The day you've been waiting for has finally arrived - you're about to head out for a night on the town with that special someone in your life, which is something that you've literally been looking forward to for weeks. This isn't the first time you've been out with them and at first glance, everything seemed to be going perfectly. You really enjoyed the restaurant and, more importantly, you really hit it off with them sitting across the table from you. You both hopped in your car and headed directly back to your place...

... which, of course, is when the dread set in.

You were beyond certain that they would want to have sex when you arrived, so your mind did what it always does - flashes back to the last few times you had sex together. The embarrassment of not being able to orgasm with your sexual partner. The look of frustration on their face. Everything that you felt in that moment comes flooding back, and suddenly you're anticipating a failure before it's happened.

Am I going to disappoint again this time? Am I not in love with them anymore? Does this mean the end of our relationship? These are the last questions you should be fixating on right now, but there they are.

Believe it or not, the problem may be equal parts biological and psychological. It's called Delayed Ejaculation and if you truly want to put these types of experiences behind you, there are a few key things you'll want to keep in mind.

The Biological and Psychological Causes of Delayed Ejaculation

As the name suggests, delayed ejaculation is defined as a "persistent or recurrent delay in, or absence of, orgasm after a normal sexual excitement phase" as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Metal Health Disorders. Not only is it one of the least common male sexual dysfunctions, it's also among the least understood.

Sometimes, the cause for these issues is totally biological. Issues that could be a contributing factor include but are not limited to ones like:

• You've recently experienced some type of medical procedure (or disease) that disrupts the activity of your genital region, like a spinal cord injury, pelvic-region surgery or a diagnosis of multiple sclerosis.

• You've started using medications like antidepressants which have been known to cause delayed ejaculation as a side effect.

Psychological issues can absolutely be a contributing factor, too. Unconscious aggression, unexpressed anger and even malingering can all contribute to the issues you're now experiencing. Pregnancy fears could also be directly related, as a lot of men experience delayed ejaculation as a result of their fear of a female partner's desire to get pregnant.

Along the same lines, partner issues can absolutely play a role in your interest in and ability to ejaculate on a regular basis. Fears associated with conception have already been covered - this is likely the case if you can easily ejaculate during protected sex while wearing condoms, but are unable to do so during unprotected sessions.

Either expressed or unexpressed anger towards your partner could also easily explain the situation. A lot of people don't realize that anger is a powerful anti-aphrodisiac. While it's common for men to not want to have sex at all if they're angry at a partner, those who do attempt to "perform" are usually unable to do so - thus directly contributing to the issues you're now going through.

The Power of Psychosexual Therapy

Thankfully, there are a wide range of sex therapy techniques that you can use to address the delayed ejaculation issues head-on. A comprehensive Psychosexual and Relationship Therapy regimen includes a number of options designed to tackle this problem from every angle, including ones like:

• Masturbation exercises. Under the right circumstances, masturbation can easily be seen as a type of "dress rehearsal" for sex with a partner. These exercises can help you better learn the part that you're intended to play.

• Self-relaxation exercises. This can be a great way to better understand those important areas of your body which bring about greater periods of arousal in the first place.

• Exercises that bring in your partner. This is critical in terms of making sure the two of you truly understand one another and that each person "gets" how to bring the other to the point of climax. Remember, no two people are created in quite the same way.

• Cognitive behavioral therapy. This can act as the single most effective way to work through those negative thoughts you may be experiencing either towards your partner or about the idea of sex, along with your insecurities and fear of failure.

So while delayed ejaculation is certainly a frustrating problem, it is NOT one without a solution. Provided that you understand the root cause of the issue, it's absolutely possible to work through it and become better connected to your partner at the exact same time.

If you still have any additional questions about the impact and after-effects of delayed ejaculation, or if you'd just like to discuss your own needs with someone in a bit more detail, please don't delay - feel free to reach out to me directly today.

References:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

Apfelbaum B. Retarded ejaculation: a much-misunderstood syndrome. In: Leiblum SR, Rosen RC, eds. Principles and Practice of Sex Therapy, pp. 205-241. Guilford Press; 2000.

Perelman MA. Regarding ejaculation, delayed and otherwise [letter to the editor]. J Androl 2003;24(4):496.

Perelman MA. Retarded ejaculation. Current Sexual Health Reports 2004;1:95-101.