I have a very embarrassing problem: for all our marriage I have been unable to ejaculate. I get a firm erection which doesn’t go away, but even if I thrust inside my wife for an hour or two I still cannot come. It makes her sore and leaves me frustrated. All our friends are having children and my wife is getting upset that we can’t conceive. I don’t feel ready to become a father as I can’t seem to be a man. When I start to try to explain our problem to friends they just joke that my wife has a highly prized stud and that she should make the most of it. The reality is I am a failure in bed, and as a result am avoiding sex as much as possible.

It is an insensitive myth that somehow it is pleasant to be trapped in your erection without resolution. Your starting point is to go to your doctor and get them to rule out if there is any illness, injury, substance abuse or medication side effects that is causing what we call ‘male orgasmic disorder’ for you. If physical causes are not pertinent, then you are dealing with psychological patterns that need shifting. These then need translating into your learned physical behaviour.

 

I can hear the pressure you feel to deliver a child for your wife, and your own sense of not being ready for that. Sometimes an inability to ejaculate is directly linked to unresolved conflicts over conceiving that feel too unwelcome to verbalise and so get acted out in our bodies. I would encourage you to find mature friends or a counsellor you can discuss your deeper questions with regarding potentially becoming a father.

 

However, there are many other mental conflicts that could be causing this. For some people, a strict religious upbringing or current influences can engender guilt at being sexually active. It will be releasing to adopt a more rounded and biblical view of sex as a good gift from God to be enjoyed within marriage. For others it is caught up in suppressed anger or, dare I say it, ambivalence towards their partner. Sometimes it is as basic as being fearful of the physical ‘messiness’ caused by the semen. At other times it is due to insufficient sexual arousal, and you need to learn how to focus your mind and body together to allow yourself to get really turned on!

 

Your wife will be needing reassurance that you find her attractive. Although you feel a failure, she still needs you to be sexual with her. Please don’t back off sex altogether, but enjoy what you can and learn to relax together in a sexual way. It may be best not to have penetrative sex if this is difficult for you both. Instead, pleasure her without coming inside her and encourage her to stimulate you, stopping before it becomes a chore. Use plenty of lubricant on both of you so that nothing becomes sore (eg ‘TLC Lube’ from Pasante or ‘sylk’ from Pure Nature; I wouldn’t recommend KY jelly). When you have both had enough, if you haven’t ejaculated just get her to stroke you gently to help bring you down and lessen the frustration.

 

At a physical level, you haven’t learned a mechanism which allows a comfortable transition from self-control to release and then back again. That is what you are aiming at. You have over-strengthened your selfcontrol regarding your sexual responses. Some men struggle with the opposite. Maybe the influences around you have taught you the critical importance of self-control; maybe letting go is an unsafe or uncomfortable position for you. For whatever reasons, selfcontrol has become a continual stimulus for your behavioural decision-making. You need to learn to relax into experiences of release, and letting go while focusing on being turned on. I have given details below about a physical treatment model that you may find helpful to implement, preferably with the support of a psychosexual therapist.

 

You truly can learn to let go into ejaculating – it is built into you. Trust your body that it can do it. You will need to shift your psychological brakes, and I suggest you seek help in doing this. Then allow this to translate into your physical patterns and let go of the old habits. You can do it!

A pioneering treatment model has been developed recently with considerable success at Bar-Ilan University in Israel by David S. Ribner. It will be best implemented with the support of a Psychosexual therapist.

The recommendation is that you refrain from intercourse whilst learning the technique, but enjoy any other non genital pleasurable touch. First identify the sensation of tensing your pubococcygeus (PC) muscle: this is the one you would use to stop urinating mid-stream. Then tense and relax this muscle twenty times in succession each day for a week, with the tension lasting two seconds and the release one second. (You can do it once whilst urinating to locate the muscle but thereafter don’t do it whilst urinating). Then the periods of tension and release should be gradually increased with a final goal of ten seconds of tension and three seconds of release. Each increase should be practised each day for at least a week. Once you have mastered this, then recommence intercourse with good fore-play first. Use the male on top position, thrust at a moderate pace and start the PC muscle exercise when you begin to feel any heightened level of excitement. Focus your mind on things that turn you on from within your relationship. The now familiar relaxation of the tensed PC muscle allows for the release that can unlock your orgasm.