An inability to ejaculate (ejaculatory failure or retarded ejaculation) during sexual intercourse is the male equivalent of a failed orgasm in the female. Some men can ejaculate when masturbating or with oral sex, but not with vaginal sex. This problem may be due to a drug side effect, psychological problems, an inhibited personality, subconscious anxiety, conscious anxiety or fear of losing self-control. Any significant underlying disease should be excluded.
Treatment involves progressive desensitisation with the assistance of a co-operative sex partner. The partner initially masturbates patient to ejaculation and over a series of weeks, learns to bring him almost to the point of ejaculation by hand stimulation before allowing vaginal sex. Another technique involves additional stimulation of the penis during intercourse, with the woman massaging the penis with her fingers while the man thrusts in and out of the vagina. Distracting the man from consciously holding back the ejaculation by passionate kissing or other stimulation of the face or back during intercourse may also help. Reasonable results can be achieved with commitment to the treatment program.