Overview Of Treatment

Treatment Depends On The Cause

As you can see below, treatment depends on the cause of your problem.

1 Physical Issues (Rare!) Or Medical Issues (Sometimes Medication Causes DE)

If a man’s delayed ejaculation is due to a side effect of medication, treatment may include changing the nature of the medication which he is taking.

Sometimes doctors look out for vascular or neuropathic damage, and other causes, such as spinal injury, which may be irreversible. Here, a man may have to find other ways of gaining sexual pleasure and satisfying his partner.

If a man has low testosterone levels, he may need testosterone replacement therapy.

2) For Psychological Issues (Very common)

Treatment Of Delayed Ejaculation

A combination of several approaches usually works well.

But some attention to a couple’s relationship will almost always help a couple have better sex, no matter what the cause of the man’s ejaculatory problems.

A more specific example? Well, for example, it might be helpful to increase a man’s confidence around sex, or to lessen his sense that he must be in control all the time during sex, thereby allowing him to give up the belief that he must work hard to please his partner during intercourse.

When he relaxes about sex, when he is able to give up control, when he is able to take as much pleasure during sex as he gives his partner, he will be much more likely to be able to ejaculate inside his partner without difficulty.

Often, a man who is experiencing slow arousal and a long delay before he ejaculates can reach orgasm during masturbation  – and sometimes during foreplay – but not during intercourse.

couple in bed where the man has delayed ejaculation
Progressive desensitization has been used to overcome delayed ejaculation, but more modern treatments may work better.

One way of dealing with this is for the man concerned to try a series of progressive desensitization exercises: he may start by developing the ability to achieve climax in the presence of his partner when she is, let’s say, across the room, then gradually work his way nearer to her, until he can “come” just outside his partner’s vagina, and from there he can gradually develop the ability to release (i.e. ejaculate) inside her.

Another approach is sensate focus, a treatment which involves the couple working through a series of stages, starting with mutual touching and gradually moving on to mutual masturbation and penetrative vaginal sex.

All of these approaches to treating delayed ejaculation are described in a simple and comprehensive way in the treatment program on this website.

You also get clear instructions which will allow you to work with your partner and recover or develop complete ability to enjoy intercourse naturally. 

Stimulation Techniques For Slow Climax

Common sense tells us that men who are unable to ejaculate during sex must have either:

  • a high threshold for sexual arousal (perhaps due to fear or some other emotion) or
  • require exceptional levels of stimulation during sex and masturbation to trigger their ejaculatory reflex.

But delayed (also known as retarded) ejaculation is involuntary and mostly unconscious, so the reasons why a man has problems in this area may not be obvious at first. You can see the causes here: emotional and physical.

Why Bother Treating DE?

As with other sexual dysfunctions, the objective of treatment is to achieve normal sexual enjoyment.

Often, the focus is to eliminate the need for high levels of sexual stimulation, so a man can ejaculate normally during sexual activity, given the natural levels of sexual stimulation that couples give and receive during sex.

If a man’s sexual responses are inhibited or over-controlled, then desensitization will help to provide increased stimulation, reduce the man’s need for control, and reduce the impact of any fears or anxieties which inhibit his sexual arousal.

Sometimes these fears are unexpected – for example, some men have an aversion to the vagina.

Desensitization treatment is designed to reduce a man’s need to be in control during sex and allow him to receive more sexual stimulation by being more relaxed and responsive….

two pc keys reading danger and safety
Desensitization is, essentially, about making a man feel safe during lovemaking.

This technique depends on two basic ideas:

  • desensitization can help a man to feel less anxious in situations which he previously found threatening
  • and enhanced awareness of what turns a man on can help him increase his arousal and permit him to relax into his sensual nature.

Of course these two techniques go hand in hand. Together the two components offer an effective treatment.


Before a program of desensitization can be applied in the treatment of delays in ejaculating, it’s helpful to know what is causing the man’s difficulty ejaculating in the first place.

This information is the starting point to design a series of behaviors, each of which is less anxiety provoking than the previous one because of the adaptation which has gone before it.

Cognitive-Behavioral Interventions

Two factors involved in causing delayed ejaculation are high-frequency harsh masturbatory techniques and the way a man may have an inner world of fantasy which is very different to the outward form of his sexual behavior with his partner.

To overcome this, he can learn to take his masturbation fantasies into his sexual relationship, which will help to reduce feelings of guilt and bring his inner and outer sexual behavior more in line.

Sex Therapy

In a 1997 review of treatment methods for delayed ejaculation, Heiman and Meston came to the conclusion that there were so few controlled studies of treating delayed ejaculation that it was impossible to work out if any treatments were really effective!

However, my work with men who have DE shows me that treatment is not only possible but can be very effective.

This can reassure men who have DE, and the therapists who work with them, that a cure is not only possible but actually rather easily achieved – and you can overcome it at home, resolving the problem on your own or with your partner.

There’s an outline of how you can stop delayed ejaculation here.

But will it work?

So now you might be asking how a self-help program can possibly get to grips with either the deep rooted insecurities and anxieties that might be at the heart of a slow (or non-existent) ejaculation, or even the insensitive penile response of a man who has masturbated with hard and fast stimulation.

In fact, self-help programs can solve both of these problems: in the first case, you can discover the techniques and skills necessary to communicate with your partner about the issues that might be in affecting your ejaculatory ability.

And, in addition, there are plenty of ways of reaching a higher level of arousal, which is almost always necessary for a man with difficulties reaching climax.

If you’re “in your head”, relying on fantasy or some paraphilia or sexual fixation (which simply means a particular stimulus needs to be present before you’re aroused enough to climax, for example the use of particular fabrics or clothing during sexual activity), then the effectiveness of the exercises of my treatment program can make it much easier to achieve climax.

They are designed to enable you to obtain a much higher level of arousal in your body, and this can make it significantly easier to reach a sexual climax.

And of course one of the most important issues is how a man experiences sex, so you might like to consider the following points:

  • are you experiencing enormous pressure to “succeed” during sex — whatever that may mean for you: probably something around satisfying your partner?
  • to what degree do you detach from your own involvement in the process, and act as what is known as a “spectator“? This level of detachment will not help you to become aroused, and may be some kind of defensive response against a sexually frightening or threatening situation.
  • to what extent do you wish to be sexually stimulated by your partner, in other words to what extent do you want a genuine sexual relationship with her?
  • do you experience guilt when using sexual fantasy?
  • are you aware of your own level of arousal and experience during sex?
  • do you believe that your partner wants to be engaged in intercourse with you or do you think she’s just doing it to please you?
  • and do you feel any anxiety about the experience of ejaculation and the loss of control it entails?