Erectile Dysfunction
Erectile dysfunction (ED) is maybe the most commonly discussed type of sexual dysfunction in men, and is the most commonly experienced. ED is defined as recurring inability to get or maintain an erection. It's not atypical to experience erection difficulties now and then, but continual problems can be an issue.
For many people experiencing ED, the cause is psychological. Feelings of stress or anxiety can impede the ability to get or maintain an erection. Particularly, performance anxiety can become problematic. Worries about ones performance or ability to stay erect can essentially become a self-fulfilling prophecy. This concern can lead to a viscous cycle where the anxiety impedes erections, and that reinforces the concern, and so on.
There are several physical causes for ED as well. The prevalence of ED in individuals with cardiovascular problems or diabetes is high. Anti-depressants, particularly SSRIs, are known to cause ED and other sexual side effects. Speak to your doctor if you have concerns about erectile dysfunction. Smoking and use of alcohol or other drugs may be responsible for ED in some cases.
In the case of psychological causes, sex therapy or mental health therapy can be beneficial. Focusing on relaxation prior to and during sex can help. Shifting focus from penetration to other kinds of stimulation can help as well as it can help decrease performance anxiety. Specifically, an exercise called sensate focus is often assigned as “homework” by sex therapists for this purpose. The basics of sensate focus are that partners take turns touching each other non-sexually, focusing on pleasant sensations, and then slowly work toward touch that includes genitals but without any expectations. Typically this leads to increased comfortability and higher likelihood of achieving an erection.
The use of cock rings or penis pumps can help maintain an erection. Hormone treatment or treatment with medication can help depending on medical causes. If cardiovascular or nerve injury is the cause, sometimes surgery may be necessary.
Premature Ejaculation
Also referred to as involuntary, early, or rapid ejaculation, premature ejaculation is recurrent ejaculation that occurs after minimal sexual stimulation. A quick response to sexual contact in the form of ejaculation isn't abnormal, and evolutionarily speaking might even be beneficial since it more efficiently transfers sperm! But, dissatisfaction may occur when this happens because the individual feels unable to satisfy their partner due to this issue.
Premature ejaculation is often caused by a habit of rushed masturbation and can be altered by changing that habit. Like erectile dysfunction, it can be cause by performance anxiety as well.
By practicing the start-stop technique you can learn to control your orgasms. Practice this by starting arousal, stopping when you begin to feel moderately aroused, then start again once your arousal level has gone down, and repeat the process a few times before allowing yourself to orgasm. Try this alone or with a partner.
Another technique to try is the squeeze technique developed by renowned sexologists Masters and Johnson. Just before reaching orgasm, squeeze the penis just below the head for about 30 seconds. Repeat a few times before allowing yourself to orgasm.
The simple act of thinking of something boring or distracting can work, also!
Reframing expectations of sex can be important, too. Just because one person comes, it doesn't mean the sex is over. There are plenty of ways you can still please them, including toys, hands, and mouths!
Delayed Ejaculation
Delayed ejaculation, also referred to as male orgasmic disorder, is a pattern of inability to ejaculate during prolonged intercourse (30-45 minutes or longer). Sometimes this is a lifelong occurrence and sometimes it is temporary or situational. Typically a person experiencing delayed ejaculation during sex is still able to ejaculate within minutes when masturbating. There's a lot of variation in how long it takes a person to reach orgasm during intercourse, but if the length of time this takes becomes distressing, then one might seek out solutions.
The cause of delayed ejaculation is often psychological, including depression or anxiety disorders, performance anxiety, poor body image, relationship issues, feelings of shame or guilt regarding sex, etc. Sex therapy or mental health therapy can be beneficial to address these issues.
Sometimes the cause can be medical, such as injury to or loss of sensation in nerves, UTI, low thyroid hormone or testosterone, neurological diseases, retrograde ejaculation, or medication side effects (especially SSRIs). In some of these cases, a doctor may prescribe (or alter) medication to treat the underlying issue. Speak to your doctor if you are worried about delayed ejaculation.
Like with premature ejaculation, delayed ejaculation may be related to masturbation habits. Often times when people have difficulty reaching orgasm with a partner it's because they are used to orgasming while alone and/or sensations are not the same as the specific ones felt during masturbation. To recondition oneself to achieve orgasm with a partner, a technique called bridging is recommended, which consists of three stages. In the first stage, you masturbate while your partner is with you. Once this becomes comfortable and orgasm can be reached with a partner present, then instead of masturbating, your partner will perform manual stimulation (hands only). During the final stage, your partner puts your penis inside them once you're ready to orgasm. Good communication is key to let your partner know what feels good to you.
By: April
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