As is probably apparent, implants have their problems. There are risks involved with any surgery, and recovery from the surgery takes many weeks. Like any mechanical device, the implants themselves have some percentage of failure. Also, the implants don’t go all the way into the head of the penis, so the head may be a little floppy even though the rest of the penis is hard. Implants obviously take some getting used to, but I have seen many men who are happy with them.
Other Surgical Options
Sometimes erection problems occur because blood flow to the groin area is severely compromised. If this is the case, undergoing an arterial bypass may be an option. In other cases, a man can’t maintain an erection because some of the valves at the base of the penis that hold blood in the penis are faulty. The valves can sometimes be tied off surgically. Obviously, these two surgical repairs are very serious and should be undertaken only if no other options are available.
chapter 25
Healing Male Orgasm Disorder
In the chapter on healing premature ejaculation, I discussed three things a man needs to do in order to get ejaculatory control. Similarly, if you are experiencing inhibited ejaculation, there are a number of things you will need to do.
Behavioral Changes: A Summary
Like the man with premature ejaculation, you will need to get control of your PC muscle by exercising it (see exercises in Chapter 17). The man with premature ejaculation needs to get control of his PC muscle so he can squeeze it to delay ejaculation. You will need to do the opposite: You will get control of your PC muscle so you can learn to consciously relax it as you near ejaculation. One of the biggest problems in men with inhibited ejaculation is that they unconsciously tense their PC muscle as they approach ejaculation, and we know from the findings of Masters and Johnson that this only leads to more of a problem with ejaculation.
Also, like the man with premature ejaculation, you will need to learn to become more aware of your sensations of arousal. The man with premature ejaculation needs to get experience with the lower levels of his arousal scale. You will need to get experience with the higher levels of your arousal scale—7, 8, and especially 9. One of the biggest problems with men with inhibited ejaculation is that they start anticipating ejaculation too soon. They start anticipating it at arousal level 7 or even 6, instead of at level 9. They lose their sense of what it feels like to be at level 8 or 9, and they start tensing up and working at ejaculation at low levels. Because of this lack of awareness of arousal levels, the peaking process works very well for both premature ejaculation and inhibited ejaculation. I know it seems ironic that the same process would work well for completely opposite problems, but it’s the case.
You will probably also have to change your masturbation habits, at least temporarily, if your habits are contributing to a problem of being unable to ejaculate with intercourse. I’ve included several suggestions and exercises to help you do this.
Last, but by no means least, in order for you to learn to ejaculate more easily, you will probably have to work on promoting the intimacy in your relationship. Your sense of emotional closeness with your partner will have a huge impact on your ability to ejaculate more easily during intercourse with her.
Before you begin to deal with your inhibited ejaculation problem, there are a couple of things you should stop doing. First, you should limit the amount of time you spend having intercourse. For example, if you find that you are having intercourse for half an hour and are unable to ejaculate even though you want to and are trying to, then limit yourself to a certain time frame. Tell your partner that from now on you will stop at ten minutes or fifteen minutes or some other mutually agreed on comfortable limit, whether you have ejaculated or not. Contrary to what you may believe, it will not hurt you to become aroused and then naturally allow your arousal to go down without ejaculating.
Limiting the time you spend in intercourse will allow you to stop thinking, “If only I had another few seconds (or few minutes, or half an hour), I know I could ejaculate.” Women, if you are the partner of a man who is having problems with inhibited ejaculation, there is no need to feel guilty about ending intercourse before he ejaculates. Prolonging intercourse will not help inhibited ejaculation. In fact, it will make it worse. Doing more of what you are already doing will not help. Learning some alternative activities will.
Limiting the time you spend in intercourse will also force you to focus on the sensations of intercourse that are happening in the here and now, rather than on sensations that may happen in the future (orgasm and ejaculation). It will also force you to admit that you have a problem ejaculating, which is something you may not have truly accepted.
Also, resolve that from now on, when you have intercourse, you will do it as slowly as possible, and in a sensate-focus, nondemand fashion. You have probably become used to a hard-driving mode of intercourse that is actually making your problem worse. When you catch yourself going too fast, consciously make an effort to slow down.
The Role of Intimacy
Take another look at Chapter 10 for a discussion of the role of repressed anger in inhibited ejaculation. The anger you are holding inside may be overcome to some degree by fostering intimacy in your relationship, and you can accomplish this by doing the exercises described in this chapter (provided your anger is at a woman from your past, not at your current partner). In order for this to work, you will have to want it to work. That is, you can’t do these exercises halfway, as they will definitely produce a certain amount of intimacy. If you know that you do not want that level of intimacy, then do not attempt these exercises.
Although all of the partner exercises in this book will promote intimacy between you and your lover, the two exercises that follow are specifically aimed at building intimacy.
Exercise 50. SENSUOUS KISSING
In this exercise to foster intimacy, you and your partner will take turns kissing each other on the mouth. The active person should kiss as if it were a caress. Caress the outside and inside of your partner’s mouth with your tongue. Focus, breathe, and relax, just as you would with any sensate-focus caress. The best position in which to do this is lying on your sides facing each other.
Each partner should do the kissing caress for at least five to ten minutes. Stop occasionally and gaze into each other’s eyes. Finish the kissing caress with five or ten minutes of mutual kissing.
The goal of this exercise is not to leave each others’ lips and tongues sore. The idea is to kiss as slowly, sensuously, and intimately as possible. If you find that you are going too fast, kissing too hard, or unable to maintain concentration, stop for a moment, refocus your attention, and start over more slowly.
It is important that you do this exercise separately from any other exercise at least once. Talk about your feelings about the exercise after you do it. Then, use this kissing exercise as a prelude to the other exercises in this chapter.
If you feel anxious during this exercise, that’s because it promotes tremendous intimacy between partners, whether you want it to or not. Many people find kissing on the mouth to be a more intimate act than oral sex or even sexual intercourse. Remember, if you feel anxious or uncomfortable during this exercise, do what you would do if you feel anxious during any exercise: Tell your partner you are anxious, and back up to something you are comfortable with. For example, if you are uncomfortable looking into your partner’s eyes while kissing, practice the exercise with your eyes closed until you can relax. Then move on to the more intimate version of the exercise and repeat it as many times as you need to until you are completely comfortable with it.
Exercise 51. EYE GAZE
This is a very simple but powerful exercise. Lie together on your bed and face each other. Wrap your arms comfortably around each other and gaze into each other’s eyes for a few minutes without talking. Consciously relax your whole body so that none of your muscles are tense.
The Role of Masturbation
In my experience, the most common cause of inhi
bited ejaculation is probably masturbation habits. If you have learned over the years to masturbate with a harder and harder and faster and faster stroke, pretty soon you will have difficulty ejaculating with intercourse because your partner’s vagina cannot provide the same level of physical stimulation that your hand can. Here are some activities that can help you change your masturbation habits.
There are three ways to change your masturbation habits: decreasing masturbation time, decreasing masturbation frequency, and softening your stroke.
Exercise 52. DECREASING MASTURBATION TIME
Some men experience inhibited ejaculation with intercourse simply because they masturbate for excessive amounts of time but don’t have the stamina to continue intercourse for the same amount of time. Their partner probably doesn’t have the stamina either. Research indicates that some men masturbate to ejaculation in a few seconds, while others may spend several hours stimulating themselves before they allow themselves to ejaculate. Chances are, if you have difficulty ejaculating with intercourse, you tend to masturbate for a long period of time. Our goal here is to shorten the amount of time it takes you to masturbate to orgasm and ejaculation.
Don’t worry. I’m pretty sure you like your masturbation habits. I am not asking you to change them permanently. Once you have learned to comfortably and predictably ejaculate with intercourse, you can go back to masturbating in whatever way makes you comfortable.
The easiest way to decrease your masturbation time is to simply keep track of your masturbation habits. Don’t try to change anything at first. Just masturbate the way you normally like to, but jot down what you do in a notebook. If you like to masturbate while using things like videos or magazines, continue to do so.
Look at a clock before you start masturbating, and then look at it again right after you ejaculate. You may be surprised to discover that you’ve gone much longer than you thought. For two weeks, keep a chart of your masturbation time. Record how many times a week you masturbate and how long it takes you each time. During week three, try to take five minutes off your time. Each successive week, try to take two minutes off your time until you can easily masturbate to orgasm and ejaculation within ten minutes at the most. At this point you will be ready to begin peaking exercises with your partner.
Exercise 53. DECREASING MASTURBATION FREQUENCY
Again, try keeping a two-week record to see how often you masturbate. Then cut down the frequency by about 10 percent each subsequent week until you feel a noticeable increase in your penile sensitivity and a greater ease in ejaculating.
Exercise 54. SOFTENING YOUR STROKE
Here is an exercise that will help sensitize your penis. It will help you become more aware of the delicate sensations of being inside your partner’s vagina.
Do a genital caress on yourself. Close your eyes and concentrate on the sensations of your touch. As you caress your genitals, slow your stroke down so that it is half as fast as when you began. Enjoy the sensations of this new stroke. What sensations do you feel in your penis, your fingers?
Now slow down a second time, until your fingers and palm are barely moving over your penis. Continue this caress for fifteen minutes whether you ejaculate or not.
Do this exercise on a regular basis to decrease the roughness of your masturbation stroke. To help slow yourself down, try using your left hand if you are right-handed (and vice versa), or try using an open palm or your fingertips alone instead of a closed fist.
Some men find that they can make changes in their masturbation time, their masturbation frequency, and their masturbation stroke during the same week or weeks. Other men find it easier to concentrate on one area at a time; for example, they may concentrate on decreasing masturbation time for a couple of weeks, and then on decreasing masturbation frequency for a couple of weeks, and then on changing their stroke for a couple of weeks. You know yourself, and you will have to decide which of these approaches will work best for you. I believe that working on one thing at a time is best from a behavioral standpoint, but some men get bored with this approach.
Also, try not to get discouraged if this process seems to take a long time. It may take you a good six or eight weeks to change your masturbation habits enough to start doing peaking exercises with your partner. Remember that you can still have sexual intercourse with your partner during this time frame, as long as you set a time limit on the intercourse and never work at ejaculating.
Here are a couple more exercises that use self-touch to help you learn to ejaculate more easily.
Exercise 55. SIMULATE THE VAGINA
Another reason why men develop an inability to ejaculate with intercourse is because they are so used to masturbation that the sensations of being inside a vagina are not stimulating enough for them. A solution for this is to introduce something into your masturbation habits that makes masturbation feel more like intercourse.
There are several things you can use to masturbate with that feel more like a vagina than your hand does. Adult stores and catalogs sell many varieties of artificial vaginas. One that is quite popular is shaped like a flashlight and has a removable liner. Other men have used a banana peel filled with lubricant, or an old sock warmed in the dryer or microwave and filled with lubricant. Or you could use a large-size condom filled with lubricant. The point is to thrust into something that is warm and isn’t as tight as your closed fist. (Although, as I’m writing this, I’m thinking, when you have intercourse with your partner, don’t say to her, “Honey, being inside you feels great. You feel almost as good as an old sock filled with K-Y Jelly.”)
To make the most of your vagina substitute, use it during a self-touch exercise. Start by stroking your penis with your hand and doing a peaking exercise as you learned in Chapter 18. Do several high-level peaks while thrusting into your vagina substitute. See if you can ejaculate into it.
Exercise 56. PROLONGING ORGASM
This exercise can help you ejaculate more easily by helping you learn the difference between the sensations of ejaculation and those of orgasm. Remember that orgasm and ejaculation are not exactly the same thing. Orgasm is systemic and includes full-body responses like rapid heart rate, muscle tension, and a feeling of extreme pleasure, whereas ejaculation is the localized genital response in which the PC muscle spasms and forces semen out of the penis.
Start with a slow, sensual genital caress, using plenty of lubrication. Remember to breathe, focus on your sensations, and keep all of your muscles, including your PC muscle, relaxed. Using the psychological/subjective arousal scale, peak up to lower levels like 4, 5, and 6. Let your arousal decrease two levels between peaks. Let each complete peak last three to five minutes. Now peak up to levels 7 and 8.
Next, peak up to level 9. When you reach your point of inevitability, stop thrusting, stop your hand movement, hold perfectly still, close your eyes, and take a deep breath. Focus all of your attention on your pelvic sensations. Feel the semen start to move from your testicle area into your urethra. This is the “emission” phase of ejaculation. Feel the contractions of organs such as your prostate, and then notice how a few seconds later your PC muscle starts to pulse rhythmically. This is the “expulsion” phase of ejaculation. Now breathe deeply again, open your eyes wide, and focus all of your attention on the sensations in the base of your penis. You will feel each spurt of semen distinctly as you ejaculate, and you will experience a sense that your orgasm lasts longer than usual. Experiencing these sensations and the difference between ejaculation and orgasm can help you ejaculate more easily because it will help you look forward to ejaculating without pressuring yourself.
More Behavioral Strategies for Changing Masturbation Habits
Here’s a final thought on changing your masturbation habits. Let’s say you have learned to decrease your masturbation time, decrease your masturbation frequency, change your masturbation stroke, simulate a vagina, and prolong your orgasm. Do you have any “weird” habits that you think might be contributing to your ejaculation difficult
ies?
I’m not trying to suggest that your masturbation habits are bad, wrong, or kinky. Rather, I’m pointing out that men who have no difficulty ejaculating tend to masturbate in particular ways that involve no “weirdness.” Here’s what I mean by “weirdness.” Do you masturbate in an unusual position—for example, do you always kneel to masturbate? Do you always use sexually explicit materials when you masturbate? Do you have to have certain objects around you when you masturbate? Do you consistently use an unusual stroke, such as rubbing your penis between your hands like someone trying to light a fire in the wilderness? Do you have to fantasize about unusual scenarios (coercive scenarios or anything else) in order to come? Do you require anal stimulation in order to have an ejaculation when you masturbate?
I’m not saying that any of these things are wrong. I’m saying that they can stand in the way of your learning to ejaculate easily with intercourse. If you have any of these habits, now’s the time to taper off the behaviors. You will have the best chance of learning to ejaculate easily with intercourse if you masturbate while lying on your back or sitting up leaning against a wall or headboard. You have the best chance of learning to ejaculate with intercourse if you masturbate by gripping your penis with one hand and moving your hand up and down.
You can taper off any behaviors that you think might interfere with your ability to ejaculate during intercourse using the following strategy:1. Chart your behavior. For example, let’s say you are trying to taper off anal stimulation, because you know your partner won’t do it during intercourse. For two weeks, record how frequently and how long you masturbate, and also record what percentage of time you stimulated your anus during masturbation. Chances are it will be for a large percentage of your total masturbation time.
Sexual Healing Page 28
