – arousal in women
The American Psychiatric Association (DSM IV) Definition
DSM IV defines delayed ejaculation as “a persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity, that the doctor, taking into account the person’s age, judges to be adequate in focus intensity and duration.”
The Diagnostic and Statistical Manual DSM IV emphasized the similarity between difficulty ejaculating in men and failure of orgasm in women, commonly known as female orgasmic disorders, by calling this condition male orgasmic disorder.
Bernard Apfelbaum’s Definition
Sex therapist Bernard Apfelbaum, a man who has spent many years studying retarded ejaculation, believes a man who cannot ejaculate during intercourse or any other sexual stimulation does not reach his orgasmic threshold (i.e. the level of stimulation at which he “should” ejaculate) because he is simply not aroused enough.
Of all the theories this makes the most sense. Nobody, man or woman, can cum if they are not aroused (or, colloquially, “turned on”) enough.
Of course, the arousal a man has may enable him to develop a strong erection and indeed feel quite aroused on a conscious level. But the body doesn’t lie!
Truth is – unconsciously this man has not reached the level of arousal sufficiently high for orgasm. This is why many men can thrust for up to an hour (assuming the woman is willing to let them!) or more during intercourse without ejaculating.
Of course we ask WHY is he not sufficiently aroused.
There are many possible reasons: depression, performance anxiety, traumatic masturbation, and porn addiction, lack of attraction to the partner, sexual boredom, family of origin trauma and/or attachment disorder (i.e. difficulty with, or fear of, intimacy). And finding out can be very difficult sometimes. Perhaps that makes it better to treat symptoms than causes…..
Marcel Waldinger’s Definition
The simplest definition is the one set out by Marcel Waldinger in Handbook of Clinical Sexuality For Mental Health Professionals, second edition, edited by Stephen B Levine.
In this he writes that delayed ejaculation is a condition where a man finds it difficult or even impossible to reach orgasm and ejaculate despite receiving adequate sexual stimulation, and having a hard erection, and experiencing the desire to achieve orgasm.
Difficulty In Reaching Climax:
Defined By Its Effects
Why does not being able to ejaculate cause problems?
If you’re a man who suffers from premature ejaculation, you may feel that a long time to ejaculation would be a godsend.
However, the benefits of long lasting sex (if you think being able to thrust for an hour or more without ejaculating is a “benefit”), and possibly giving a woman a vaginal orgasm, are far outweighed by the drawbacks.
These include not being able to father children, not being able to bring the sex act to a natural close and feel the intimacy of releasing in your partner’s vagina, not giving a woman the satisfaction of feeling responsible for the ultimate male pleasure, not to mention doubting her own attractiveness, and leaving her sore and frustrated. The man’s penis can become very sore as well.
Signs and Symptoms –
What To Do About Delayed Ejaculation
First try the treatment program on this site and see if it helps.
Then, if you have never ejaculated in any way, including nocturnal emission, masturbation, or sexual intercourse, ask your doctor to conduct a complete check up.
If a man is able to ejaculate with some form of sexual stimulation, then he can learn to ejaculate with any type of sexual stimulation.
Better communication, more awareness of his bodily arousal, and developing greater sensitivity to sexual stimulation can all help. These and many other approaches to overcome the difficulty in ejaculating are described in the treatment program you can see advertised in the top right hand column of this page.