"I think there's something wrong with him – or with me. We'll have sex for thirty minutes and he still can't come. I can't help thinking he's just not that attracted to me anymore."
If you're a woman reading this article, chances are you've had some version of this thought. You're watching the man you love struggle to reach orgasm during sex, and despite his reassurances, you can't shake the feeling that somehow it's all your fault.
I’m here to help.
I’m an MD sex therapist based in New York City who specializes in male ejaculation problems.
I’ve treated hundreds of men for this issue. And here’s the most important thing I can tell you right away:
This isn't about you. It's not about how attractive you are, how good you are in bed, or how much he desires you.
What is it about? That’s what I’m going to explain in this article. I’ll also show you ten things to consider right now that might help.
Here’s a guide to what you’ll find:
Feel free to skip ahead, if you like. But I think the whole discussion makes more sense if you read it all in order.
Ready? Let’s get started . . .
You know we’re living in a golden age for female orgasm, right?
No one these days thinks there’s anything wrong with a woman if she has trouble having an orgasm through intercourse alone. Everyone today knows a woman is entitled to climax any way she wants.
It’s also, of course, a golden age for vibrators and other sex toys – delivered to your door next-day, courtesy of Amazon Prime.
But the most magnificent thing about female orgasm in the 21st Century is the first thing I mentioned above:
No one these days thinks there’s anything wrong with a woman if she has trouble having orgasms through intercourse alone.
For most of the 20th Century, women weren’t so lucky.
Freud’s patient Marie Bonaparte was so desperate to orgasm through intercourse that she underwent psychoanalysis for it. When this didn’t work, she had three separate operations to relocate her clitoris closer to her vagina. You can read the whole sordid tale here.
Millions of women who needed clitoral stimulation to climax were told they were defective, and fortunes were spent on psychological treatment to correct this assumed defect.
Happily, we’re mostly past all that. Women today are done with thinking there’s something wrong with them for not being able to orgasm from intercourse alone.
Unfortunately, we men aren’t so lucky. In fact, we’re about a century late to the party.
Most people today are still in the dark ages of thinking all men should climax in the same way – and if they don’t, there’s something wrong with them.
So if your male partner struggles to climax during sex, ask yourself the following:
Do you really want to repeat the whole sorry history of misinformation about the female orgasm in bed with your man right now?
If not, then please continue reading below.
Here’s a question:
Why do we call it “delayed ejaculation”? Why not call delayed ejaculation what it really is – a problem with orgasm?
The answer is pretty obvious, right? Men are supposed to ejaculate. That’s how the species gets perpetuated. That’s their job.
The problem with this line of reasoning, as every sex therapist knows, is you never want to use the words “sex” and “job” in the same sentence.
But there’s something deep in the human psyche that does exactly that, when it comes to men.
In the modern world, we’ve now evolved to where we know female sexuality is about pleasure, not performance. But “men and pleasure” is a bigger intellectual jump.
There’s something deep in our souls that values men chiefly for being “pleasure providers” – not pleasure consumers.
Right or wrong, we value men for what they’re able to produce, be it semen or a paycheck.
Plus, there’s the not insignificant fact that men are famous for being able to come easily. A man who struggles to climax during intercourse is different from what’s expected.
When it comes to sex, “different” nearly always tends to shade into “wrong.” That’s definitely going to push your anxiety buttons. “What’s wrong with this man?” you wonder. “Is he gay? Kinky? All psychologically messed up?”
My advice: Give him the same consideration you’d give a female friend who struggles to climax with a partner and tells you she feels broken.
“Nonsense,” you’d say. “You’re fine, just as you are. It’s not a performance.”
We men don’t get told that very often.
If you Google “causes of delayed ejaculation,” what you’ll find may make your heart race – and not in a good way.
Scary medical stuff – like stroke, spinal cord injury, multiple sclerosis, and birth defects.
Scary psychological stuff – like “sex addiction” and “pornography addiction.”
In a rational world, there’d be a boxed warning at the top of all these sites, warning you that by and large the people who put them together are writers – not doctors – who’ve never actually treated anyone for a problem ejaculating.
They’ve composed the article the same way you’d write a term paper in high school: You’d look things up.
But there’s very little published medical or psychological research on DE. The writers simply did their best, based on what they could find.
As a result, much of what you’ll read online is just medical folklore. Not evidence-based, but enough to scare the daylights out of the average reader.
What you generally won’t learn on the internet is that most men who struggle to ejaculate with a partner don’t have any medical or psychological disorder at all.
Most are simply at the other end of the bell curve from premature ejaculation. It just happens to take a lot of stimulation for them to climax.
But medical websites tend to work within the medical model. If there’s a problem, there must be an accompanying medical disorder. Or barring that, a psychological disorder.
Very rarely will you see any mention of natural human variation as an underlying cause of DE.
Most of the many hundreds of men I’ve treated for DE do not suffer from any medical or psychological disorder at all. They simply tend to have more than average difficulty reaching orgasm. Full stop.
So skip the internet search, if you can.
Instead, use the most authoritative source in the world: Ask him yourself.
Let me show you how . . .
Let’s say you’re dating a man for several weeks, and you’re having sex and everything but you’re pretty sure he hasn’t climaxed yet.
You don’t want to ask, for fear of making him uncomfortable. But still, you’re pretty darn curious!
Here’s my preferred approach:
One day, after a particularly good sexual encounter together (always the best time to ask about something like this), turn to him and say, “Hey, I want to ask you something: What’s your favorite way to come?”
It’s simple. It’s positive. And it’s a completely open-ended invitation to tell you anything he wants on the subject – especially if accompanied by the same friendly, understanding look you’d give a female friend who struggled to climax with a partner.
If, in fact, he does struggle to climax during partner sex, with any luck he’ll trust you enough to share this with you.
“Is it frustrating?” you ask, continuing to give him that same understanding look – and trying not to sound anxious. “Anything I can do to help?”
Suddenly, you get an idea: “If you ever want to try finishing by yourself here in bed with me, I’m totally okay with that.”
Maybe he’ll take you up on the offer, and you’ll get to see how he does it. Lots of guys with DE have to masturbate with a very firm grip. Or by stroking very fast. Or in a particular way that’s not easy for a partner to replicate.
You’ll read online that over-energetic masturbation can cause DE, but I think many times it’s the reverse. There’s a bell curve for male orgasm thresholds, just like there is for women. For a lot of guys, an intense technique is the only way he can reach his very high orgasm threshold.
Now that you have some information, let’s consider what to do with it . . .
As a sex therapist who specializes in this condition, I’ve helped many hundreds of men learn to ejaculate during intercourse. There are lots of potential techniques.
On the other hand, it’s never a good idea to make a relationship conditional on your partner changing something about themselves.
Let’s say your man is able to learn to climax during intercourse. Can I guarantee he’ll be able to do it every time – under any conditions? Of course not.
So I’d advise you to ask yourself the following two questions:
1. Is it really important to me as a woman for him to climax inside me every time? Would I be okay if he only ejaculates inside me some of the time? Or would that just not feel good for me?
2. If we decide to have kids together, how important is it to me to always receive his semen through intercourse? Would I be okay if some of the time we improvised other ways of getting his semen inside me? (See HERE and HERE for examples – and see Item 9 below). Or would that feel too disappointing?
It’s okay to be honest. There are no right answers here.
In sex therapy, we talk about “vitamin A” – acceptance. It’s an essential ingredient in any couple’s relationship. But there’s no law that says you have to be all-accepting.
If you’re going to be worrying about his DE to the point of unhappiness, then maybe he’s just not the right partner for you. As a sex therapist, I would never want you to stay with someone who doesn’t meet your sexual needs.
On the other hand, some disappointment in relationships is universal. Accepting disappointments is a mark of maturity – provided they’re disappointments you can authentically live with without being miserable.
These are intensely personal matters. No one’s going to fault you if you decide his DE tendency is a deal-breaker for you.
On the other hand, maybe you would like more information about how the two of you might make this work.
If so, read on . . . .
If all you knew about sex was from porn, you’d think intercourse should always last at least 30 minutes and involve at least three changes of position.
But in the real world, most people tell me the most rewarding part of intercourse is the first ten minutes. After that, truth be told, the magic tends to diminish a bit – unless it’s your first week together or you’re taking psychedelics.
As a sex therapist, I hear way too many accounts of couples having penetrative sex for 30 minutes or longer in the hopes that he’ll maybe finally have an orgasm.
Not exactly a recipe for passion, right?
I usually advise men with DE to limit intercourse to just ten minutes. That might sound counterintuitive at first. But a man’s passion tends to peak at the moment of penetration – like a tennis ball coming in fast over the net.
Most men with DE tell me that after the first ten minutes or so, penetrative sex becomes a futile quest to recapture the original excitement while contending with the nagging worry that it’s not going to work.
By 30 minutes after penetration, the ball has lost its bounce and is rolling towards the backstop. No way to effectively hit it over the net.
Here’s a better way...
Medically speaking, orgasm is simply a reflex. Like all reflexes, there’s a threshold of stimulation you need to achieve it. Men with DE tend to have high thresholds, so it takes a lot of arousal to activate their orgasm reflex.
Let’s imagine arousal on a scale from 0-100. Most men assume that once they get hard, they’re fully aroused and it’s time to penetrate. But let’s say it only takes an arousal level of 20 or so for a young, healthy man to get hard. If you penetrate at a 20, but your orgasm threshold is a 70, you’ve got a big climb ahead.
Like all men everywhere, men with DE tend to hurry penetration before they’re sufficiently aroused. But as discussed above, a man’s arousal tends to decline significantly after the initial thrill of penis meets vagina has passed. After 10 minutes of intercourse, he’s like a tennis ball that’s lost its bounce. Not very likely he’ll be able to climax.
Often, the best workaround for a man with DE whose orgasm threshold is 70 is to delay penetration until foreplay has already excited him to a 50 or so. (How to tell? For starters, at a 50 most men have trouble composing a full sentence).
If you wait till he’s at a 50 before letting him penetrate, he’ll have a good headstart for getting to 70 before his ball loses its bounce.
Note: For the above workaround to succeed, during foreplay he should be getting most of his arousal from psychological stimulation: The sight, scent, and feel of your body. The drama of the moment. (If he’s at all kinky, that’s a plus).
Don’t go overboard with penis stimulation during foreplay. Best to tease his penis a bit, keeping it away from the appetizers so it’s maximally hungry for the main course.
Then after penetration, by mutual agreement he should have permission to ravish you to his heart’s content.
That’s where we’re going next . . .
Let’s say the two of you have followed my advice so far. You’ve delayed penetration until he was so aroused he couldn’t put together a proper English sentence.
At this point, you may want to reassure him that now is not the time to act like a gentleman. Now is the time for him to be a bit of a beast.
If he’s like most men I see with DE, he may be a bit shy about really “letting go” during intercourse. It’s essential for a man with DE to learn to do this. Tell him you don’t mind being treated a bit more ruthlessly in bed, provided he’s properly relished you first. Many men with DE need to know it’s okay to be a bit rougher in bed.
Tell him it’s okay if he focuses entirely on his own arousal. Tell him you don’t mind if he pushes it to the max. Tell him you’d like that.
Best to tell him you don’t care if he comes or not. You just want him to enjoy you passionately and get as excited as he wants.
After all, the best way to get an orgasm is not to chase the orgasm. It’s to push arousal as high as it can go, until you hit your orgasm threshold.
Say you’ve followed all my advice so far, and you’ve had ten minutes of gloriously passionate penetrative sex, but there’s no male orgasm in sight. What to do next?
First, there’s no law that once you’ve started intercourse you have to keep doing it till he comes. Don’t just keep doing the same thing over and over again, hoping for a different result.
Maybe have him pull out and do something else for a while. Then go back to penetrative sex, once it’s fresh again.
Thought experiment: Imagine if during intercourse your clitoris was buried deep inside you, like the tip of his penis is now. It might feel great, but it would also limit your options somewhat for how to stimulate it.
Even in the best lovemaking, a man with DE can eventually hit a point where he’s run out of options for ejaculating inside you.
That’s why you need a backup plan.
The classic backup plan is for him to pull out and give himself an orgasm with his own hand, in bed – holding you with one hand, and holding his penis with the other.
Unfortunately, most men with DE have to sneak off to the bathroom by themselves to give themselves an orgasm after you fall asleep. But the bathroom can be a rather cold and lonely place. Much better to have him do it in bed with you, where it’s all cozy and loving.
In sex therapy, we call this “going to Haagen Dazs”: Imagine you’re at a fine restaurant. The meal was wonderful, but they’re all out of dessert. Happily, there’s a Haagen Dazs right next door.
It’s a fine way to end the meal, and they have loads of flavors to choose from. All he needs is your acceptance that it’s okay.
Unless, of course, his self-stimulating in bed next to you doesn’t feel okay for you. Hey, it’s a private matter. I’ve met lots of women who know intellectually it’s fine, but for whatever reason it bothers them or turns them off.
If that’s the case, maybe consider having him self-stimulate almost to orgasm, then penetrate just before he comes, so he’ll still ejaculate inside you. Some sex positions are obviously better for this than others.
Or perhaps it might be time to have another heart-to-heart talk with yourself, as in Item 5 above.
That, or you could get some guidance from a professional . . .
To find competent professional help for DE, you have to know what you’re looking for.
Many couples affected by DE will first consult a primary care physician or a urologist – often prompted by an internet article listing all the possible physical causes of DE.
But such physical causes turn out to be rather uncommon. The usual outcome is a referral to a sex therapist.
But most sex therapists don’t have much experience treating men with DE.
Lacking specific knowledge, a sex therapist may shift into “relational” mode and propose weekly psychotherapy, hoping that a deeper understanding of the couples’ issues will somehow help the man’s DE. That’s mostly wishful thinking.
Most couples affected by DE don’t need psychotherapy – or even “sex therapy.”
Remember, in most cases DE isn’t caused by psychological problems. The root cause of most men’s DE is simply a natural tendency to need more stimulation to climax.
Most commonly, what a man with DE needs is to understand his specific requirements for reaching orgasm and why his current sexual practices aren’t working. Plus a specific action plan for what to do differently.
In many cases, all of this can be accomplished in a single consultation session.
My advice: Interview a few sex therapists by phone. Ask how many men they’ve personally treated for DE. Ask about their success rates.
Most importantly, ask how long treatment typically takes.
Look for a sex therapist who says, “The main thing is to get all the specific details. That usually doesn’t take too long.”
