Sexuality And Sex Therapy
Edward A. Dreyfus, Ph.D.

COMMON MALE SEXUAL DYSFUNCTIONS

The following are the most common forms of sexual dysfunction. They are all treatable with a high probability of success.

Inhibited Sexual Desire: Inhibited sexual desire or response refers to the lack of desire for erotic sexual contact. In almost all cases when there is a lack of sexual desire the underlying causes are psychological in nature. Avoidance of sexual contact because of fears of rejection, failure, criticism, feelings of embarrassment or awkwardness, body image concerns, performance anxiety, anger towards a partner or women in general, lack of attraction towards a partner, all play a part in reducing or eliminating the sexual response. Most men are too uncomfortable to talk to their partner or anyone else about these issues preferring to simply avoid sex or attribute their lack of sexual appetite to stress, worries, etc. Some of these men have a very active fantasy life and prefer the solitude of masturbation to the intimacy of sexual relations.

Premature Ejaculation: Premature ejaculation is the most common dysfunction and it is the easiest to treat. Masters and Johnson define premature ejaculation as the inability to delay ejaculation long enough for the woman to orgasm fifty percent of the time. (If the woman is not able to have an orgasm for reasons other than the rapid ejaculation of her partner, this definition does not apply.) Other therapists define premature ejaculation as the inability to delay ejaculation for thirty seconds to a minute after the penis enters the vagina.

For the most part, premature ejaculation occurs as a function of a learned response. Early sexual experiences were hurried in nature. Even masturbatory activity had to be hurried for fear of being caught. From youth onward men have trained themselves to be more concerned with the end result and their own pleasure rather than with the sexual process and their partner. The object of sex for most of these men, was and often continues to be, ejaculating as quickly as possible. This rapid ejaculating pattern can easily become a way of life after even only a few episodes. It then begins to create a pattern of anxiety in the male each time he engages in coitus thus increasing the probability of it occurring. Fearful of displeasing their partner and feeling inadequate as a function of it, men would rather avoid sex rather than experience the humiliation and discomfort.

Retarded Ejaculation or Ejaculatory Incompetence: Ejaculatory incompetence is the opposite of premature ejaculation and refers to the inability to ejaculate inside the vagina. Men with this difficulty may be able to maintain an erection for 30 minutes to an hour, but because of psychological concerns about ejaculating inside a woman, are not able to achieve orgasm. One of the reasons this dysfunction goes undetected is because the male’s partner is satisfied and indeed often is able to achieve several orgasms. Most of these men can readily achieve orgasm through masturbation or in some cases through felatio. Many factors contribute to this condition, some of which are religious restrictions, fear of impregnating, and lack of physical interest or active dislike for the female partner. In addition such psychological factors as ambivalence toward one’s partner, suppressed anger, fear of abandonment, or obsessional preoccupation also play a significant role in developing retarded ejaculation.

Erectile Dysfunction: Primary & Secondary Impotence Primary impotence refers to a man who has never been able to maintain an erection for purposes of intercourse either with a female or a male, vaginally or rectally. In secondary impotence a man cannot maintain or perhaps even get an erection, but has succeeded at having either vaginal or rectal intercourse at least one time in his life. The occasional failure to get an erection is not to be confused with secondary impotence. Familial, societal, and intrapsychic factors contribute to primary impotence. Some of the more common influences are (1) performance anxiety, (2) a seductive relationship with a mother, (3) religious beliefs in sex as a sin, (4) traumatic initial failure, (5) anger toward women, and (6) fear of impregnating a woman.

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For forty years Dr. Dreyfus has been practicing as a clinical psychologist and life coach in Santa Monica, California where he specializes in individual psychotherapy, relationship counseling, and sex therapy. He has recently published two books,
Someone Right for You: 21st Century Strategies for Finding Your Special Someone
and
Keeping Your Sanity (In an Insane World)
released by Xlibris and can be found at
www.SomeoneRightForYou.com
and
www.KeepingYourSanity.com.

For further information or consultation regarding psychological issues, or life coaching, you may contact Dr. Dreyfus by letter, phone, email, or fax.

You can e-mail him or call (310) 208-5700.