Physical Causes

Physical Causes

Harsh Masturbation Technique

When a man’s ejaculation only comes during masturbation, and not intercourse, it could be because a man has conditioned himself – usually during adolescence – to reach orgasm and ejaculate by using an “idiosyncratic” way of masturbating, a technique which usually does not involve touching the penis with his hand, but instead uses harsh and/or fast thrusting against solid objects such as the mattress of a bed.

Sometimes, though, the cause of ejaculation delay is what’s been called the penis “death grip”. This kind of pressure this ferocious masturbation technique puts on the penis simply can’t be replicated during sexual intercourse. Hence – no ejaculation…. or a very delayed one…. or at the very least, difficulties with ejaculation.

There are several other physical causes.

Ejaculation Problems Can Be
A Side Effect Of Medication

A video which explains how SSRI antidepressants cause slowness and delay in ejaculating. We have other pages on this subject.

Medication as a cause

Penile Insensitivity

Are slow penile reflexes, or an insensitive penis, ever responsible for difficulty in ejaculation?

What does “reduced penile sensitivity” mean? When you think about it, these ideas are not particularly easy to investigate.

Sure, some work has been done with vibratory stimulation of the penis, and some evidence has emerged that men with delayed ejaculation have a slower bulbocavernosus reflex (if you even know what that is….)

However, is that really a cause of delayed ejaculation – or is it a symptom? The problem here is separating cause and effect.

And the same applies to suggestions that speed of ejaculation (or lack of it) may be associated with levels of serotonin in the brain.

Serotonin is both a cause and effect of alterations in mood, but it seems challenging, to say the least, to investigate its association with ejaculation speed.

Depression has a major role to play in delayed ejaculation
Which comes first – depression or poor sexual performance?

To put it another way: are you feeling depressed because you can’t come? Or maybe you can’t come because you’re feeling depressed? Who knows?

So do we know anything at all about the physical causes of delayed ejaculation?

Well, yes. We know that some physical issues like diabetic neuropathy and prostate surgery, plus other kinds of pelvic surgery, and a large number of drugs, in particular mood altering drugs and beta-blockers and alpha blockers and, oh, loads of other  medications, are 100% linked to a slowing – and a stopping – of the ejaculatory reflex.

These drugs are clear culprits when it comes to delayed ejaculation.

Lack of Penile Sensitivity

A large number of men claim that they have an insensitive penis.

Unless there is a clear reason why this might happen — as in diabetic neuropathy — it’s extremely difficult to demonstrate whether or not there’s any truth in this.

I mean, when you think about it, how can a man know if his penis is more or less sensitive than other men’s?

Of course it may be that a man thinks his penis has become less sensitive as the years have gone by, but then again, how could he be sure of that?

That’s a subjective impression, and my own belief is that when a man claims that his penis is less sensitive than it used to be, he’s probably really experiencing some kind of reduction in his emotional or psychological sensitivity to sex.

Think about this, for example: consider how very exciting it is to have a new sexual partner. After a while, the excitement of sex, even the anticipation of sex, become much less thrilling and arousing than they were in the early stages of your relationship.

I think it’s possible that something similar happens in delayed ejaculation. (Sex is so boring…. not that it ever was much good….)

But…. there is of course the thorny question of circumcision and how it affects penile sensitivity.

So what about a penile sensitivity test?

Age Plays Its Part

We know that men take longer to ejaculate as they get older, because age causes degeneration of the fast conduction peripheral sensory axons, which results in a number of problems including difficulty in achieving a high level of sexual stimulation, and the consequent arousal necessary to trigger the ejaculation reflex.

However, in the vast majority of cases, psychological explanations of delayed ejaculation are much more important than physical.

And there’s no shortage of therapists and counselors who have offered their own interpretation of delayed ejaculation in terms of psychodynamic process.

In case that baffles you, it means something in the unconscious mind of a man holds him back from ejaculation, inhibits his ejaculation.

So Helen Singer Kaplan, for example, said that she believed some men with delayed ejaculation were over-controlled individuals who resisted letting themselves go because they basically felt hostile towards a sexual partner. Ouch. (Mind you, I kind of agree with her.)

Other, simpler, explanations include a man’s fear of pregnancy, or fear / resentment about becoming a father, or anything else, combined with a man being unable to communicate this to his partner.

Or, even simpler, if young children are present, maybe the man feels inhibited about having sexual activity in their presence.

Or maybe he’s just emotionally withdrawn from his partner. A lot of men do, you know. Especially when they had a bitch of a mother….

All of these, and no doubt many more things too, could stop a man ejaculating.

Nerve Paths Associated with Ejaculation

Even when a man who is experiencing delayed ejaculation has enjoyed sufficient sexual stimulation that in the “average” man would trigger orgasm and ejaculation, he will simply not be able to achieve climax.

Conventionally, of course, climax is divided into two parts: orgasm and ejaculation.

We speak as if the two are very closely linked, so that a man who fails to reach orgasm generally won’t ejaculate, and vice versa.

This is a working assumption that’s good enough, although it’s technically incorrect since the two events are both mediated by different parts of the nervous system, and they can both occur independently of each other.

Some men with delayed ejaculation may find that they can only reach orgasm through stimulation by their own hand during masturbation, while others may find that they can occasionally reach orgasm during intercourse with a partner.

It’s hard to understand how such problems could arise, but knowing that orgasm and ejaculation are in fact separate processes can help clarify it.

As we mentioned before, orgasm is an experience in the mind – very pleasurable, it is too….

…. whereas ejaculation is an unconscious reflex response which is triggered by a certain level of sexual stimulation being applied to the penis, until the nerves responsible for the reflex of ejaculation reach a threshold of stimulation which triggers the emission and release of semen.

Clearly the phenomenon of dry orgasm — which means an orgasm where no semen is released — has a bearing on delayed ejaculation. We know it’s not necessary for the ejaculatory response to take place before a man can move into the orgasm phase of his sexual response cycle.

So why don’t men who have delayed ejaculation enjoy the experience of the physical and mental sensations of orgasm? maybe they are just not aroused enough?

Of course all men experience orgasm differently, and it’s true that even in the same man the experience is different from time to time.

Nonetheless, we know that orgasm generally involves similar features in all men: it involves contraction of certain body muscles, including the pelvic musculature and other body muscles, that have built up tension during the excitement phase of sexual arousal. All of this tension is released in the moment of orgasm.

All of these sexual responses, including the ejaculatory response, is mediated by the interaction of the sympathetic and the parasympathetic nervous system. The former is associated with activity, while the latter is linked associated with relaxation and recovery.

The interplay of these two involuntary nervous systems is highly relevant to any discussion of the etiology of DE. For example, in order for a man to develop an erection the smooth muscle fibers of the internal cavities of the penis have to relax: only then can blood flow into the penis in sufficient quantities to generate an erection.

The control of this process is under a complicated network made up of the nervous system, the circulatory system, and hormonal influences, all of which are initially dependent on the relaxation of these muscle fibers induced by the parasympathetic nervous system.

However both orgasm and ejaculation are controlled by the sympathetic nervous system, as is the phenomenon of relaxation and recovery which is commonly become known as the “afterglow”.

Ejaculation itself is divided into two parts, emission, which is under the control of parasympathetic nervous system, where seminal fluid is released from the seminal vesicles into the base of the urethra in preparation for ejaculation proper, which is controlled by the  sympathetic nervous system.

But these generalizations are indeed just that: there’s no better example of this than the fact that a man can reach orgasm during sleep when no physical sexual stimulation has taken place.

Simple, powerful, effective solutions for men who have difficulty coming during intercourse