relationships - dating - love - intimacy - health
The way you think about your relationships, the skills and attitudes you bring to them and the time and effort you put in can make all the difference. People are social creatures and relationships matter to us. We enjoy them, we cry over them and we're curious about how to get our relationships to be the way we want them. How well your relationships work can have a big impact on how satisfied you feel with life. Stimulating, resilient, satisfying relationships with partners, friends and family rank high on many people's wish list for a happy life.
Some men find it difficult to ejaculate when they have sex. A psychosexual therapist looks at the physical and psychological causes of delayed or retarded ejaculation, and how it can be treated.
What is retarded ejaculation?
Difficulty in ejaculating is known by doctors as retarded ejaculation. Although men with this problem may be fully sexually aroused during sex and enjoying the stimulation, orgasm seems to take for ever and may not happen at all.

Retarded ejaculation (RE) can be a very distressing condition and make men feel embarrassed, isolated, confused and very frustrated.

Partners often blame themselves and feel inadequate, which puts even more pressure on the man to perform and compounds the problem.

Some men may have had the condition all their life, in all sexual situations. Some will have no problem when masturbating alone but tense up completely with a partner. Others may only have the problem during intercourse.

Retrograde ejaculation
Retrograde ejaculation is very different to retarded ejaculation. If you experience the sensation of orgasm but don't ejaculate, you probably have this. Instead of the semen being expelled, it's forced backwards into the bladder and men with the condition will sometimes notice that their urine is cloudy after orgasm. It is often a result of spinal injury, diabetes, neurological diseases or prostate surgery. Retrograde ejaculation can cause infertility if left untreated.

Physical causes
If you experience retarded ejaculation when you're masturbating as well as with a partner, then the cause may be physical. Check with your GP if you think any of these may apply to you:

* diabetes
* nerve damage
* prostate disease
* alcohol abuse
* prescription drugs such as betablockers or antidepressants

Psychological blocks
The most common causes of RE are psychological, the mind blocks the physical sensations and prevents ejaculation. Your body is telling you you're ready - you have an erection to prove it - but your head may be trying to tell you something else. Possible psychological reasons include:

Change your habits
If you've always masturbated in exactly the same way, with exactly the same stroke and exactly the same pressure, your body may not know how to respond to anything different. Intercourse, or a new partner, is going to feel different. Try varying how you masturbate. Gradually, you should notice your body's increased sensitivity to a variety of touch.
* You're a perfectionist. Sex is a performance and you must make it perfect for your partner. Sex has become all work and no play.
* You're scared to lose control. This may be a character trait in many areas of your life, not just sexually.
* You're worried that you're not a good lover. You can't enjoy your physical sensations if you're worrying about your sexual prowess and ability to please your partner.
* Deep down, you believe sex is wrong. Shame or guilt about sexuality due to negative childhood messages or a sexual trauma will prevent your enjoyment.
* You're distracted. Concerns about work or other tasks mean your mind's not on the job.
* You're spectating. Concentrate on the physical sensations of love making, slip off into your favourite fantasy. This will free you from feeling too conscious of reaching a climax.
* You're unhappy. If you're feeling angry or insecure with your partner, you may struggle to feel relaxed enough to enjoy yourself. Try to sort out relationship tensions before you get to the bedroom.

Self-help advice and exercises
For ways to put these tips into action, see the section on practical exercises.

* Make sure you're feeling relaxed, try breathing exercises or buy a relaxation tape
* Enjoy being sensual first, taking time to focus on pleasurable sensations
* Escape into your favourite fantasy to block out any negative thoughts or distractions
* Try different positions to maximise stimulation
* Cut down alcohol consumption and don't use recreational drugs
* Discuss with doctor if medication side effects may be responsible

More help
If some of these points have rung a bell for you, you may find that simply talking it through with your partner will help. Or you may both decide to try the support and guidance of a psychosexual therapist.