Current Sexual Health Reports

, Volume 1, Issue 3, pp 95–101 | Cite as

Retarded ejaculation

  • Michael A. Perelman
Article

Abstract

Retarded ejaculation (RE) was considered a rare and difficult-to-treat sexual dysfunction. Recently, some urologists and sex therapists are reporting an increasing incidence of RE in clinical settings. The etiology of RE is frequently multidimensional, resulting from the man’s biologic set point for ejaculatory latency being affected by multiple organic and psychogenic factors, in varying combinations during his life. This article highlights the role of high-frequency, idiosyncratic masturbatory style, in addition to fantasy/partner disparity, in predisposing and maintaining RE. Successful evaluation and treatment of RE can be enhanced through an integrated understanding of these masturbation-related factors with sex therapy techniques and procedures. In addition, the development of new pharmaceuticals is needed to increase the ease and speed of ejaculatory latency. These pharmaceuticals could be combined with sex therapy to optimize function and satisfaction.

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References and Recommended Reading

  1. 1.
    Masters WH, Johnson VE: Human Sexual Response. Boston: Little, Brown & Co.; 1966.Google Scholar
  2. 2.
    Kaplan H: The New Sex Therapy. New York: Brunner/Mazel; 1974. Sex therapy is integrated into psychiatry in this classic text.Google Scholar
  3. 3.
    Kaplan H: The Evaluation of Sexual Disorders: Psychologic and Medical Aspects. New York: Brunner/Mazel; 1995. An excellent summary of Kaplan’s approach to sex therapy.Google Scholar
  4. 4.
    Perelman M: Regarding ejaculation: delayed and otherwise [letter]. J Androl 2003, 24:496.Google Scholar
  5. 5.
    Perelman M, McMahon C, Barada J: Evaluation and treatment of ejaculatory disorders. In Atlas of Male Sexual Dysfunction. Edited by Lue T. Philadelphia: Current Medicine LLC; 2004:127–157. The most current comprehensive summary of all aspects of ejaculation, superbly illustrated with tables and drawings.Google Scholar
  6. 6.
    Rosen R, Altwein J, Boyle P, et al.: Lower urinary tract symptoms and male sexual dysfunction: the Multinational Survey of the Aging Male (MSAM-7). Eur Urol 2003, 44:637–649. Important paper linking lower urinary tract symptoms and sexual dysfunction.PubMedCrossRefGoogle Scholar
  7. 7.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000.CrossRefGoogle Scholar
  8. 8.
    McMahon CG, Meston C, Abdol, et al.: Disorders of orgasm in men and women, ejaculatory disorders in men. In Sexual Medicine: Sexual Dysfunctions in Men and Women. Edited by Lue TF, Basson R, Rosen RC, et al. Paris: Health Publications, 2004. Comprehensive and current review of ejaculatory disorders by an international committee.Google Scholar
  9. 9.
    Blanker MH, Bosch JL, Broeneveld FP, et al.: Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: prevalence, concern, and relation to sexual activity. Urology 2001, 57:763–768.PubMedCrossRefGoogle Scholar
  10. 10.
    Lauman EO, Paik A, Rosen RC: Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999, 281:537–544. This robust epidemiologic analysis assessed the prevalence of selfreported sexual dysfunction in men and women between 18 and 59 years of age and analyzed correlates of dysfunction.CrossRefGoogle Scholar
  11. 11.
    Simons J, Carey MP: Prevalence of sexual dysfunctions: results from a decade of research. Arch Sex Res 2001, 30(2):177–219. Excellent summary of a decade of epidemiologic research on sexual dysfunction.CrossRefGoogle Scholar
  12. 12.
    Masters WH, Johnson VE: Human Sexual Inadequacy. Boston: Little, Brown & Co.; 1970. This classic text launched modern sex therapy.Google Scholar
  13. 13.
    Apfelbaum B: Retarded ejaculation; a much-misunderstood syndrome. In Principles and Practice of Sex Therapy: Third Edition. Edited by Lieblum SR, Rosen RC. New York: Guilford Press; 2000: 205–241. An excellent critical analysis of RE etiology and treatment.Google Scholar
  14. 14.
    Perelman M: Sildenafil, sex therapy, and retarded ejaculation. J Sex Educ Ther 2001, 26:13–21. Excellent in-depth description of a complex case of RE.Google Scholar
  15. 15.
    Abdel-Hamid IA, El Naggar EA, El Gilany AH: Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in early ejaculation. Int J Impot Res 2001, 13:41–45.PubMedCrossRefGoogle Scholar
  16. 16.
    Nurnberg HG: Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial. JAMA 2003, 1:56–64. Important paper highlighting outcome research on reducing SSRI sexual side effects.CrossRefGoogle Scholar
  17. 17.
    Shafik A: The mechanisms of ejaculation: the glans-vasal and urethromuscular reflexes. Arch Androl 1998, 41:71–78.PubMedGoogle Scholar
  18. 18.
    Karen LM, Barfield RJ: Differential rates of exhaustion and recovery of several parameters of male rat sexual behavior. J Comp Physiol Psychol 1975, 88:693–705.PubMedCrossRefGoogle Scholar
  19. 19.
    Gil-Vernet JM Jr, Alvarex-Vijande R, Gil-Vernet JM: Ejaculation in men: a dynamic endorectal ultrasonographical study. Br J Urol 1994, 73:442–448.PubMedCrossRefGoogle Scholar
  20. 20.
    Rowland DL, Keeney C, Slob AK: Sexual response in men with inhibited or retarded ejaculation. Int J Impot Res 2004, 16(3):270–274. Recent laboratory research paper by a leading researcher on ejaculatory disorders.PubMedCrossRefGoogle Scholar
  21. 21.
    Xin ZC, Chung WS, Choi YD, et al.: Penile sensitivity in patients with primary premature ejaculation. J Urol 1996, 156:979–981.PubMedCrossRefGoogle Scholar
  22. 22.
    Bleustein CB, Eckholdt H, Arezzo JC, Melman A: Effects of circumcision on male penile sensitivity [abstract]. J Urol 2003, 219:1260.Google Scholar
  23. 23.
    Paick JS, Jeong H, Park MS: Penile sensitivity in men with early ejaculation. Int J Impot Res 1998, 10:247–250.PubMedCrossRefGoogle Scholar
  24. 24.
    Bancroft J: Central inhibition of sexual response in the male: a theoretical perspective. Neurosci Behav Rev 1999, 23:763–784. Excellent theoretical position paper on male sexual response.Google Scholar
  25. 25.
    Perelman M: Masturbation revisited. Contemp Urol 1994, 6(11):68–70. First description identifying the relationship between sexual dysfunction and idiosyncratic masturbatory style and frequency.Google Scholar
  26. 26.
    Sank LI: Traumatic masturbatory syndrome. J Sex Marital Ther 1998, 24(1):37–42.PubMedGoogle Scholar
  27. 27.
    Waldinger MD: The neurobiologic approach to early ejaculation. J Urol 2002, 168:2359–2367. Provides valuable insight into possible central mechanisms of ejaculation.PubMedCrossRefGoogle Scholar
  28. 28.
    Perelman M: Sex coaching for physicians: combination treatment for patient and partner. Int J Impot Res 2003, 15(suppl 5):S67-S74. Excellent summary of useable sex therapy techniques for the health care practitioner.PubMedCrossRefGoogle Scholar
  29. 29.
    Heiman JR, Meston CM: Empirically validated treatment for sexual dysfunction. In Annual Review of Sex Research. Edited by Rosen R, Davis C, Ruppel H. Mount Vernon, IA: The Society for the Scientific Study of Sexuality; 1998. Excellent summary of empirically validated sex therapy outcome research.Google Scholar
  30. 30.
    Perelman M: The impact of the new sexual pharmaceuticals on sex therapy. Curr Psychiatry Rep 2001, 3:195–201.PubMedCrossRefGoogle Scholar
  31. 31.
    Perelman M: FSD partner issues: expanding sex therapy with sildenafil. J Sex Marital Ther 2002, 28:195–204. Good demonstration case on integrating sex therapy and pharmaceuticals in treating a multidysfunctional couple.PubMedCrossRefGoogle Scholar
  32. 32.
    Barbach LG: For Yourself: A Guide to Female Orgasmic Response. New York: Doubleday; 1974. Classic guide to teaching women how to orgasm.Google Scholar
  33. 33.
    Perelman M: Combination therapy: integration of sex therapy and pharmacotherapy. In Handbook of Sexual Dysfunction Edited by Balon R, Seagraves R. New York, NY: Marcel Dekker, Inc.; In press. Clinical and theoretical paper emphasizing combination therapy in which sex therapy and pharmacotherapy were integrated to treat sexual dysfunctions.Google Scholar
  34. 34.
    McCarthy B: Relapse prevention strategies and technique with erectile dysfunction. J Sex Marital Ther 2001, 27:1–8. Thoughtful paper reminding the reader of the importance of relapse prevention.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2004

Authors and Affiliations

  • Michael A. Perelman
    • 1
  1. 1.The New York Presbyterian HospitalWeill Medical College of Cornell UniversityNew YorkUSA

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