A delay is not always a good thing

When Elsie and John came to the sexology clinic, they were both convinced that it was Elsie with a problem. PHOTO | FILE| NATION MEDIA GROUP

What you need to know:

  • I made a diagnosis of delayed ejaculation. On average, a man should ejaculate five to seven minutes after penetration.
  • When this goes beyond 30 minutes then it is not normal; it is a medical condition that requires treatment.
  • “But I thought women hate premature ejaculation. What is this now?” John protested.

When Elsie and John came to the sexology clinic, they were both convinced that it was Elsie with a problem. The two had only been married two months and should have been enjoying their intimate sessions but as fate would have it, there was an obstacle in their way. “He takes too long to orgasm. I can’t take it any more,” Elsie complained. John just smiled like a macho man proud of his achievements.

I went deeper into interviewing the couple to understand what was going on. They were age mates at 25 years old. They were also classmates when they met at university studying for their Bachelor degrees in education. They became attracted to each other when they were posted to the same school for teaching practice. Being the only teaching students, they spent a lot of time together and engaged in common social activities. They soon fell in love and the rest is history.

It had been four years since the love bug hit the couple. They engaged in sex but always had to stop midway. “She usually pushes me away after a point. I never reach climax,” John explained. He added that they enjoyed foreplay – they just didn’t enjoy the natural end.

“He labours on and on and at some point pleasure turns into pain. I get exhausted and I just have to stop him,” Elsie said.

DELAYED EJACULATION DIAGNOSIS

I made a diagnosis of delayed ejaculation. On average, a man should ejaculate five to seven minutes after penetration. When this goes beyond 30 minutes then it is not normal; it is a medical condition that requires treatment. “But I thought women hate premature ejaculation. What is this now?” John protested.

Well, there is voluntary delaying of ejaculation; some men have mastered the art of doing that but it rarely goes beyond 10 minutes. John confirmed that in his case it was not intentional, meaning he had a problem.

There are many causes of delayed ejaculation and it is very important to diagnose the cause before substantive treatment can proceed. In some cases the cause is derangement of hormones, especially those that control sexual function. In other cases the problem is a diseases of the nerves.

Ejaculation is highly dependent on nerve signals and if the signals do not happen as expected there can be premature or delayed ejaculation. Nervous system diseases can lead to lack of or disorganisation of nerve signals, and this affects ejaculation.

Diabetes is a known cause of delayed ejaculation. It does this by destroying the nerves responsible for ejaculation.

Some prescription medicines also cause premature ejaculation. Chronic use of such drugs can numb the sexual system and retard or completely prevent ejaculation from happening.

Other cases of delayed ejaculation are due to psychological stress. Relationship problems, power struggles in the relationship and relationships not built on love can all affect the way sex happens.

“Well, I believe we are in love so your last point may not apply,” Elsie interjected. I did a thorough medical evaluation of John and the main abnormality was his prolactin levels. Prolactin is a hormone found in high amounts in lactating mothers. It is found in small amounts in the male. It regulates the sex cycle but when its levels are higher than normal, it causes havoc in the bedroom. There are times when high levels of prolactin are a result of a tumour in the brain. Fortunately, this was not the case for John.

“So how do you explain the high levels of this hormone now that there is no tumour in my brain?” John asked anxiously.

“Idiopathic!” I replied. John frowned, not sure of what I meant. There are instances when science fails to explain an abnormality in the body like in this case. The word we use is that the problem is ‘idiopathic’, meaning that ‘we do not know the cause’. I put John on treatment to correct his prolactin levels and it was four months before improvement occurred.

When they came back for a review, Elsie could not contain her joy. “Finally, I am no longer suffering in the bedroom!” she exclaimed, the glow evident in her skin and posture.