CategoriesEjaculatory Incompetence

Ejaculatory Incompetence Treatment

Treatment of ejaculatory incompetence follows the basic approach described for treatment of premature ejaculation. Once the couple interest in sensate focus has been secured, the next step is direct approach to penile stimulation.

Instead of using the squeeze technique to avoid ejaculatory response as with the premature ejaculator, the female partner is encouraged to manipulate the penis demandingly, specifically asking for verbal or physical direction in stimulative techniques that may be particularly appealing to the individual male.

Care should be taken to employ the moisturizing lotions to avoid penile irritation.

The first step in therapy for the incompetent ejaculator is for his wife to force ejaculation manually. It may take several days to accomplish this purpose.

The important concept:

There is no rush for sex. The mere act of ejaculation accomplished with the aid of the female partner is a long step in the right direction. Once he has ejaculated in response to any form of stimulation acceptable to her, the male no longer will tend to withdraw psychologically from her ministrations.

When she has brought him pleasure, he identifies with her, for the first time in the marriage as a pleasure symbol rather than as a threat or as an objectionable, perhaps contaminated, sexual image.

Three of the 17 men had never been able to masturbate to ejaculation before entering therapy. For the remainder, masturbation had been the major form of sexual tension release, but the men had infrequently included their wives as contributors to their release mechanisms (4 of 17). By denying their wives the privilege of participating in the ejaculatory experience, even if occasioned manually, they further froze the possibility of a successful sexual relationship.

As might be expected, some of the wives had no real interest in relieving their husbands through means other than successful intercourse connection. Although only three men constrained their ejaculatory processes to frustrate their wives, many more were accused of this motivation by their partners.

Since ejaculatory incompetence is a relatively rare clinical entity, few members of the general public have heard of it. When wives did not understand that their husbands were involved in a form of sexual inadequacy, as evidenced by their ejaculatory incompetence, they were reluctant to participate in any sexual approach designed, in their minds, only as a means for male relief.

Masturbatory Techniques

The tremendous advantage of dealing with both members of the husband and wife in approaching the concerns of sexual dysfunction has no better example than in treating ejaculatory incompetence. If one dealt only with the hush, and, and the wife received her information second-hand, if at all, her rebellion would continue in a large percentage of cases.

For the husband to suggest specific manipulative techniques at the direction of his therapist does not carry the weight of authority or enlist the degree of wifely cooperation that an adequate explanation can elicit when given to both members of the husband and wife as equal participants in the therapeutic program.

Inevitably, since education is always the procedure of choice, the husband and wife must be dealt with directly. When these techniques of direct confrontation are employed, the wife’s cooperation improves immeasurably.

Sexual Stimulation

Once the wife has been made fully aware of techniques that simultaneously tease and stimulate her husband, great variation is available in measures to relieve the problem of ejaculatory incompetence. As a first step, the husband should be encouraged to approach his wife sexually in order to provide her with release from sexual tensions accrued during the stimulative sessions she has conducted for her husband.

The basic give-to-get apply to the concerns of the incompetent ejaculator. He must feel not only the stimulation of his wife’s sexual approach, but, in addition, he must be stimulated sexually by her obvious pleasure responses to his direct sexual approaches.

Every possible advantage should be taken of this multiplicity of sexually stimulative physiological and psychological influences in order to achieve regularity of ejaculation for males faced with ejaculatory incompetence.

After establishing competence in ejaculatory function with masturbatory techniques, the next step toward intravaginal ejaculatory response is in order. Male partners are stimulated to a high degree of sexual excitation by their wives’ direct physical manipulation of the penis.

As the male closely approaches the first stage of orgasmic return (the stage of ejaculatory inevitability), rapid intromission of the penis should be accomplished by the wife in, the female-superior position. She should continue penile stimulation during the attempted intromission.

Once the coital connection is established, a demanding style of female pelvic thrusting against the captive penis should be instituted immediately. Usually this teasing, technique is sufficient to accomplish ejaculation shortly after intromission. If the male does not ejaculate shortly after intromission under the designated circumstances, pelvic thrusting should cease.

The wife should terminate the coital connection and return to the demanding manual stimulation. As the husband, now conditioned to masturbatory response, reaches the stage of ejaculatory inevitability, he should notify his wife.

She should remain in the female-superior position while demandingly manipulating the penis, and from this positional advantage quickly reinsert the penis into the vagina at her husband’s direction.

It matters not if she is a little too late in her intromission efforts. If the stage of inevitability has been reached and some of the ejaculate escapes during the intromissive process the first few times the technique is employed, there is no cause for concern.

Even if but a few drops, of ejaculate are accepted intravaginally, the mental block against intravaginal ejaculation, will suffer some cracks. Every partial success at intravaginal ejaculation should be underscored in a positive fashion, and rite obvious therapeutic progress should be emphasized in all discussions with the distressed husband and wife.

In short order most of the ejaculate will be delivered within the vagina and the husband’s mental block neutralized or removed.

With the first intravaginal ejaculatory episode, the marriage has been consummated. This is a moment of rare reward for the wife of any man suffering from ejaculatory incompetence. Some wives referred to the Foundation have waited more than ten years, to consummate their marriages.

Their levels of psychosexual frustration during these barren years are beyond comprehension, despite their relative facility at multi orgasmic release of sexual tensions during their coital patterning.

Whether or not the wife is particularly stimulated sexually at this stage of the therapeutic program is of little or no importance. She has had her moments in the past of pure tension release, and she has much to gain if her husband’s ejaculatory block can be obviated. The important fact is that the unit, with full communication, works well together.

Proper application of effective stimulative techniques, the incompetent ejaculator usually has been enabled to consummate his marriage. After three or four such episodes of rapid intravaginal penetration as the male is ejaculating, confidence in intravaginal ejaculatory performance will have been established. Then every effort is made to increase female partner involvement by including a period of voluntarily lowered levels of male sexual excitation before coital connection is initiated.

In this way, a lengthened period of intravaginal penile containment is encouraged, for it has a specific purpose. The male’s fears of continuing as an incompetent ejaculator have been dimmed or negated, both in view of his recent intravaginal ejaculatory success and the fact that he is controlling his ejaculatory response voluntarily to accommodate and not frustrate his wife.

Needless to say, her fears for his facility of sexual performance disappear even more rapidly than do his performance concerns after the initial episode of intravaginal ejaculation.

The male usually experiences high levels of sexual excitation in the therapeutic sequence as opposed to feeling very little sexual interest during prior experience with involuntary ejaculatory incompetence. Taking advantage of his pleasure in these subjective changes and acceptance of the therapeutic program as devoted to his psychosexual security, every professional effort should be directed toward reconstitution of the marriage on a healthy, communicative basis.

Weaponry necessary to reinstitute the destroyed channels of communication within the marriage is described, and its usage is supported by direct exchange between cotherapists and patients at every session.

CategoriesEjaculatory Incompetence

Ejaculation Incompetence Development

There is a multiplicity of factors that can force the development of ejaculatory incompetence. In addition to the primary influence of religious orthodoxy, male fear of pregnancy, or lack of interest in or physical orientation to the particular woman are major etiological factors.

They usually underlined etiological factors of unopposed maternal dominance or homosexual orientation were present but quite in ‘the minority in this small series.

Male ability

Frequently, one particular event, one specifically traumatic episode, has been quite sufficient to terminate the individual male’s ability to, facility for, interest in, or demand for ejaculating intravaginally. Occasionally a man may lose ejaculatory facility subsequent to a physically traumatic episode, but usually the only trauma is psychological.

Thus, ejaculatory incompetence, the clinical opposite of premature ejaculation, is indeed a specific dysfunctional concern separate from impotence. Since current conceptualization of this sexual dysfunction varies considerably from prior approaches, the clinical entity has been documented exhaustively.

A sidelight to the clinical picture of ejaculatory incompetence is the level of orgasmic response of the female partner. In some instances, grossly misinterpreting the causal factors in their husband’s sexual dysfunction, wives have felt personally rejected when husbands could not or would not ejaculate.

Multi-orgasmic

Yet most of these women, despite a real concept of personal rejection, have known many occasions of multi-orgasmic response during their marriages. Even those wives rejected by their husbands as physically unappealing occasionally were multi-orgasmic during their coital opportunities.

Two of the four wives whose husbands had no problem in the regularity of ejaculatory response during the marriage prior to the specifically traumatic episode that turned them into incompetent ejaculators were multi0rgasmic before the destructive experience. All four wives were multi-orgasmic after the onset of their husband’s pattern of ejaculatory incompetence.

The major exception to the pattern of rut 1 female response in husband and wifes contending with ejaculatory incompetence developed, as would be expected, in the five couples with religious orthodoxy as a background. Only two of the five wives reported occasional orgasmic return, during coition, regardless of frequency or duration of coital exposure, and neither of these women described multi-orgasmic experience.

Seven pairs with the psychosocial complaint of ejaculatory incompetence initially were referred to the conceptive inadequacy section of the Foundation in the past 22 years. Four of the seven units have conceived by artificial-insemination procedures, using the husband’s seminal fluid produced by masturbatory techniques.

Sexual exposure

They were not treated for the clinical symptoms of ejaculatory incompetence. Three of the seven units have conceived during routine coital exposure after therapy for their sexual dysfunction.

As previously stated, the incompetent ejaculator presents clinical symptoms that are on exactly the opposite end of the ejaculatory continuum from those of the premature ejaculator.

The premature ejaculator usually has no difficulty in achieving an erection during the initial years of his distress. His concern has to do with maintaining the erection before, during, and for a significant period after the mounting process.

Ejaculation anxiety

He may become so excited sexually during precoital sex play that he may ejaculate before any attempt is made to insert the penis into the vaginal barrel; or the stimulation inherent in the actual act of penetration may suffice to cause ejaculation.

If the premature ejaculator should survive these two precipices in sexual adventure, usually the ultimate in stimulative activity for any male, the onset of female pelvic thrusting will stimulate an ejaculatory response in but a few seconds.

The only physiological parallel between the incompetent ejaculator and the premature ejaculator is that neither has any difficulty in achieving an erection. As opposed to the premature ejaculator, the incompetent ejaculator can maintain an erection indefinitely during coital sex play, with mounting, and not infrequently for a continuum of 30 to 60 minutes of intravaginal penile containment.

The incompetent ejaculator’s only sexual difficulty arises from the fact that he cannot or will not ejaculate during periods of intravaginal containment.

The two variants of ejaculatory dysfunction each demonstrate one correlation with the classic concepts of impotence, but their causations are diametrically opposed. The premature ejaculator frequently loses his erection during or immediately after penetration, as does the impotent male.

However, the premature ejaculator’s loss of erection usually is on a physiological basis (post ejaculation), while the impotent male’s erective loss is primarily psychogenic in character. The incompetent ejaculator’s inability to ejaculate intravaginally is usually on a psychogenic basis.

The impotent male does not ejaculate intravaginally on a physiological basis. He usually cannot physically accomplish intravaginal ejaculation when he has no erection.

Thus, on the opposite ends of the spectrum of male sexual dysfunction there is the volatile male, the premature ejaculator, and the non reactive individual, the incompetent ejaculator. Neither of these entities should be confused with the basic concerns of primary or secondary impotence either from theoretical or practical points of view, or when dealing with the restrictive clinical approaches to diagnosis and treatment.

CategoriesEjaculatory Incompetence

Ejaculatory Incompetence

It is a specific form of male sexual dysfunction that can be considered either primary or secondary in character. From diagnostic and therapeutic points of view, it is easier and psycho physiologically more accurate to consider this form of sexual inadequacy as a clinical entity entirely separate from the classical concepts of impotence.

In the spectrum of male sexual inadequacy, symptoms of ejaculatory incompetence should be assessed clinically as the reverse of premature ejaculation.

A man with ejaculatory incompetence rarely has difficulty in achieving or maintaining an erection quality sufficient for successful coital connection. Clinical evidence of sexual dysfunction arises when the afflicted individual cannot ejaculate during intravaginal containment.

Frequently this inability to ejaculate intravaginally occurs with first coital experience and continues unresolved through subsequent coital encounters. Some men contending with the dysfunction of ejaculatory incompetence experience such pressures of sexual performance that they may develop the complication of secondary impotence. If this natural progression in dysfunctional status occurs, the man with ejaculatory incompetence parallels the man with premature ejaculation.

There have been 17 males seen in therapy in the last 11 years with the complaint of ejaculatory incompetence. Fourteen of these men were married and with their wives sought relief from this specific distress. One man had been divorced for 18 months, and another was seen seven months after a year old marriage had ended in annulment. The remaining man had never married.

Twelve of these men, including the two males with divorce or annulment in their backgrounds had never been able to ejaculate intravaginally during coition with their wives. One of the 12 men had ejaculated intravaginally with another woman outside of marriage, and a second man ejaculated effectively in homosexual encounters. The single man had two engagements and numerous sexual encounters in his background, but had never been able to ejaculate intravaginally.

The remaining four men, all married, had no historical difficulty with coital function before or during marriage (marriages ranging from 6 to 21 years’ duration) until a specific episode of psychosocial trauma blocked their ability to ejaculate intravaginally. Thereafter they were unable to maintain ejaculatory effectiveness within the marriage, but one of the four men could and did ejaculate with female partners outside of marriage.

Hence, the possibility arises of considering the dysfunction of ejaculatory incompetence as either primary or secondary in character. Actually, this form of sexual dysfunction has been encountered so infrequently that the clinical entity does not warrant separation into delimiting categories at this time.

In view of the relative rarity of this form of ejaculatory incompetence, skeletonized clinical pictures of the 17 men referred for treatment will be resented. Hopefully, clinical identification will become easier with a broader concept of etiological background.