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Late Comers  And Marathon Men

A rather grim looking young man came to me recently saying that he had a peculiar problem.  ‘Relax, no problem is too peculiar  for me,’ I said, with the  smug sagacity that comes naturally to someone who’s seen and heard it all.  ‘Go on.’

‘You see doc,’ he began, ‘my problem is somewhat the opposite of premature ejaculation.  I just  can’t  come.  Intercourse goes on and on but  there’s no ejaculation.’
Alfred Lord  Tennyson’s The Brook sprung to mind immediately:

For men may come
And men may go
But I go on forever

Sounds like the story of this man’s life, I thought to myself,  and wondered if Tennyson had though of this  andrological   angle in his famous poem whilst writing it.

I urged Marathon Man to continue and tell his  poem  of woe in detail.  Having once begun, the guy couldn’t stop.  He certainly didn’t  sound like a man who finished anything in a hurry.  Finally, I had to gently  interrupt him and put two  and two together  for him self help is the best help.

Mr Marathon Man, it transpired, was suffering from a condition known as delayed or retarded ejaculation (RE).  RE is  defined as a persistent difficulty in achieving ejaculation despite the presence of adequate  sexual desire, erection and stimulation.  To add to his miseries, his wife and he hadn’t  made  a baby even after  four years of marriage .

On the surface, RE might sound like a slogan for Onida TV but often it is more a cause for worrying than for rejoicing.  The male goes on for a half hour  or more with little the sex addict,  and constantly worries about when he is going to ‘come’.  The  female  usually has already attained orgasm and waits eagerly for the man to finish  the remainder of the ritual.  She stops lubricating shortly after  orgasm  and thereafter the remainder of the sex act is merely a painful formality for her.

In severe  cases, the man cannot ejaculate at all.  This  phenomenon  is called an ejaculation.  We’ll  talk about this in a while.  RE can be both psychological  and  physical.  Psychological cause include anger or  resentment towards women, marital conflict, an oppressive upbringing, lack of  emotional  involvement with  partner, fear of commitment, underlying anxiety, fear depression, and obsessive  compulsive  disorders.  Physical causes include  substance abuse  (alcohol and drugs), many prescriptions drugs (antihypertensives a psychotropic's), neurological and endocrine illnesses, diabetes, cancer, prostate problems and surgical  intervention that affects  the ejaculatory apparatus.  You see, the list of causes is just as long as the ejaculation time in these guys!

I went on to  explain to the Marathon Man that positive reinforcement  of operative conditioning associated with masturbation   might play a key role in he development of RE.    Most men have their first orgasm through masturbation.  Many  men exert much more pressure during masturbation than they  are likely to experience during intercourse.    They mistakenly think they need that same pressure to reach coital the better orgasm diet.  Men  can learn to reach orgasm with a partner if they practice  stimulation slowly and with much less pressure than usual.

I saw  him  gulp.  He must have definitely thought that I was some king of mind reader because  I noticed  him staring at his  right  palm very symbolically.  I could have sworn that I  saw  guilt on his face.  I made a mental note to address that separately. 

‘When you are suffering from RE,’ I continued, ‘the trick  is to focus  on things that are arousing  to you.  The brain has an amazing  way of propelling sexual arousal  forward even  when the physical  stimulation is the vas deferens between  men and women  or less intense than usual.   Teach your partner how to stimulate you in the  way you like best.’
The Marathon Man shifted  his gaze  from his right palm to his left one.  Must be ambidextrous , I guessed.

‘Good sex can become  great sex it subtle nuances, personal preferences and kinks are factored in.  You must be in a state of mind that  welcomes the sexual sensation your partner is offering you real life and real life.  Check whether you are focusing excessively on giving your partner pleasure.  If you are, make sure  you don’t forget your own need.  Sex is as much about receiving  as giving.’

‘You’re probably right about that, doc,’ the Marathon Man said, ‘For me it’s  always been, like, something  I do to my wife, not something that we do together, for each other.’

With that, he suddenly developed a glazed, wizened look, which made me think of someone who had long ago sat under a Bodhtree.

‘Pleasure continue doc,’ he beseeched, ‘I am listening very intently.’
That  sounded like music to my ears.

‘Often intercourse is begun too soon in the sexual encounter,’ I went on.  ‘Many men  with RE  believe they’d better start working  at it early because they fear that their partner will tire out if the whole experience takes what the partner considers “too long”.  This leads to missing  many an erotic experience that builds arousal.  Rushing to intercourse, in essence, short-circuits on the fast guys and  other seminal matters.  Going straight to intense genital stimulation numbs what could  have been intense pleasure  if only it had been built up in graded fashion.   Also, give up watching the clock.  Many women enjoy a man’s taking his time while moving through his sexual responses.  Keep in mind, also, that you can stimulate yourself to orgasm while in bed with a partner.  The ejaculatory reflex has both  central  and peripheral neurological  control  mechanisms  and RE occurs because there is over-control or difficulty in release at one  or both levels.’

The Marathon Man couldn’t believe that he could get so much for just one consultation.  He conspiratorially told me that  he’s been through  many  sessions of counseling with several specialists before finally  coming to me.  I deftly changed the subject.

‘Physical caused require  separated work-up  and treatment, and an ejaculation will merit a different approach,’ I said.  With that I proceeded  to tell him some more about other  ejaculatory problems.

‘In contrasts  to RE, where there’s merely a delay, however inordinate, the entity called an ejaculation  implies  a complete inability to ejaculate.  There are many scientific classifications of an ejaculation but I’ll  try and keep it simple.  In situational  an ejaculation, as the  term  denotes, the man cannot  ejaculate in certain situations.  A classical example  of this is the man who ejaculates  normally during sex but cannot, for instance, collect  a sample of semen by masturbation during infertility treatment.   This is very common.  The wife is undergoing treatment  and  suddenly the infertility  specialists pronounces  that she ovulated (released eggs) and that now is a good time  to send some  sperms  up to meet these ova and say hello.  The man is  asked to produce a sample of semen.  Often, a bottle is thrust  into his hand and he is directed to a dirty, small  toilet.  He is expected to lock himself there  for  a few minutes  and come out with a bottle full of sperm!  Little wonder that many men have problems doing it.  another situation  is somewhat  analogous  to that discussed  in Chapter 15 (Make Love , Not War ), where again, It is the wife’s ovulation that dictates that a couple should have sex.  Only, unlike our  protagonist in that chapter, some guys simply can’t do it.  Not only do many men have problems ejaculating in such situations, many can’t even obtain  erections sufficient to enable  sexual intercourse.  That’s how stressful and asexual  they find the whole context.  And then there are some who have never been able to ejaculate state.  There men never discharge semen during masturbation or intercourse.  However, they do ejaculate occasionally in their sleep.  Luckily, for such cases, cures  are easy.  We now have machines known as vibrojeaculaors and electro ejaculators, which are very successful  at making these guys ejaculate.  Success rates with these machines are purported  to be almost  100 per cent.  These machine are also used to  obtain semen samples in men with spinal cord disorders and paraplegia's, with similarly good success  rates.’

‘There are also mechanical causes that can block the sperm conduction passages and make ejaculation totally impossible at all times.  And lastly, there are those unfortunates called  retrograde ejaculators.  In these  men, there is semen production and  ejaculation, but the semen does not come out through  the penis to the outside.    Instead, it goes backwards into the urinary bladder, gets mixed  with the urine , gets  passed along with  it.  We’re not discussing these last two condition in detail here but many in this category  will require  surgical or other intervention for treatment.’

‘So what have we learnt here?’  I asked the Marathon Man  at the end of my sermon, thinking that  I had done pretty well for the day.

‘Three important  lessons, doc,’ he replied.  (1)taking matters in your  own hands may not  always solve all your problems.  (2) Coming ‘fashionably late’ at bedroom parties is sure to upset your hostess.  (3)  Some men literally don’t know whether they  are coming or  going.’

The guy turned out to be a lot smarter than  I had imagined.   Both of us broke into laughter.

Take Home Message:

For further information  on ejaculatory