Inhibited Ejaculation
There are two contrasting male orgasmic dysfunctions, both affecting a man’s control of his ejaculation capability. The most common of these ejaculatory control dysfunctions is premature ejaculation but, for many men and equally distressing, is the less well documented condition of ‘inhibited (or retarded) ejaculation’. This condition may also sometimes be referred to as ‘ejaculatory incompetence’ in strictly medical terminology. These descriptions, and the sexual dysfunction itself, should not be confused with ‘retrograde ejaculation’ which is a medical condition where ejaculation occurs backwards into the bladder, where it is mixed with urine.
Whether the dysfunction is referred to as inhibited or retarded ejaculation, or ejaculatory incompetence, the symptoms are similar and characterised by the inability to ejaculate during sexual intercourse despite a full erection and relatively high levels of sexual arousal.
Retarded ejaculation describes the condition when the causes of the problem are due to physical or medical factors (e.g. side-effects of some medications, high alcohol consumption, heavy smoking, recreational or addictive drugs etc.). Inhibited ejaculation is the term used to describe the absence of ejaculation occurring during sexual intercourse when there are no apparent medical or physical causes for the problem.
Some men have never experienced orgasm with ejaculation during sexual intercourse. Some men have never experienced orgasm with ejaculation during any form of sexual stimulation with a partner. Some have never experienced orgasm with ejaculation through any type of sexual stimulation, including solo masturbation.
Other men who present for sexual therapy with this complaint may have ejaculated in the past but are experiencing current or more recent difficulties in this area of their sexual life.
To the objective observer, inhibited or retarded ejaculation may, at first, seem preferable over premature ejaculation; in reality this is not the case. It can adversely affect relationships, especially if the man’s partner perceives his lack of ejaculation as being an indicator of a lack of pleasure, arousal or attraction towards her. The dysfunction itself may also create a great physical and sexual demand upon the man’s partner. Where a relationship has broken under the strain of this particular sexual dysfunction, the man may lack the confidence to enter into a new relationship and may feel like giving up, even in everyday situations.
Although inhibited ejaculation is the least well documented of male sexual dysfunctions, it can be successfully treated through The ICASA Surrogate Partner Therapy Programme. Compared with other male sexual dysfunctions, however, this complaint has a strikingly lower success rate. During an internal ICASA efficacy study in 2001, forty per cent of clients who presented with inhibited ejaculation achieved the maximum possible therapeutic gain, compared to an average of eighty eight percent who achieved the maximum gain when presenting with the complaints of erectile dysfunction, premature ejaculation and non-consummation. There are identifiable reasons for the comparatively lower efficacy, the majority of which are due to personality and behavioural patterns causing some clients to discontinue therapy before resolution, a personality trait which resonates with the symptoms of the presenting complaint itself.
