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Sexual Problems For Men

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Sexual Desire

sexual dysfunctions - information, advice and treatmentBoth men and women suffer from problems with desire and they probably always have. They used to be written off under the heading of "impotence" or "anorgasmia," which are really response disorders.

More recently, therapists have referred to "lack of sexual arousal" and "inhibited sexual interest."

Wider interest was stirred in 1979 when Helen Kaplan published her classification of desire problems in Disorders of Sexual Desire.

Kaplan suggested that perhaps 40 percent of people seeking help for a sexual problem have difficulty with sexual desire rather than with sexual response.

It's a common observation that the strength of the ejaculation declines when men get older or if they are taking medication for the prostate such as Flomax (Tamsulosin). The same may be true for other medications.

Hypoactive sexual desire disorder may show itself as difficulties with either arousal or orgasm, a fact discussed in a relevant eBook, Dating Tips For Women which is all about problems with sexuality and relationships.

The identification and treatment of sexual desire problems is still far from being fully understood. All we can be sure of at present is that something activates a turn-off mechanism so that the person no longer experiences sexual desire.

The causes of inhibited sexual desire are still the subject of speculation.

Anxiety about sex is one possibility; fear of intimacy, anger with a partner and anxieties about relationships are three more.

Any of these may interact and there may be other emotional or psychological factors too. It is possible that organic problems may be wholly or partly responsible as well. Certainly anyone with a sexual desire problem (or a sexual response problem, for that matter) would be well advised to see a doctor and possibly a therapist.

Treatment for inhibited sexual desire is usually multidimensional. Individual and relationship psychosexual therapy is common. Medication to control anxiety or depression may be indicated.

Erotic exercises to be performed at home may be proposed by the therapist - touching, non- demanding pleasuring routines, body image exercises and maybe others too, depending on the person and the relationship.

The treatment approach is flexible and tends to integrate a variety of psychotherapeutic methods as indicated, but success rates in treating inhibited sexual desire are apparently lower than with other sexual problems.

Sexual Response

Problems of response are generally more easily diagnosed than problems with desire. Some can be treated more successfully too.

The most common response problems are: for men - retarded ejaculation, also known as delayed ejaculation or anorgasmia, and erectile difficulty, also called impotence. For women: orgasmic difficulty, painful intercourse, and vaginismus. They are discussed in that order.

Premature Ejaculation

The definition of premature ejaculation is particularly difficult and experts differ. Everyone agrees that a man who ejaculates before his penis enters the vagina is premature, but thereafter? Two minutes? Three to five? Ten to 15?

The most useful definition provided to date has been Helen Kaplan's, as elaborated by Michael Perelman and others.

They define a premature ejaculator as a man who is unable to recognize that he is almost ready to come and is unable to act in order to delay his orgasm.

Therapists all agree that premature ejaculation is not only one of the most common male sexual disorders but that it can sometimes lead to other problems - questioning of one's masculinity, relationship conflicts, erectile difficulty and inhibition of desire.

It is unfortunate that for many young men in our society speed in sexual experiences seems desirable.

You cannot take your time in the back seat of a car in the same way that you can relax at home. If a young man goes to a prostitute, she is likely to want him to complete the act quickly.

A boy who feels guilty about masturbating is likely to do it as fast as he can. It is thought by some therapists that this kind of early experience may contribute to the inability to delay ejaculation.

The causes of premature ejaculation are not certain, but they are unlikely to be organic. Psychological factors such as fear of failure or relationship factors such as anger at the partner seem more likely.

Therapists conventionally work through individual and relationship problems when they are treating a man for premature ejaculation.

The treatment for premature ejaculation - see www.the-relationship-works.com for more information here - which has proved most successful is that evolved by Dr J. Semans in 1956 and subsequently modified by others.

The idea is to make the man more aware of the sensations that precede orgasm. As the man learns to recognize the stages he learns to modify his movements to delay the ejaculatory reflex.

Treatments are highly individual and therefore go beyond the scope of this book, but experienced therapists working with willing individuals or couples achieve high success rates in curing premature ejaculation.

A cure may be achieved in a few weeks, but is more likely to take a few months of once a week sessions.

Q: Is premature ejaculation similar to retarded ejaculation?

A: No. They are at opposite poles. Premature ejaculation is a too rapid ejaculation, and is resistant to treatment (at least, if the full co-operation of the man concerned is not forthcoming!).

Delayed ejaculation or delayed ejaculation or retarded ejaculation is the inability of a man to ejaculate when he would like to; by contrast finding an effective delayed ejaculation cure is easy enough.

Men who suffer from delayed ejaculation may experience it regularly or on occasion; they are usually able to ejaculate during masturbation and often during oral sex, but rarely during intercourse.

It is not a common problem, but men with this condition find it extremely frustrating and often humiliating, and their partners frequently experience it as a powerful rejection and as a sign of their own inadequacy.

We don't really know what causes delayed ejaculation. Over control of and over-concentration on ejaculation may be one answer, and this might be the result of multiple emotional/relationship factors.

Some analysts believe that retarded ejaculation may be connected with symbolic castration or an unwillingness on the part of the man to give.

Q: Can women come too quickly too?

A: Coming too quickly is a problem that doesn't appear to affect women often. A woman who feels that she is not having orgasms of appropriate intensity at appropriate times could however probably be helped by a therapist.

Q: A friend of mine said that I will last longer during intercourse if I apply a special ointment to the head of my penis.

A: No. Your friend was talking about an anesthetic cream which is supposed to reduce sensation and thereby delay ejaculation.

This is not a proper way to develop control over ejaculation - becoming aware of the sensations is the important thing. Also, such ointments can rub off on the woman's clitoral area, reduce her sensation and diminish her pleasure.

Q: I heard that it was wise to think about business or something unpleasant if a man feels he is going to come too quickly. Is that a good idea?

A: Absolutely not. If a man comes too quickly it is best for him to try to be more aware of what is happening rather than distract himself as you suggest.

Ejaculatory control is the result of recognizing the signals of approaching ejaculation and allowing the* ejaculation reflex to function only at an appropriate time.

Getting into the sensations and experiencing them fully produces ejaculatory control - distraction and thinking unpleasant thoughts does not.

Erectile Difficulty

The term "erectile difficulty" has rather taken over from the older word "impotence" for the reason that impotence suggests unconditional failure rather that failure upon occasion. "Erectile problems," "erectile dysfunction" and "erection problems" are alternatives.

Two kinds of erectile difficulty have been identified. A man who has never been able to achieve an erection for intercourse suffers from primary difficulty.

 A man who has a history of successful erection for intercourse but during a particular period cannot achieve an erection has secondary difficulty.

Secondary difficulty is much more common and can be treated more successfully.

Many men experience single instances of erectile failure at some time or another. Fatigue, anxiety, poor health, medication or alcohol may all be responsible.

Erectile difficulty should not be considered a significant problem unless it occurs consistently or long enough to cause real stress to the couple or to the man himself. Erection is an automatic process, a reflex, and therefore not under the man's control.

When a man suffers from erectile difficulty, the extra blood that should flow into the penis and engorge it fails to do so, even though the man is excited and stimulated. The causes of erectile difficulty can be physical, psychological or both.

These are some of the more common causes of erectile dysfunction:

Factors causing erectile dysfunction

  • injury to the spinal cord
  • diseases such as diabetes and multiple sclerosis
  • effects of drugs like alcohol, heroin and some prescribed drugs
  • surgery, such as a prostate cancer operation
  • insufficient male hormone
  • fear of isolation
  • anger with a partner or other relationship problems causing conflict
  • religious belief that sex is sinful, evil, dirty
  • fear of pregnancy
  • boredom with sex
  • anxiety about sexual experiences
  • sexual guilt or conflict

In the late 1970s, it was believed that a very small percentage of erection issues could be attributed to physical factors.

However, many more men have physical ED than previously thought, and although psychological factors remain as the likelier causes of impotence, the full extent of possible physical causes needs to be investigated.

In dealing with erectile dysfunction, Masters and Johnson's approach has been elaborated on by others.

The couple in therapeutic exercises aim to reduce the fear of failure, to direct and encourage the development of effective couple communication, so partners may have full expression.

Much depends on the willingness of the couple to be open to the therapy, and discussion of relationship issues. that must be worked through.

Q: My husband can't get an erection anymore. I know it's killing him but he won't go for help. What should I do? I feel terribly inadequate.

A: It is natural for you to do to support him in these circumstances. The best thing for e to try to get him to go with you to see a qualified therapist or look here at a home cure for erectile dysfunction. 

Sometimes it takes a while before a man will face up to accumulated frustration but in the end it may make a man go to a therapist when the simple fact he can't get erect is not sufficient to make him do so.

Next: female problems with sexual desire and response