Understanding a Hidden Cause of Infertility
“Doctor, I want to get pregnant,” said a distressed Sowmya. “But my husband is not able to ejaculate inside me. Please advice us.”
“Are you getting an erection and sustaining it?” I asked her husband, Mani. “Oh! Doctor I can keep my erection for one to two hours,” he boasted. “But how is it that you are able to ejaculate only during masturbation?” snapped Sowmya.
Mani’s condition, known as ‘Retarded Ejaculation,’ is defined as a “potency disorder in which there is full erection but ejaculation is inordinately delayed or fails to take place altogether despite the patient’s conscious desire to achieve orgasm”. It is also known as Delayed Orgasmic Response, Ejaculatory Impotence or Inhibited Male Orgasm.
This condition can be situational (Ejaculation occurs on some occasions and not on some) or selective (occurring with one partner, situation or type of stimulation only.)
Retarded ejaculation can occur due to physical or psychological causes or a combination of both.
Some of the physical causes are birth defects of the genitals, disorder or diseases of the spinal cord, surgeries involving the nervous system, spinal injury, diabetes, testosterone deficiency, consumption of certain medicines (especially for psychiatric problems), addiction to narcotic drugs, lax vagina in women, infection and stricture of the male urinary passage and extreme fatigue.
Factors like anxiety associated with ejaculation, pregnancy, hurting the woman or being hurt by her, performance anxiety, inability to let go, guilt due to religious orthodoxy, hostility/resentment towards the sexual partner, homosexual orientation, post-traumatic stress disorder and unresponsiveness of the partner are among the psychological causes.
While some may envy those suffering from retarded ejaculation as they can have sustained erections for prolonged periods, the sufferers are actually miserable as they cannot experience the joys of an orgasm. The culmination of the sex act in a male is ejaculation and orgasm. If this does not occur, there is a lacuna which can be traumatic for the couple. The woman might feel the man is not interested in impregnating her or is having an extramarital affair. The man might feel incomplete and strain himself to ejaculate. This will further aggravate the delay in ejaculation.
Treatment strategy depends upon the causes(s). For physical causes, appropriate medical/surgical measures have to be undertaken. For psychological causes, psychotherapy and sex therapy will be beneficial. In certain cases, vibrators and electro ejaculators may have to be used.
The writer is a sexologist. Mail him at dr.narayana@deccanmail.com
