Sexual Dysfunction: When to Seek Urological Help

Sexual dysfunction issues

Hello doctor, I am 33 years old.
Every girlfriend I have had has suffered because I take too long during intercourse (about an hour) and cannot ejaculate, which causes them distress.
They often have to finish themselves afterward.
I can ejaculate quickly when I masturbate, but during intercourse, it takes a lot of time and effort.
Sometimes I can ejaculate without a condom, but I definitely cannot when using one.
Do I need to seek medical attention? Thank you.

A Cai, 30~39 year old female. Ask Date: 2017/03/16

Dr. Liu Jiaju reply Urology

Your issue is delayed ejaculation.
It is recommended that you seek consultation with a specialist in male health to assist in diagnosis and treatment, in order to clarify the underlying cause and provide targeted therapy.

Reply Date: 2017/03/16

More Info

Sexual dysfunction can be a complex issue that affects many individuals, and it is important to understand the various factors that can contribute to it. Based on your description, it seems that you are experiencing difficulties with ejaculation during sexual intercourse, which is causing distress for both you and your partners. This condition, often referred to as delayed ejaculation, can be influenced by a variety of physical, psychological, and relational factors.

Firstly, it is essential to differentiate between the ability to ejaculate during masturbation versus during intercourse. The fact that you can achieve ejaculation while masturbating but struggle during sexual intercourse suggests that there may be situational or psychological components at play. Stress, anxiety, or performance pressure can significantly impact sexual function. The presence of a partner and the expectations that come with intimacy may create a different psychological environment than when you are alone.

Additionally, the use of condoms can also affect ejaculation. Some men find that condoms reduce sensitivity, which can make it more challenging to reach orgasm. If you notice that you can ejaculate without a condom but struggle with one, it may be worth discussing alternative methods of contraception or exploring different types of condoms that may enhance sensitivity.

Given that this issue has been persistent and is causing distress in your relationships, it would be advisable to seek help from a urologist or a sexual health specialist. A healthcare professional can conduct a thorough evaluation to rule out any underlying medical conditions that may be contributing to your symptoms. This may include hormonal assessments, neurological evaluations, or even psychological assessments to address any anxiety or stress-related issues.

In addition to medical evaluations, therapy can be beneficial. Cognitive-behavioral therapy (CBT) or sex therapy can help address any psychological barriers to sexual function. These therapeutic approaches can provide you with coping strategies, improve communication with your partner, and help reduce performance anxiety.

It is also important to have open and honest communication with your partner about your experiences and feelings. This can help alleviate some of the pressure you may feel during sexual encounters and foster a supportive environment where both partners feel comfortable discussing their needs and concerns.

In summary, seeking urological help is a reasonable step given your ongoing difficulties with ejaculation during intercourse. A healthcare professional can provide guidance, support, and potential treatment options tailored to your specific situation. Remember that sexual health is an important aspect of overall well-being, and addressing these concerns can lead to improved intimacy and satisfaction in your relationships. Don't hesitate to reach out for help; you deserve to have a fulfilling sexual experience.

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